Is Your Body Trying to Tell You Something? How Our Beliefs and Experiences Influence Pain
Why do two people with the same injury have completely different experiences?
As a physiotherapist, I see people day in and day out, and I'm telling you, it's fascinating how unique we all are.
Imagine ten women who give birth.
Five men who have a vasectomy.
Seven people who injure their backs.
On paper, their experiences might look quite similar.
But then add in their personalities, beliefs, past experiences, upbringing, stress levels and the messages they've received throughout their lives.
And suddenly, you have very different experiences of pain, recovery and healing.
This is something I see constantly in my pelvic health physiotherapy practice.
Some people have learned to push through everything. They ignore pain, fatigue and other signals from their body until those signals become impossible to ignore.
Others are at the opposite end of the spectrum. They become so aware of every sensation that pain creates fear, and fear leads them to avoid movement altogether.
And then there are the perfectionists, the people pleasers and those who simply want someone to tell them exactly what to do.
How much of the way we respond to our bodies is shaped by what we've learned throughout our lives?
That's what I explored in Episode 132 of The Pelvic Floor Project with Cory Arthurs, a registered clinical counsellor in Kelowna, BC, who has specialized training in sensorimotor psychotherapy, a body-based approach to working with trauma and the nervous system.
And the conversation was a fascinating reminder that physical recovery is rarely just about the physical injury.
We all learn different ways of responding to pain
A few patients inspired this episode.
One was recovering from persistent pain following a sacral fracture.
As we worked together, I began noticing that she had a tendency to push through pain and ignore the signals her body was giving her.
Eventually, she shared that this was how she'd learned to cope growing up.
Keep going.
Put your head down.
Push through.
Don't stop.
For much of her life, that strategy had served a purpose.
But now, during recovery, it wasn't particularly helpful.
Another patient was experiencing significant pelvic pain and testicular pressure following previous surgeries, including an inguinal hernia repair and vasectomy.
He acknowledged that he had never really allowed himself time to recover.
His message growing up had been something along the lines of:
Suck it up. Be a man. Keep going.
He had become so accustomed to holding tension and pushing through discomfort that he didn't even realize how much he was bracing his muscles throughout the day.
When I suggested that he could actually let those muscles relax, he was surprised.
Really? I'm allowed to let go?
It was such a simple moment, but it opened the door to a much bigger conversation.
Sometimes our coping strategies stop serving us
Cory explained that the way we respond to stress, pain and discomfort is influenced by a combination of our natural temperament and what we've learned through life.
Think about some common patterns.
The person who pushes through: They've learned that slowing down is weakness or that their needs aren't important. They may have difficulty recognizing when they've reached their limits.
The person who avoids: Pain feels threatening, so they stop doing activities that might provoke it. Over time, their world can become smaller.
The perfectionist: They want to do everything exactly right. They might worry about whether they're performing an exercise correctly or become frustrated when recovery doesn't follow a predictable timeline.
The people pleaser: They may be so accustomed to prioritizing what other people want that they struggle to identify what their own body needs.
None of these patterns automatically means something is wrong.
In fact, many developed for understandable reasons.
But a strategy that helped us navigate childhood, relationships or stressful experiences may not be the strategy that best supports recovery from an injury.
And sometimes we don't even realize we're using it.
Are you living like a floating head?
Cory used an expression that I loved.
She described how some people move through life almost like floating heads.
They're constantly thinking, planning, problem-solving and getting things done.
But they have very little awareness of what's happening from the neck down.
They might not recognize that they're clenching their jaw, holding their breath, tightening their pelvic floor or pushing through fatigue.
Other people experience the opposite.
They're so tuned into every sensation that their attention is constantly drawn to what feels uncomfortable or potentially wrong.
Neither extreme is particularly helpful.
Ideally, we want to be able to notice what our bodies are telling us without either ignoring every signal or becoming overwhelmed by them.
But how do we learn to do that?
What does “listen to your body” actually mean?
We hear this advice all the time.
Listen to your body.
But what does that mean?
For some people, it's almost a foreign concept.
Cory explained that we often think of body awareness in very basic terms.
I'm hungry.
I'm thirsty.
I'm cold.
I need to go to the bathroom.
But our bodies communicate much more than that.
Maybe you notice your shoulders creeping toward your ears during a stressful conversation.
Maybe your breathing becomes shallow when you're anxious.
Maybe you feel yourself pulling away from someone when you're uncomfortable.
Maybe your pelvic floor tightens when you're nervous.
Or perhaps you don't recognize any of those things until someone points them out.
I see this frequently in physiotherapy.
