Body Mapping – a New Way of Understanding PAIN

prefer to listen to this article? episode 36 on SportDocDC – wherever you podcast

In a couple of my recent articles I had used the term “threats” to describe how the brain reacts to certain injuries in the body.

 We talked about how extremities like the ankle and hands tend to swell yet the spinal area does more of a splinting lockdown. Two different areas of the body into different reactions.

A lot of this information is coming from some really Cutting Edge Sports practitioners that are in the research world. Much of this information comes from experts that work on pain. The way I had first heard about this was one of these pain specialists talking about how they work on soldiers coming back from the Middle East that have lost limbs. The soldiers will complain about phantom pain.  “Doc, why does my hand hurt so bad? I don’t have a hand anymore.” 

 This led to some really interesting research on why and how we feel pain. Hopefully a lot of what I’m going to go over with you today will at the root of it make a lot of sense. The first time I heard the information I thought there’s no way that that can work. But it is a great way to describe the body. As I started experimenting on some of this with my clients, it was immediately obvious that these new ideas not only worked for a large number of clients but worked almost like a miracle for some.

Over the last couple years this idea has grown. It’s a case of the science catching up with the techniques.   We knew it worked but weren’t sure why.

The boots on the ground practitioners taking the research to their clinics and patients and then sharing the results thereby driving more and better research.   

This kind of thing is happening in all fields. Healthcare, Fitness and diet just happens to be my realm so I love pushing the envelope of new ideas.

 Today I’m going to talk about the idea of “body mapping.”

 Body mapping by itself really doesn’t take much of a stretch for it to make sense. It’s just that the explanation has never been done before. We ALL do it.  We just weren’t seeing it because the WHY had never been asked.

Many of you know if you look at any of my articles on the sister site, BeAwesome365  -I love word swaps.

 Just by changing one or two words you can drastically change the way your brain sees a certain situation. By changing this perspective a lot of times you can change results. Body mapping is this. I’m going to give you a different way to visualize how your body works. 

This idea has a few different terms but I’m going to stick with the wording BODY MAPPING  because it seems to really work with my clients.  This and that’s the way the top dogs are describing it in their lectures.   You guys get what the pros get!

 I’m going to take it one step further though.  I’m going to analogize the whole idea by using the GPS map on your phone.

So hang with me here for a few minutes as I teach grad level neurology in a simple context you can use.

When you whip out your Google Maps and you tell your phone to take you to a certain location immediately all the streets and corners and shortcuts pop up and start to build your starting image.  The GPS will even tell you which directions are slower traveling, spots where more cars are backed up or there happen to be more red lights. This will then allow you to make the decision you want to. 

If you decide to turn at a different Corner than the GPS sent you,  you just do it – the  app adapts and reroutes you.

 So let’s think of the body like this.

In this analogy – 

The location that you’re trying to get to and from are body parts.   As if you stepped on a stone walkway barefoot and the brain immediately senses this. The locations are your foot and your brain.  The signal needs to get to the brain from the foot and back again to set your gait for the next step.

 The roads are your nerve pathway. They run in a certain direction and have all kinds of connections.  There are things in the way that they need to go around, over and through like your bones and muscles.  There are millions of different routes that have potential to get you to the same place.

 So if the locations are the body parts and the roads are your nerve highway and road system,  your fascial chain and skin are basically your map.

 There are  millions upon Millions of receptors in your skin. This is how your brain keeps track of where you are in space and how you’re moving. 

Think of your foot. We always tend to think of the foot as the part of the body that makes us move through our world. But at the heart of it, the primary function of the foot is the ultimate sensor. Every step you take your foot is relaying information to your brain. Not just where you are, but if that stone pathway has sand, snow,  gravel or Pokey sticks lying on it. 

The foot, particularly the skin and fascia chain surrounding the foot,  tells you how much pressure you are putting on the rest of your body.    It senses if you’re going out for a stroll to your mailbox versus Landing after having dunked on James in front of his mom and Big Blue..

