Show Notes
In this episode, Sarah looks at two broad pain patterns, people who tend to push through pain and people who tend to avoid it, and explains how each one can shape your relationship with exercise. Before getting into those categories, she lays out a key foundation of modern pain science: pain is not a simple one-to-one signal of tissue damage. Instead, pain is a subjective experience shaped by the brain's interpretation of threat, context, past experiences, beliefs, and emotions. She also explains why the common zero-to-10 pain scale is often misunderstood, what it is useful for, and why phrases like "I have a high pain tolerance" or "my pain is a 10 out of 10" may not communicate what people think they do.
From there, the episode walks through the fear avoidance model, pain catastrophizing, and the avoidance-endurance model to explain why some people stop moving the moment something feels wrong while others ignore pain until it becomes a much bigger problem. Sarah breaks down the strengths and liabilities of both patterns, including how pain avoiders can become deconditioned by steering clear of normal exercise discomfort and how pain endurers can blow past clear warning signs and delay recovery. She also talks through how these patterns show up in real life, how to tell which direction you tend to lean, and how better pain literacy, gradual progression, and thoughtful exercise programming can help you recalibrate your response to pain without swinging all the way to the opposite extreme.
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RESOURCES
Fear Avoidance Model revisited [https://journals.lww.com/pain/fulltext/2016/08000/the_fear_avoidance_model_of_pain.5.aspx]
Pain Catastrophizing Model [https://pmc.ncbi.nlm.nih.gov/articles/PMC7772183/]
Avoidance-Endurance Model [https://pubmed.ncbi.nlm.nih.gov/20664333/]
Pain Catastrophizing Scale [https://www.oregon.gov/oha/HPA/dsi-pmc/PainCareToolbox/Pain%20Catastrophizing%20Scale.pdf]
Avoidance-Endurance Questionnaire [https://eprovide.mapi-trust.org/instruments/avoidance-endurance-questionnaire#need_this_questionnaire]
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