"Pacing"... Physio's warped mantra or recovery on the horizon?

[Michael Reinvented]

I noted with interest Moving Clouds post and reference to how pacing had aided recovery:
http://www.tmswiki.org/forum/threads/walking-map-reading-and-achievements.810/

Pacing is often featured as a cornerstone of other Chronic Pain Recovery Programs.
Here's my conundrum:

8 weeks of SEP/Unlearn Your Pain and trying to gradually increase daily activity and exercise.
More symptoms on walking now worse than ever.

I started to read the link posted by MC and quickly stopped fearing it would dilute my SEP/Schubiner/Sarno Work.

More Physio (I have seen 6 of them and none have assisted in any way) diatribe....PACING. They say "Without it you'll be locked in a BOOM BUST pain cycle".

My head tells me pacing is what's missing. Go back to baby steps and start again. It's a heartbreaking prospect.

And, this is at odds with Schubiner/Sarno et al..??
Forest, you especially have benefited from challenging the mind to unleash learned pain patterns via extra movement.

Any comments please?

 

[Forest]

Pacing is sometimes helpful depending on what your confidence level is at. Sometimes, it is helpful to build up confidence in both yourself and in the approach. Remember though, with TMS you do not have a structural problem, so physical activity will not harm you, so you don't HAVE to pace yourself. There are some activities that you may need to work up to in terms of conditioning, primarily weight lifting and long distance running. If you haven't been active in a long time, you will simply need to build your stamina, but I have always considered that slightly different than pacing in the way you describe it.

There were a couple of activities where I started out some what slow, such as typing, but one of the most helpful things for me was when I went out and played broomball. If you haven't heard of broomball it is basically hockey without the skates. It involves a lot of running on ice, so I wouldn't say that I paced myself in the least at that point.

One of the most challenging parts of becoming active again is that you worry if you are doing too much too soon. The problem is that this is exactly what your unconscious wants you to do, because it is distracting you from what is really going on. If you feel comfortable being active than be active. If you still need to build up your confidence than start a little bit slower. Just remember, that you have TMS, not a structural issue, and physical activity will not harm you.

 

[movingcloud]

Most interesting debate, Michael and Forest!
I learned about the pacing before finding out about TMS, and it was the only effective management tool I was presented with. I found it exhasperating and very difficult to stick to, especially since most activities are not timed to the nearest minute. But, I did it, and it helped me. I don't think I did it perfectly, as I'm too compulsive and want to get on to the next level too quickly. But it DID teach me that I could do activity and my world didn't collapse. I cut hedges (OK, in 5 sessions), filled garden bags, lifted things - progressively heavier, made my car journeys slightly longer oh so slowly over time, and I realised I could accomplish so much more than I ever thought I'd be able to. The walking I did most days, and its taken me a year to get as far as I have. Only with all that behind me am I realising that I can be confident in going much much further. I still mostly have constant daily pain - though not nearly as bad as last year, and one of my long-term goals is to go on a walking holiday with my friends.
I don't think Sarno said "drop everything and go at life like you used to"...! Chronic pain brought with it deconditioning for me. Pacing has given me confidence.

I have retrieved my copy of "Healing back pain" and here is what Sarno says (Ch. 4 on p111 in mine)

"how can I tell the difference between TMS and pain from overworking unused muscles?"
That's easy. When you've done some unaccustomed physical activitiy and wake up the next morning with aches in your arms of lags, it's a good kind of ache and it's usually gone by the following day. The pain of TMS is always nasty, and it doesn't go away very quickly, if at all.

"what kind of exercise can I do?"
When the pain has subsided, one can do anything and everything, the more strenuous the better. Obviously one should follow a strenuous routine only after consulting with one's doctor. But the point is that exercise should be done for general health reasons, not for the back."

I guess what I'm trying to say here is that pacing is an OK tool for building fitness where there is little/none. And I don't think it contradicts what Sarno says above. When I have no pain anymore I am going to go back to playing Badminton.