Understand that some places in your body have more nerves that focus on these type of Sensations. Nerves for pain, pressure, temperature. Then there are nerves that are deep inside your joints that tell you if you are upside down or if your shoulders are in a position that isn’t safe. There are nerves that keep your heart running without you having to think about it and tell your intestines how much nutrients to absorb and how much to pass on.    Some are highways and some are county roads.

I can go on and on with these kind of explanations but you get it. Neurologists and scientists in these fields spend their entire careers and lifetimes just on certain aspects of one of these. It goes DEEP!

 But let’s make this easy. 

 Your skin and sensors are the map. The nerves are the roads. And the GPS on your phone…, what you are looking at right now?   the actual screen…That’s the brain. Not the location brain, but the overall information processor.   

That’s taking in all that  information at the same time.   It senses everything!

Following me?  

 Let’s say you asked your GPS to get you to your favorite sports based chiropractor. But once the GPS map calculated the route you noticed there was a giant black circular area in the middle of the map.

Basically what’s happening is the GPS isn’t getting the proper information.   It could be that a meteor had landed there and destroyed the entire area. Maybe there’s some sort of federal lockdown and the government and their techy superstar hackers  have issued a blackout for that area. Or maybe there’s an emergency and the GPS has some sort of mechanism that keeps other people and vehicles from travelling there.

At the end of the day, your screen doesn’t care why- it just knows that there’s a big black area on the map. More than likely you will reroute yourself if the computer doesn’t do it on its own. I mean who wants to drive into a great big black area that they don’t know about?

 This is kind of what happens when you have an injury to an area on your body. 

 Let’s say you were wrestling with your friends and you injure your shoulder. Initially, All the brain knows is that something isn’t right. And initially it doesn’t even know if the injury is severe. All it knows is it something is wrong. And the Brain wants to protect the body –  the body is like, super important to the brain. 

Also the brain doesn’t entirely trust YOU.  Yeah, you’ve made some pretty poor decisions about your body in the past, it’s not ready for full trust yet. 

So what it does is kind of black out the area.    The Brain doesn’t have enough information to know what went wrong it just knows there was something painful or it moved wrong and that something’s not right. It feels a THREAT!    (“Threat” is a relatively new term in the sports med world but is very descriptive and accurate.)   see the article  “Different Responses” 

It’s going to take more information before it decides to go into emergency mode or if it just decides to let everything go back to normal.

We’ve all rolled our ankles playing basketball? 

 It’s the end of the world.  You can’t walk.  You scream like the Sorority Girl in a horror movie. The Game Stops.  The other players scatter and the coach or athletic trainer runs out onto the court to see what’s wrong. More than likely you have to be carried out with some of the bigger players carrying you away to the locker room. You see this every other night in the NBA.

2 minutes later, everything feels good again and you come back on the court. Kind of makes you feel goofy that you acted like such a sissy…I mean you feel just fine now.

 That was your brain having a couple minutes to get more information and then deciding based on that information that everything was okay and you can continue on as normal.

 In our GPS analogy. That is the black hole it was there for a minute and then “click” right  back right to normal.

But what happens when the brain doesn’t receive the information?

This is what happens with the soldiers that have lost their limbs. They still have arm pain even though they don’t have an arm. They had something so traumatic and instantaneous that the brain didn’t know what the heck happened.

 Now after some time, if the brain does not receive more information or receives poor and conflicting information it basically keeps the area blacked out. Some of us in the healthcare industry call it “smudged.”  

 If I was looking at a paper map the term “smudged” makes a lot of sense but in our analogy we’re looking at a GPS, so I used a black hole – you could also use a pixelated or diffuse or transparent idea – but either way the idea is the signal isn’t getting through strong and so the brain keeps the area disconnected.

In order to restore the pepper map –   which is where the “body mapping” term comes from,  the brain needs more information.

This is the case of the sprained ankle that doesn’t recover very well. The one that is still sore 5 days later and indeed never really seems to get all the way recovered. Maybe even 6 months later you still have some phantom pain and your foot just doesn’t respond the way it is supposed to. I mean you can walk now and you can go for a little jog but you wouldn’t even want to think about jumping rope. And that’s 6 months later. And when the doctor asks you, “Where does it hurt?” You can’t really even find the area. Basically you just kind of rub your whole foot and ankle and say “ahhhhh  somewhere around here.”

