Tame Pain

Tame Pain We are an educational and remote consultation company dedicated to helping individuals with pain man
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We know chronic pain can be debilitating, robbing humans of their identity and ability to engage life. Our mission is to empower those dealing with chronic pain through education and guidance to engage their life again.

06/16/2023

Often on initial consultations with remote clients. I discuss what I will label as the pinball effect. This is when you experience pain and are worried about experiencing pain and the meaning of the pain that you’re experiencing so you begin avoiding activities that are painful. In the opposite end of the spectrum, we become frustrated with experiencing pain and just wanting to do life activities. From there we begin pushing further and further into our pain experience in order to accomplish the activities that we value. Both of these are opposite poles that we really don’t want to find ourselves regularly going to, and the pinball effect becomes where we are bouncing between each of these poles, bouncing from one end to the other, really struggling and becoming frustrated with this process and trying to figure out a path forward. Layer in multiple clinician visits with various narratives in an attempt to explain the pain, sending us down multiple pathways for trying to fix the pain, many of which aren’t beneficial, and often more harmful simply in the narratives given to validate the intervention, and it will feel as though we are making no real progress outside of just bouncing around within the pinball game becoming hopeless.

This is difficult to address and redirecting often takes some time working together with folks to get through this process and find more fruitful self management strategies. If you find this relatable or are struggling with chronic pain, please know there are those of us who specialize in this and are willing to help.

www.tamepain.com

New Research in Journal of America Medical Association showing high incidence of chronic pain in United States from 2019...
06/02/2023

New Research in Journal of America Medical Association showing high incidence of chronic pain in United States from 2019 to 2020.

Swipe left for details.

Note: person years means number of new cases of an issue per person per year. Check out the bar graph on the last slide where chronic pain is compared to rates for diabetes, hypertension and depression.🤯

Lots of work to do in this space.

In honor of pride month, we are releasing this limited series t-shirt for the month of June. We stand with our fellow hu...
06/01/2023

In honor of pride month, we are releasing this limited series t-shirt for the month of June.

We stand with our fellow humans without discrimination. Love is love.
+

T-shirts are a dime a dozen, but this one stands out from the pack. It’s super soft, breathable, and has just the right amount of stretch. Need we say more?

• 100% combed and ring-spun cotton (Heather colors contain polyester)
• Unisex
• Fabric weight: 4.2 oz/yd² (142 g/m²)
• Pre-shrunk fabric
• Side-seamed construction
• Shoulder-to-shoulder taping
• Blank product sourced from Guatemala, Nicaragua, Mexico, Honduras, or the US

Order link in bio.

In honor of pride month, we are releasing this limited series t-shirt for the month of June.We stand with our fellow hum...
06/01/2023
Love is Love. | Tame Pain

In honor of pride month, we are releasing this limited series t-shirt for the month of June.

We stand with our fellow humans without discrimination. Love is love.
+

T-shirts are a dime a dozen, but this one stands out from the pack. It’s super soft, breathable, and has just the right amount of stretch. Need we say more?

• 100% combed and ring-spun cotton (Heather colors contain polyester)
• Unisex
• Fabric weight: 4.2 oz/yd² (142 g/m²)
• Pre-shrunk fabric
• Side-seamed construction
• Shoulder-to-shoulder taping
• Blank product sourced from Guatemala, Nicaragua, Mexico, Honduras, or the US

Link:

In honor of pride month, we are releasing this limited series t-shirt for the month of June. We stand with our fellow humans without discrimination. Love is love. +T-shirts are a dime a dozen, but this one stands out from the pack. It’s super soft, breathable, and has just the right amount o...

Did you know we offer remote consultations for individuals dealing with pain and injury? We specialize in helping folks ...
05/30/2023

Did you know we offer remote consultations for individuals dealing with pain and injury? We specialize in helping folks with chronic pain needing guidance on returning to valued activities.