Sometimes I'll ask someone to simply notice what happens when they walk to the toilet.
Are they responding to an actual urge?
Are they rushing?
Are they holding their breath?
Are they pushing before their body is ready?
People are often surprised by how much they discover when they start paying attention.
And sometimes that awareness alone gives us valuable information about what's contributing to their symptoms.
Your nervous system is part of the picture
We talk about the nervous system a lot in pelvic health, but I don't think we always do a great job explaining it.
Cory introduced the concept of the window of tolerance.
Think of it as the range in which your nervous system can manage what's happening around you without becoming overwhelmed or shutting down.
When you're within that window, you're generally better able to think clearly, learn, respond to challenges and make decisions.
You can still experience stress or difficult emotions, but you have some capacity to manage them.
When you're pushed outside that window, your body may respond in different ways.
Fight or flight: everything is turned up
Your heart rate might increase.
Your breathing changes.
Your muscles tense.
You feel anxious, agitated or on edge.
Your body is preparing to respond to a perceived threat.
For someone experiencing pain, this can mean becoming increasingly protective of an injured area.
They may brace their abdomen, clench their pelvic floor or avoid certain movements.
Shutdown: everything is turned down
Other people respond to overwhelming stress by feeling disconnected, numb, exhausted or checked out.
They may struggle to recognize their body's signals or feel that they have very little energy to respond to them.
Both are ways the nervous system can respond to overwhelming experiences.
And importantly, these responses aren't necessarily conscious choices.
Why does stress affect physical pain?
Imagine your window of tolerance as having a certain amount of available space.
Now add poor sleep.
Work stress.
Family responsibilities.
Financial worries.
A difficult relationship.
And an injury.
Suddenly, there isn't much space left.
Cory explained that stress and other demands can narrow our capacity to cope, making physical sensations feel more overwhelming.
This helps explain why the same activity might feel completely manageable one day and much more uncomfortable the next.
It's also why, as a physiotherapist, I ask questions about sleep, stress and what's happening in someone's life.
Not because I think their pain is imaginary.
Pain is real. But the way we experience pain is influenced by much more than the tissues themselves.
Our muscles, joints, nerves, brain, beliefs, emotions and environment all play a role.
That's why two people with similar injuries can have such different experiences.
Why I might give you awareness exercises instead of strengthening exercises
Sometimes people come into my office expecting a list of exercises.
They want to know which muscles are weak and what they need to strengthen.
And sometimes that's exactly what we work on.
But other times, I notice that someone is holding significant tension, moving with fear or struggling to recognize what their body is doing.
Adding more strengthening exercises may not be the most useful first step.
Instead, I might ask them to practise noticing.
What does it feel like when you tighten your pelvic floor?
What does it feel like when you relax it?
Can you recognize when you're holding your breath?
Do your symptoms change depending on how you're moving?
I can almost see people thinking:
I came here for physiotherapy. Why am I being asked to pay attention to my breathing?
But there's a reason.
Before we can change a pattern, we often need to recognize that it's happening.
And that brings me to one of my biggest takeaways from my conversation with Cory.
You don't always need to fix something immediately
As physiotherapists, we're trained to identify problems and help people improve them.
Someone has muscle tension?
We want to reduce it.
Someone has pain?
We want to help relieve it.
Someone isn't moving well?
We want to improve their movement.
But Cory reminded me that sometimes we move too quickly toward changing something before we fully understand it.
What if we started with curiosity instead?
You notice that you're clenching your pelvic floor.
Rather than immediately trying to relax it, ask:
When do I notice this happening?
Does it change throughout the day?
What was happening just before I noticed it?
What happens if I simply pay attention to it?
There doesn't need to be an immediate goal of making the sensation disappear.
Sometimes the first step is simply understanding it.
Because if we don't understand why the tension keeps returning, we may find ourselves repeatedly treating the same symptom without addressing what's contributing to it.
What if paying attention to your body feels uncomfortable?
Not everyone enjoys slowing down and noticing sensations.
For some people, turning their attention inward actually increases anxiety.
Cory was very clear that we shouldn't force this process.
Instead, she might begin with something external.
Notice the sounds in the room.
Feel your feet touching the floor.
Look outside and describe what you see.
Notice the texture of something you're holding.
Pay attention to the temperature around you.
These are simple ways of practising awareness without immediately focusing on uncomfortable sensations inside the body.
For someone who is already hyper-aware of pain, she might even encourage shifting attention away from the painful area and toward something neutral or comfortable.
The goal isn't to become better at finding everything that's wrong.
It's to become more flexible in where we direct our attention.
