Most of us are dependent on a GPS for directions to tell us where to go. The human brain works similarly, pulling up maps at lightning speed for each movement you want to make.
Sometimes, however, we don't already have the right maps. This is especially true when performing a new movement. We are often clumsy when learning something new. When a baby is learning to walk for the first time, they often wobble, fall on their bottoms, and have to use their arms to balance. As adults, we experience this if we are learning to play an instrument, taking a dance class for the first time, or any other new activity that requires our brains to create new movement maps.
Ideally, we create the maps right the first time and get ourselves into good habits, but that isn't always the case. If you make a mistake enough times, it tends to become your default movement pattern. Most coaches and music teachers will tell you that it is better to stop and slow down and get the desired movement right, than to rush through it and repeatedly do it incorrectly.
The problem is that there are many things in life that we don't have coaches for. Many of us go through life without someone telling us the correct way to move. Unless you grew up with a physical therapist for a parent, you probably went through life not being taught that there is a right way to roll over in bed, push a vacuum, and lift a box.
We often don't think about those things until there is a problem. Rolling over in bed, pushing a vacuum, and lifting a box aren't things we think about, until we've thrown our back out. Prior to that, we just did the task. As long as the goal was accomplished, we didn't pay much attention to how we did it.
When pain enters the picture, sometimes it's a sign that our maps need to change. For specifics on breaking down individual movements, see the Moving Well blog section (coming soon)
When we have chronic pain however, re-working the maps can help reduce pain signals that shouldn't be there. Sometimes the pain is present because our body is trying to tell us that we are damaging our tissues and harming our bodies. Other times, the pain is persistent and there is seemingly no good reason for it.
Training our brains to pay attention to movement instead of pain can be valuable in decreasing the amount of pain we feel over time. Correcting the movement can eliminate the repeated tissue damage we are subjecting our bodies to. However, it can also help for the unexplained pains that persist when we can't see any tissue damage at all. When your body can rationally recognize that the movements it just performed are safe and should not be causing new tissue damage, it can help you to ignore pain signals that shouldn't be there. While the pain is real, and it hurts, if it isn't harming you, it's safe to ignore (See Hurt Vs. Harm & Car Alarms: Interpreting Chronic Pain)
So how can we train our brains to sharpen their maps? By increasing our sensory awareness. There are several ways to do this, including laterality training, two point discrimination training, perfecting proprioception, stereognosis, and sensory mapping.
Sensory Mapping
Simple sensory mapping can be done with a partner at home. It can even be made into a game to play with your kids. All you need is some paper and pencils.
Have your child hold the piece of paper against your back and start to draw a picture. Let's say your child starts to draw a house. As your child draws square on your back, your job is to draw a square on a piece of paper in front of you that is about the same size as what they drew on your back. Next they might draw a triangle for the roof, and you would follow suit. The goal is for your picture to look as similar to your child's as possible.
If you have multiple kids, this can even be turned into a game of Telephone Pictionary on family game night. If you have kids who struggle with chronic pain, or are just clumsy and uncoordinated, this can help with their coordination and motor development.
If that seems a little too challenging and artistic for you, a simpler version of sensory mapping is Clock Mapping. Again, if you have young kids, this can even be an educational game to help them learn to tell time.
This time, you'll draw a clock on your paper. It is easiest to label the numbers at 12, 3, 6, and 9 o'clock for beginners. This time you will tap your partners' back over one if the numbers. They have to guess which time you touched. As this gets easier, you can add the other hour marks onto your clock.
As you get better at differentiating the hours, you can draw a smaller circle in the middle of your clock. Now you can tap on the outer circle for the big hand of the clock, or the smaller circle for the little hand of the clock. That will make your brain work harder to know exactly what time it is.
Both of these methods involve training the sensory system on your back. You can work on your upper back or your lower back with these methods, but they tend to work best for people with back pain. If you have a smaller child, you could also have them stand facing you and draw on your stomach.
Even if lower back or abdominal pain isn't your particular area of struggle, there can still be some value in sensory mapping. As you try and reproduce the image being drawn on your back, your arms and hands are active as well, so the nervous system that controls your upper body is engaged in the process.
If you're looking for a whole-body sensory mapping experience, feel free to get creative. Try having someone trace letters on your leg or the back of your hand to spell a word. You can do this on any part of the body that is painful or hard for you to coordinate using. If you're looking to use these skills for kids, to keep them engaged, this option can become a race game of deciphering secret codewords that you are spelling out to your partner.
Whether your nerves are trying to sense a picture being drawn, a location of time being tapped on your back, or letters being traced, they are working to fine tune their awareness of what is happening to your body, and where it is happening.
Stereognosis
Stereognosis is a medical term for your body's ability to identify the shape and form of three-dimensional objects. If we have healthy nervous systems, if we hold a nail in our hand, we can recognize it as being different than a screw. While we may traditionally think of this as being difficult for someone with neuropathy, they aren't the only ones. For many people with chronic pain (of many kinds) this ability becomes dulled. The brain is so busy processing pain, that it has trouble focusing on identifying the objects.
Because the brain works on a "use it or lose it" basis, if we use it to process pain all the time, that is what it gets good at doing. On the other hand, if you consciously tell your brain to focus on other things, it can teach it to prioritize something else over pain and over time the pain experience becomes less consuming and less severe. If you've ever learned something in school (such as a foreign language) and then not used it for years, your memory of it fades over time. The same neurological principles can help us to dull chronic pain in our nervous system.
The most basic form of stereognosis training is to reach into the bag, take an object in your hand and move it around with your fingers in your palm until you can identify what it is.
The more similar the objects are that you place in your bag, the trickier it will be. A ChapStick tube and a AA battery for example will be harder to tell apart than a toothpick and a Lego.
Stereognosis training can be done inexpensively at home. All you need are some small household objects and a bag to place them in. You can get creative using miscellaneous objects from around the house like office supplies, kids toys, hardware items, personal care items, etc. Some common items you might have at home could include:
Office supplies: paper clips, binder clips, pen caps, erasers, rubber bands, or ear pods
Kids toys: Legos, crayons, dice, marbles, dominoes, puzzle pieces, or board game pieces
Personal care items: ChapStick, bobby pins, hair clips, hair ties, toothpicks, floss picks, toothbrush head caps, earrings, rings, makeup containers, cotton balls, or Q-Tip's
Hardware items: batteries, screws, nails, washers, nuts, bolts, keys, or allen wrenches
Miscellaneous items: coins, buttons, bobbins, thread spools, beads, bottle caps, wine corks, wrapped candies, or clothes pins.
As you assemble your kit, keep in mind, safety first. Avoid using objects that are sharp and could cause injury to your hands. While paperclips and binder clips are fine to include, thumbtacks are not advised.
If you feel like identifying objects out of the bag is getting easy, the next step is to be able to find the object amongst others. Instead of using a bag, try a bucket of dried beans. Mix your objects into the bucket, and search for them in the beans. This can add another layer of challenge without too much expense.
If you're looking for more ideas on how to train your brain, don't forget to check out the related posts for more information on laterality training, two point discrimination, and proprioception training.
This article is intended for educational purposes and is not a replacement for individual medical advice from a licensed healthcare provider. If you are interested in personalized recommendations for your specific situation, call or click book online to request an appointment for a physical therapy evaluation.
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