See what Lindsay (Canada) had to say about working with us:

“Dr. Michael Ray helped me through debilitating radicular pain a few years ago. Prior to consulting with Dr. Ray, I had seen various physiotherapists who left me fearing movement and told me to stop deadlifting, squatting and benching or I would just wind up with more damage. Not only was I in horrible pain, but my mental health was plummeting from being told I could no longer do these basic exercises.

After six months of getting worse, I consulted with Dr. Ray and within days he started me on a program to get me back to what I wanted to be doing again: lifting. Five days after I started working out again, my pain and range of motion were starting to improve. I was shocked and elated. After months of being told that doing any of these movements would make things worse, here I was already seeing positive changes. The workouts were tough, but it was so rewarding and relieving to know that there was a light at the end of the tunnel. After two months of working with Dr. Ray, I was pretty well back to normal and have been lifting ever since. When I do have a flare up now, I know what to do and I am able to get it under control in a very short period of time thanks to what he taught me.

Dr. Ray is a wealth of knowledge about pain and his insights have changed my perspective about pain completely. Dr. Ray is compassionate, patient and he pushes you when you need to be pushed, but always in a good way. I honestly cannot recommend Dr. Ray enough. He has completely changed my life 😊”

Click the link to setup a 1-hour zoom call today: https://forms.wix.com/f/7010981918241981217

📣 Introducing our exclusive online mentorship program for health and fitness professionals! Stay ahead of the curve on p...
05/26/2023

📣 Introducing our exclusive online mentorship program for health and fitness professionals! Stay ahead of the curve on pain education and exercise therapy research with our cutting-edge resources.

🏋️‍♀️ Are you a personal trainer, strength and conditioning coach, chiropractor, physical therapist, or athletic trainer looking to elevate your practice? Our mentorship program is tailored just for you!

🌟 Unlock the benefits:
- Stay up to date with the latest research in pain education and exercise therapy
- Access weekly zoom meetings involving a coach led lecture and activities
- Gain insights into evidence-based practices for improved client outcomes
- Network and collaborate with like-minded professionals
- Elevate your professional profile and attract new clients

💡 Upgrade your expertise! Join our mentorship program today and empower yourself with the knowledge and tools to make a real difference in your clients' lives.

Comment below or send us a message with your email. Limited availability!

About the instructor:
- Collegiate educator since 2009 having taught for the University of South Carolina’s phys education department, James Madison University’s kinesiology department, and now a tenure track assistant professor for Bridgewater college actively teaching and researching these topics.
- Healthcare clinician since 2016, owning and operating a sports rehab clinic as a chiropractor and since 2018 operating remotely in the telehealth space.

Feel free to ask questions!

Don't miss out on this opportunity to take your career to new heights.

Rehab PeriodizationI put this post together a few years back and it’s been updated a couple of times. Here’s the latest ...
05/12/2023

Rehab Periodization

I put this post together a few years back and it’s been updated a couple of times. Here’s the latest version of Rehab Periodization.

Sometimes we have to make alterations to training for various reasons, one of which may be pain. During this time, instead of chasing numbers, sets, reps, time, competitions, etc (performance based goals) - a better premise would be training with tolerable symptoms to return to baseline rather than training for improvement based on our abilities prior to symptoms.

This premise shift of building towards baseline will help with accepting an “embrace the process” mindset while making appropriate progressions. In situations where we are making alterations to training due to symptoms it is likely we will have a loss of baseline fitness (defined based on athlete’s activity of choice) but what matters - we alter training to minimize complete loss of baseline fitness levels while keeping the athlete progressing back towards baseline, having a game plan can help with this.

Periodization is defined as the planned manipulation of training variables: frequency, intensity, volume, duration, and rest.

There are two principles to keep in mind when programming through rehab to ensure we progress athletes from where they are at day 1 in the clinic to where they want to be based on their goals:
1) Specificity
2) Progressive Overload

Here are some slides I put together to help guide the path (swipe left) through four phases:
1) Return active range of motion
2) Strength
3) Power
4) Return to Sport (i.e. pre-season)
*** Sometimes it may be appropriate to progress based on just RPE/RIR, % of 1RM, or both. Some cases may not warrant a particular phase.***

Reference:
Lorenz D CURRENT CONCEPTS IN OF STRENGTH AND CONDITIONING FOR THE SPORTS PHYSICAL THERAPIST. International journal of sports physical therapy. 2015; 10(6):734-47.