“Go in before you go out”
This is something I find myself saying to patients, particularly pregnant and postpartum women who are inundated with advice.
Go in before you go out.
Before asking social media, a friend or even a healthcare professional what you should do, take a moment to check in with yourself.
What do I feel?
What am I concerned about?
What do I want to be able to do?
What has my experience been so far?
Of course, there are times when we need professional guidance.
But that doesn't mean our own experiences are irrelevant.
Cory explained that people who have spent years looking to others for approval or direction can lose confidence in their ability to recognize their own preferences and needs.
Rebuilding that trust can be an important part of recovery.
What does this mean for parents?
At one point in our conversation, I admitted that discussions like this make me overthink parenting.
If the messages we receive growing up influence how we respond to pain and stress as adults, how do we make sure we're giving our children the right messages?
Corey's response was reassuring.
We aren't going to get everything right.
And we don't need to.
What matters is being able to recognize when we've made a mistake and repair the connection.
We can also help children learn to recognize and describe what they're experiencing.
Are they tired?
Frustrated?
Scared?
Overwhelmed?
Do they need comfort?
Do they need a break?
Rather than always telling children what they should feel, we can help them become curious about their own experiences.
That doesn't mean children make every decision for themselves.
It means we can guide them while also helping them develop trust in their own bodies and feelings.
When might counselling help with physical symptoms?
This is an important distinction.
Suggesting counselling for someone experiencing physical pain is not the same thing as saying their pain is psychological or “all in their head.”
Sometimes the physical and emotional pieces of recovery benefit from being addressed together.
For example, someone may have experienced a traumatic injury or surgery.
Someone else may recognize that they have spent decades ignoring their needs.
Another person may feel so fearful of movement that it becomes difficult to participate in rehabilitation.
Or someone may notice that stress consistently increases their muscle tension and symptoms.
In these situations, working with a counsellor who understands pain, trauma or body-based approaches may offer another useful perspective.
And it doesn't have to be traditional talk therapy.
Cory discussed how counselling can involve body awareness, sensory experiences, nervous-system education and gradually exploring patterns that have developed over time.
For someone who isn't ready for counselling, even reading a book, listening to a podcast or learning about different therapeutic approaches can be a starting point.
The important thing is recognizing that there are options.
Recovery is about the whole person
One of the reasons I love working in pelvic health is that it constantly reminds me how interconnected everything is.
A person doesn't arrive in my clinic as a pelvic floor, a bladder, a tailbone or a set of muscles.
They arrive with a whole life.
Their experiences.
Their beliefs.
Their relationships.
Their stress.
Their habits.
Their fears.
Their goals.
And yes, their physical symptoms.
All of those pieces can influence how they experience an injury and how they recover.
Sometimes we need strengthening.
Sometimes we need mobility.
Sometimes we need medical treatment.
Sometimes we need to better understand the nervous system.
And sometimes we simply need to slow down long enough to notice what's happening.
The next time your body is giving you a signal, rather than immediately ignoring it, fearing it or trying to make it disappear, consider getting curious.
What might your body be telling you?
And what could you learn by listening?
This blog is intended for educational purposes only and does not replace individualized medical advice.
About Cory Arthurs
Originally from Calgary, AB, Cory completed her undergrad degree in Addiction Counselling from the University of Lethbridge, and worked for many years with individuals struggling with substance use and related issues. She later moved to Vancouver, where she completed her Masters of Counselling degree at City University of Seattle, and expanded her work into working with trauma and altered state integration. She uses both Sensorimotor Psychotherapy and EMDR in her work with PTSD, both nervous system based approaches to treating trauma. Using these trauma therapy modalities, she helps clients reduce the impact of trauma by working directly with the nervous system and body, not just thoughts and memories. This means slowing down, tracking what’s happening somatically in the moment, and supporting the kind of regulation that makes lasting change possible. Her work with clients over the years has taught her many lessons of the innate wisdom we all carry, and capacity for healing.
Episode Partners
This episode of The Pelvic Floor Project is supported by Embodia and SRC Health, organizations that help make it possible for me to continue creating evidence-based pelvic health education.
Embodia provides online continuing education and mentorship for pelvic health and rehabilitation professionals, including access to courses and expert-led learning from clinicians around the world.
SRC Health creates medical compression garments designed to provide support during pregnancy, postpartum recovery and for women experiencing pelvic health concerns.
Some partner links may be affiliate links, which means I may receive a small commission if you make a purchase, at no additional cost to you. Sponsorship does not influence the topics, guests or educational content of The Pelvic Floor Project.