 Well in that case, it’s poor mapping. The GPS isn’t receiving any more information so it just gives the information to the brain that “it’s not sure what’s going on.” 

Now here’s an important point…In most cases the brain doesn’t want to risk you going back to full activity so it just fills that area in the brain map with the best way it knows how to protect the body.  With pain.     Diffused, annoying, broad pain.

The body mapping idea is simply that: 

 -A black spot on the map is filled with pain sensation because the brain isn’t sure what’s going on and that’s how it protects.

Like I see in my clinic  – this pain theory doesn’t work for all issues –  Body Mapping theory isn’t injury based, it’s diffuse pain based.   It’s a different pain than a more severe or “true injury” 

One of the clues that we know this is happening is that with a true injury – like a fall on an outstretched hand – (called a FOOSH injury) the body reacts differently..   When you have an acute moderate to severe injury-  you describe your injury to your doctor kind of like this, “doc it hurts when I raise my arm like this, and it hurts right here.”

 You can describe the injury to your doctor by pushing directly to one area and then moving your body in the mechanism that causes pain.   Like pointing to one specific spot on your shoulder and saying, “it hurts when I do this.” 

 In a body mapping error,  that’s not the case. When I ask you where you hurt,  you rub your entire shoulders, neck, upper back and arm and say,” ahhh somewhere around here”      The area you described  has dozens of muscles, multiple joints, multiple bones. 

It’s not even similar to the way you describe the acute injury.  

The entire area hurts. The entire area of the map has been blacked out.

By understanding the body this way, we can start to affect how to get you out of pain better.

As doctors and therapists we all learn the body the American way.  Often called Western Medical Model.   First you learn all the bones, then the muscles, Then the nerves. Then you learn how each nerve goes to each muscle and innervates or stimulates that specific area.   In the last decade the fascia has been big news in our industries, yeah for something new!  

 And although I agree that is a great way to learn and is the standard for the last three to four hundred years. I think at times, with certain issues,  this is why we fail. We have been taught that the shoulder has 6 rotator cuff muscles, the PEC, the upper back muscles, three different bones. Six different major nerves etc.  

 We, as practitioners, learn that when you throw a ball there is a firing sequence. First the muscles on the back side of the shoulder and upper back have to fire. That is how you load the ball back.   Next in sequence the external rotation muscles fire to allow your arm to go even further back .  This is where the ball starts to turn backwards. So there are additional muscle and joint activities happening in the elbow and wrist. Then as we start to throw the ball the anterior side muscle start.  Muscle spindle cells and Golgi Tendon Apparatus allow a smooth transition from firing sequence to shut down sequence without even having to think about it!    The firing sequence dictates that the pec will start to increase velocity, followed by the muscles of the anterior delt and so on and so on.

 This is what makes being a Kinesiology major so much fun. You can talk such a huge game. When you understand this stuff, you are the smartest guy in the class and you can impress all of your friends. It makes you sound smarter and  what’s even better is so many of these words are huge important sounding Latin derivatives. I feel like a genius and I talk like a genius. Maybe I am…?

 Basic anatomy and physiology I think is a fantastic way to examine and diagnose as well as treat sports injuries. But it has its drawbacks because often the pain has been there for a while and is the body mapping version.

 You see your brain doesn’t see your body in motion as anatomy and firing sequences. That happens automatically. Your brain sees your shoulder as a shoulder, your knee as your knee, and your foot as your foot. It doesn’t think to throw a ball by utilizing the firing sequence I discussed above.

It just thinks “throw the ball” and it does it.   You’ve been ingraining that for years and the brain has a whole area set aside to just throw it.

That’s why this  “body mapping” analogy and visualization helps with a lot of different injuries especially, long-term diffuse annoying injuries.

 The brain only recognizes it hurts when you throw or that something isn’t safe yet. 

It senses and relays a threat.  It’s just a different version of pain.   

 So here’s the good news.

 If we can just step back a second and try a different version of treatment, ie use the body mapping version we get more efficient with our doctoring.