SUMMER SPECIAL OFFER20% OFF ANY PRODUCT/SERVICE - Use code
04/26/2023
SUMMER SPECIAL OFFER

SUMMER SPECIAL OFFER
20% OFF ANY PRODUCT/SERVICE - Use code

20% OFF ANY PRODUCT/SERVICE - Use code

At  we often get questions about programming related to outcomes or pain.Typically we discuss this in two categories: ae...
04/23/2023

At we often get questions about programming related to outcomes or pain.

Typically we discuss this in two categories: aerobic and anaerobic (I.e. resistance training).

The usual resistance training outcomes of interest are: strength, power, hypertrophy, and endurance.

Once goals have been set for resistance training then programming should align. Swipe through for insight and a sample program.

Programming isn’t complicated once you learn the pieces you can mess with to get desired outcomes. The good news, there are no none responders to exercise but one certainly may appear non responsive or insensitive to the stressor due to inadequate programming.

We really only have a few pieces to play this game: Frequency, volume, and intensity.

Focusing on volume (sets x reps) and intensity (external is load and internal is RPE), these variables are inversely related. As volume goes down, then intensity goes up.

For beginners new to RT, starting higher volume makes sense to minimize loading and allow time to learn technique. Then over time these two variables can be altered.

Struggling with implementing RT? We have a template for that, Blueprint.

Want individual guidance? We’d be happy to consult. Click the link in bio.

IASTM - Scraping the Bottom of the Barrel for SupportiveEvidenceKey Points:1. The effectiveness of Instrument Assisted S...
04/17/2023
IASTM - Scraping the Bottom of the Barrel for Supportive Evidence

IASTM - Scraping the Bottom of the Barrel for Supportive
Evidence

Key Points:
1. The effectiveness of Instrument Assisted Soft Tissue Manipulation was examined for the following populations: healthy, athletes, and those reporting spinal and/or extremity issues.
2. Articles were included in the review, overall the quality of the evidence was very low with a high risk of bias.
3. Primary finding: the current evidence does not support IASTM for any studied population for any of the usual supplied narratives (pain, function, or range of motion).

Introduction Instrument Assisted Soft Tissue Manipulation (IASTM) is a popular intervention in the pain & rehab field that involves placing an external instrument (often metallic) on the skin of a patient and repeatedly scraping the area of tissue. IASTM isn’t new and has roots in East Asian medic...

Friendly reminder, when dealing with chronic pain, not every day will feel amazing or great. Rather, pain tends to ebb a...
04/16/2023

Friendly reminder, when dealing with chronic pain, not every day will feel amazing or great. Rather, pain tends to ebb and flow for innumerable reasons (similar to emotions). Like emotions, we may not be able to explain why we feel a particular way but that doesn’t invalidate our experiences.

This is why at tame pain, we like rare of perceived exertion to help regulate activity based on fatigue, difficulty, and pain.

Remember to give yourself grace and patience on this journey.

Flash Sale 10% OFF Initial Remote Consultation (10%OFFEASTER)20% OFF Remote Consultation + 1 Month of Programming (20%OF...
04/04/2023
Flash Easter Sale

Flash Sale
10% OFF Initial Remote Consultation (10%OFFEASTER)
20% OFF Remote Consultation + 1 Month of Programming (20%OFFEASTER)
40% OFF Any template (40%OFFEASTER)

Hurry! Before time runs out.

Latest Blog PostThis one is for those who are dealing with shoulder pain AND had imaging. 🔑Key Points:1. Patients presen...
03/24/2023

Latest Blog Post

This one is for those who are dealing with shoulder pain AND had imaging.

