Tame Pain

10/05/2025

Finding the Line Between “Safe” and “Warning” Pain

That balance between safe discomfort and warning pain is one of the hardest things to gauge—especially after an injury. There’s rarely a perfect algorithm for knowing when to push or pull back. The key is learning to make small adjustments based on how your body feels.

Tools like perceived exertion or symptom rating scales (RPE) can help anchor those decisions — noticing when sensations rise above your usual training discomfort or linger longer than expected. Even when symptoms flare, we often find ways to reintroduce movement gradually and confidently. That’s part of rebuilding trust in your body and maintaining quality of life.

The goal isn’t to eliminate uncertainty, but to grow your ability to recognize the difference between challenge and threat — the skill that keeps you progressing safely.

We saw this same dilemma emerge in our qualitative investigation into clinician beliefs about low back pain, where participants described patients “walking a tightrope” between over- and under-doing it — too little activity leading to deconditioning, or too much, too soon, leading to flare-ups.

📄 Ray BM, Washington L, Thompson BL, Kelleran K. (2024). An exploration of low back pain beliefs held by health care professionals in North America. Musculoskeletal Care, 22(1): e1877.
https://doi.org/10.1002/msc.1877

08/15/2025

Pain can feel like a rollercoaster—full of ups and downs, twists and turns. It’s an individual experience shaped by innumerable factors, and those peaks and valleys are often a normal part of the journey.

Rather than just being along for the ride and fearful of what’s next, we can take back some control. One way is through pacing—adjusting your activity based on how you feel. Just like you might go lighter at the gym after a tough workout, pacing helps you stay active without pushing past your limits.

You may not control every hill or drop, but you can control how you respond to them.
If you’re struggling to navigate the ride, we can help.

Click the link in our bio to schedule an appointment today.

07/09/2025

🧠 New in Our Newsletter: Research to Practice
What’s the most important thing people learn in pain science education?

Researchers asked those who improved after living with persistent pain—and their answers might surprise you.

✨ Pain ≠ Damage
✨ Emotions and experiences affect pain
✨ You can retrain your pain system

These ideas changed lives—and they might change yours too.

📬 Read the full breakdown in our latest issue: link in bio

💻 Need guidance applying this to your own life?
We offer remote consultations and personalized coaching to help you move forward—wherever you are.

03/25/2025

A recent meta-analysis shows that most treatments for acute and chronic low back pain lack meaningful efficacy. Even those that outperformed placebo failed to reach a clinically important difference—meaning they likely don’t translate into real patient improvement.

Pain intensity reduction is often treated as the gold standard outcome, but it doesn’t have to be our only—or even primary—focus.

“Suffering may be related as much to the meaning of pain as to its intensity. Persistent helplessness and hopelessness may be the root causes of suffering for patients with chronic pain yet be reflected in a report of high pain intensity.”
— Ballantyne & Sullivan

“To understand the sufferer, one must understand the narrative, for it is through the story that the patient’s suffering is accessed. This means both hearing the illness story and listening for the suffering narrative therein.”
— Egnew, 2018

There’s value in expanding what success looks like in pain care.

Helping may have less to do with eliminating pain, and more to do with guiding patients through the pain experience—supporting them in returning to valued life activities. This process requires pain reconceptualization and a strong foundation of supported self-management strategies.

Short, powerful read by Ballantyne and Sullivan: https://lnkd.in/ee6b_v8G

Further reading on pain-related suffering from Peter Stilwell https://lnkd.in/eKG_jzVp

NYT article: https://lnkd.in/eFBtKA68

01/13/2025

Check out our January newsletter!

Check out our latest updates

12/14/2024

The new year is upon us, and many people are contemplating change. Often, this involves doing something different in daily life; diet or physical activity. It’s much easier to think about change than implementing it. As humans, we get stuck in loops, our daily actions become automated and habitual. We find comfort in stability even if those choices are not the best for us in the long run. Breaking the loop is hard and our affordances are variable.

When attempting change, establishing a why is quite helpful, “I want to be more active so I can be healthier and around longer for my family”. That’s a great basis for change.