Because it is often simple.   The way to fix the issue, decrease the pain and increase the range of motion is simply to give the  brain more and better information. When you can show the brain that it is okay to go into a certain range of motion, that it is okay to stand on your ankle and jump again… That there is no threat. The brain gets good information again.    The black hole on your GPS starts to come back again. Sometimes it comes back slowly and blurry, as I talked about before, smudged. But given enough information and doing it the right way and the picture comes back. The brain remaps the body.

 When there IS NO MORE black hole, and the brain has a good picture of what’s happening. And the information coming from its map is solid, it’s business as usual. Joints start to move better, muscles work the way they’re supposed to and you go on with your happy day.

 When you treat the same injuries with the anatomy and physiology model oftentimes it just doesn’t seem to get anywhere. There’s no direct injury so it’s very hard to come up with a direct treatment.

 The idea is just to give the brain better information.

 What’s so unique about this system however isn’t the explanation or even the understanding.  It’s the hack that we can use. When we think about the skin as our biggest sensory organ – the information system- the MAP…we can then use it to give the brain better signals.

 The skin and the hair follicles around the skin have anywhere from 30 to a hundred times more nerve endings, specifically the type of nerves that tell us about pressure, temperature and oh yeah PAIN.  Why do you think paper cuts hurt like they do?  Tiny injury/Large pain signal…Because there are so many nerve endings there.   

What else is important to know.  Is that pain signals travel quite slowly as compared to the nerves for Movement and Tactile sensation, like scratchy feelings or decompression.

 I once heard it in a seminar that pain signals travel about 2 miles per hour, which is very quick from your ankle to your head. 

However…Tactile sensation like scratch, drag and rubbing and decompression sensation like a cup or Rocktape,  as well as movement travel about 70 miles per hour and bombard the brain with new information.  Faster and and more Amplified than their slow moving pain signal counterparts.

 Basically they, in a fashion, block the pain signals from getting to your brain.

Remember when I said that a lot of this becomes common sense when you see the body with this idea of body mapping?

 So let’s take it to a real life example – we’ll use someone that has never heard of body mapping in their life.

 Picture my eight-year-old boy as he’s running through the house and he bangs his hand on a solid wooden chair.

 His initial reaction, even before he starts to cry,  is to rub his skin around the area very lightly and start to move his fingers and hand.

 We’ve all done this. It’s automatic. The tactile sensation of rubbing as well as immediate movement will decrease the pain faster than doing nothing.

This is how a bunch of guys much smarter than me decided that we could probably use that information to create better treatments for our patients that were having issues involving body mapping.

 To see some videos of this in action check out a few of the ones I put on YouTube as I think seeing a visual is pretty powerful.  Basically we are using the skin to give the brain better information. This has been going on for a few years so it’s not as brand new as it might sound.  .

Treatment involves simply getting in there and just starting to stimulate an area.  We can use a rubber drag tool, a scratchy tool, Rocktape and movement    That is what we did a few years ago. Now we Innovate and test and retest.   We take the skin different directions with different pressures, different tools, twisting, decompression, all trying to modulate cutaneous nerves to connect and communicate with the body and brain faster and more efficiently.

 Sometimes the results are mind-blowing. As a practitioner nothing makes me feel better than helping somebody that has had pain for months Or to get them  feeling better for the first time.

 It’s why I got into the profession.

BODY MAPPING  –  is a new style of seeing the body, a new way of working with the anatomy. And definitely something different than what was being done even a few years ago. It doesn’t work for everything. There’s no way for me to guarantee it or to deliver every time. It depends more on how the brain is seeing the body. 

It’s simply another trick for our practitioner tool box.   

 It’s a way to use existing Tools in a new fashion.

 I think it explains why a lot of the things that we are doing in our clinics via trial and error are working despite us not being able to explain it.

It’s the science catching up to what was working already only we weren’t sure why.

Body mapping is better wording. Is better vocabulary. It is a word Swap and is a super powerful tool that has made working in my clinic more enjoyable.

 I think the idea of looking at this and explaining this via GPS is a very powerful analogy to simplify it.

There you go.  Enjoy it, play with it – and impress the guy in the next cubicle with your newfound knowledge! 

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