🔑Key Points:
1. Patients presenting with unilateral shoulder pain underwent bilateral shoulder MRIs. The authors found similar MRI changes in both shoulders of participants.
2. The radiologist and shoulder surgeon had a moderate level of inter-rater agreement for their findings. This further demonstrates the subjectivity in identifying MRI changes from textbook “norms”.
3. Collectively, these findings further bring into question the utility of MRI for the majority of patient presentations for shoulder pain (especially atraumatic situations). MRIs for many shoulder cases may be an unnecessary use of healthcare resources that increase cost and increase the potential of incidental findings leading to further unnecessary intervention.

Check it out and let us know what you think in the comments. 👇

https://www.tamepain.com/post/peering-beneath-the-surface-might-not-be-as-insightful-as-we-once-thought

Tame Pain Blueprint is now available! This template includes 12-weeks of physical activity programming designed to go fr...
03/17/2023

Tame Pain Blueprint is now available!

This template includes 12-weeks of physical activity programming designed to go from being sedentary to making moves towards meeting physical activity guidelines. We provide educational materials specific to those who have been dealing with chronic pain.

Here's a video tutorial of the template: https://www.youtube.com/watch?v=Q38R7u0F3T0

Product Description:
This is a brand-new 12-week template designed by Dr. Michael Ray. A map outlines an existing territory we already know, but a blueprint outlines a new terriority we wish to create. That is why our new template is called a blueprint, a schematic that is meant to help individuals dealing with chronic pain forge a new path to overcome their pain.

✅Logical progressions
✅26 page guide with educational materials on pain and autoregulation
✅Builds towards meeting activity guidelines over twelve weeks for both aerobic activity and resistance training.
✅A community forum to share experiences
✅Live support if any technical issues arise
✅Video walk through tutorial
✅Research supported
✅Clinician approved

In addition to the template, each purchase comes with an eBook guiding the path through the template, aiding with exercise selection, progressions, and much more. We hope you find this template helpful.

Purchase link in bio.

🚨This is the last week to order our new template: Tame Pain Blueprint 🚨***Pre-Order: Discounted Rate. Template will be r...
03/11/2023

🚨This is the last week to order our new template: Tame Pain Blueprint 🚨

***Pre-Order: Discounted Rate. Template will be released by March 17th at full retail price.***

This is a brand-new 12-week template designed by Dr. Michael Ray. A map outlines an exisiting territory we already know, but a blueprint outlines a new terriority we wish to create. That is why our new template is called a blueprint, a schematic that is meant to help individuals dealing with chronic pain forge a new path to overcome their pain.

✅Logical progressions
✅26 page guide with educational materials on pain and autoregulation
✅Builds towards meeting activity guidelines over twelve weeks for both aerobic activity and resistance training.
✅A community forum to share experiences
✅Live support if any technical issues arise
✅Video walk through tutorial
✅Research supported
✅Clinician approved

In addition to the template, each purchase comes with an eBook guiding the path through the template, aiding with exercise selection, progressions, and much more. We hope you find this template helpful.

At Tame Pain, we often hear when individuals change their behavioral responses to pain, say using a passive modality to ...
03/08/2023

At Tame Pain, we often hear when individuals change their behavioral responses to pain, say using a passive modality to not, they then view that as “doing nothing”. I think it’s important to know that changing the response through elimination doesn’t equate to doing nothing. Perhaps addition can be accomplished by subtraction. Thoughts?

Mobility ExplainedAuthor's note: I wrote this article back in 2018 based on current data. There has been updated researc...
02/02/2023

Mobility Explained

Author's note: I wrote this article back in 2018 based on current data. There has been updated research on this topic and the blog needs updating accordingly. I will get to it :) If you have an article you'd like for me to review please email [email protected]

Rolling through social media, we find narratives and interventions claiming to improve something called “mobility”. We can select from options including stretching, foam rolling / body tempering, lacrosse ball smashing, voodoo flossing, power tools converted to guns being sold as therapeutic, and the list goes on. The level of marketing would make even Donald Draper of Mad Men proud.