Once value, or a why, has been established, then it’s accepting change is a process. Just like our habits took years to establish, breaking out of them is going to take time. However, and this is important, small changes add up over time. There’s no need to commit to going to the gym 5 times per week when you’ve not been going at all for years. You may not even need to start with the gym. Making a realistic goal that fits with your life is key. Perhaps there’s space between when the kids are picked up at the bus stop in the morning and you needing to leave for work. Can we fit in a five minute walk? Maybe 2 sets of sit to stands in the kitchen?

These are my usual recommendations:
1) start small - it’s even ok if it initially feels somewhat easy.
2) make it fit your current abilities - if we’ve not been barbell back squatting, then starting with sit to stands to assess abilities makes a lot of sense
3) make it fit your life - new goals do not mean deprioritizing all other aspects of life. Yes, something may need to be reduced to create more time and maybe that’s a good thing (e.g., sitting for long periods for screen time)
4) find YOUR thing - just because it’s poplar to go to XFit doesn’t mean that’s what you just do too. Maybe you try it and don’t like it, that’s ok. Try something else. Maybe your thing is with others and maybe it isn’t, that’s ok too. On this health journey, what matters is enjoying the process so you stick with it. Then we can focus on nuance, like meeting physical activity recommendations.

Hope this helps!

08/25/2024

**A Comprehensive, Research-Based Guide to Shoulder Pain**

FREE at tamepain.com

Have you ever been told your “tight” upper traps are causing your shoulder pain? Or that your shoulder blade moves abnormally, leading to “impingement”? Maybe you’ve heard you should avoid certain movements, like upright rows, because they’re bad for shoulder health. If any of these narratives sound familiar, this guide is for you.

We’ll bring clarity to the causes of shoulder pain and examine the research behind these common explanations. Most importantly, we’ll provide a practical path forward to help you manage and alleviate shoulder pain effectively.

Struggling with shoulder pain? We can help. Click the link in our bio to set up a remote consult.

07/24/2024

Setting appropriate expectations is crucial when working through pain symptoms. Sometimes, we need to adjust activities due to symptoms. Instead of focusing on performance-based goals like numbers, sets, reps, time, or competitions, it’s better to stay active with tolerable symptoms to return to baseline. This shift helps embrace the process mindset and make appropriate progressions.

Comment below for a discussion.

07/22/2024

Rememberq - Although a prior experience with a movement may have involved pain, that’s not a reason to avoid a movement forever.

Movements aren’t inherently good or bad, harmful or not harmful.

Don’t let prior experience feed into fear avoidance.

07/04/2024

Happy 4th of July!

We are having a flash sale to celebrate.
Over the next two days, enjoy 20% OFF ALL ITEMS.
New or returning customers.

07/03/2024

Let’s talk about narratives.

Whether you are a clinician seeking to explain pain to a patient or an individual wanting to better understand their lived experiences, our words matter.

Many clinician narratives used to explain pain are rooted in an outdated model that views humans as machines, capable of wearing down, breaking, and needing replacement parts. This drastically oversimplifies our experiences, and runs the risk of harm. These narratives are often attached to the idea pain is a direct indicator of tissue damage to the body and if you experience any pain then avoid. Sadly, these narratives often lead to fear avoidance behaviors.

As individuals we want to understand and rationalize our experiences. We may latch on to the clinician narratives which maps to our daily behaviors. Additionally, our self talk may become negative, in which we view ourselves and our bodies differently, potentially negatively, perpetuating a broken mindset.

As clinicians we must balance our uncertainty with useful information and reassurance while minimizing a nocebo effect.

As individuals, positive self talk can go a long ways with self-management while also ensuring we don’t become too anchored to labels or a holy grail diagnostic search.

Hence , our narratives and beliefs map to our behaviors and world engagement … shaping our future experiences. These narratives have the ability to reach far into the future. Leading me to believe, that our words are likely one of the most important tools in our tool boxes, capable of empowering and reassuring or scaring and harming.

Thoughts? Tag someone who needs to read this. Like, comment, and share. 🙏

06/27/2024

***Movement and Pain***

Remember - Although a prior experience with a movement may have involved pain, that’s not a reason to avoid a movement forever.

Movements aren’t inherently good or bad, harmful or not harmful.

Don’t let prior experience feed into fear avoidance.