But are these implements doing what we think they are? Are we just hidden pliable versions of Gumby walking around, waiting for our supple potential to be released? Or, are we committing the post hoc ergo propter hoc fallacy? Before we decide, we must first define our terms and examine the narratives being given to validate these interventions.

So how do we define mobility?

Read more at tamepain.com.

Our beginner’s template is almost done. Our Google spreadsheet team is putting the final touches on it now. A template d...
01/28/2023

Our beginner’s template is almost done. Our Google spreadsheet team is putting the final touches on it now.

A template designed to help those who haven’t been active find a tolerable entry point into activity.

✅Logical progressions
✅26 page guide with educational materials on pain and autoregulation
✅Builds towards meeting activity guidelines over twelve weeks for both aerobic activity and resistance training.
✅A community forum to share experiences
✅Live support if any technical issues arise
✅Video walk through tutorial
✅Research supported
✅Clinician approved

To say we are excited to bring this to everyone would be an understatement. Questions? Drop them 👇

Steps to calling something a problem in healthcareIf we want to call something (“X”) a problem in this context, here are...
01/20/2023

Steps to calling something a problem in healthcare

If we want to call something (“X”) a problem in this context, here are some questions that we need answer.

1. Evidence demonstrating X exists. A prevalence rate identified in asymptomatic population vs symptomatic. If we wish to label something a problem then it's good to assess correlation to symptoms and knowing base rates helps with likelihood of correlation. Saying everyone has X nullifies this from being a problem and instead it is a normal part of being a human.

2. Let's say we have evidence X exists. Then we'd need evidence demonstrating there's a risk to having it. They've been demonstrated to have a non-negligible detrimental harm to those X is identified in & if not addressed may effect prognosis, QoL, function, etc.

3. We'd need valid assessments (reliable, accurate, and replicated from clinician to clinician) - likely layered into identifying X exists.

4. Do we have published data on interventions repeatedly demonstrated to specifically address X in this context and impact it in a meaningful manner as previously discussed (prognosis, QoL, function, life span, etc). Have the risks vs benefits of the interventions been adequately weighed? Have the interventions been demonstrated to have meaningful effects beyond placebo/contextual/meaning effects.

5. Finally - what healthcare professional is qualified to assess and intervene on X and why?

We can find all sorts of Xs, label, quantify, categorize, etc. but if we’ve not gone through these steps then we may be unnecessarily pathologizing leading to overmedicalization.

Thoughts? Comment below for a discussion. Tag someone who needs to see this.

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Tame Pain's The Guide to Low Back Pain is now available for purchase, $9.95.

3 Parts:
Part 1 - Introduction to low back pain discussing definitions, risk factors, and healthcare models

Part 2 - Low back pain in healthcare, involving a lengthy discussion on what is normal vs pathological, and the negative effects of unnecessary imaging

Part 3 - Being a Guide, this section discusses in-depth management for low back pain and specifically guides clinicians through the process of helping others.

I hope folks enjoy this guide and find it useful. As always, feedback is welcomed.
Tame Pain's The Guide to Shoulder Pain is now available for purchase on Amazon.com Kindle. If you happen to purchase the ebook or have already read it as the pdf version, a review would be greatly appreciated.

https://www.amazon.com/dp/B0B6JV16KT?ref_=pe_3052080_397670860

Up next: The Guide to Neck Pain is available for pre-order and will be available for download on August 1st.
https://www.amazon.com/gp/product/B0B7269Z64/ref=dbs_a_def_rwt_bibl_vppi_i1

Thanks for the continued support!
Slightly hot and humid today.
Up to 194 # BWT, which is sweet.

Also this shirt is for sale Tame Pain.

Memento Mori -
https://www.tamepain.com/product-page/memento-mori
Pre-orders for Tame Pain The Guide to Shoulder Pain on Kindle is now available.
https://www.amazon.com/Guide-Shoulder-Pain-Guides-ebook/dp/B0B6JV16KT/ref=sr_1_1?crid=112CGPFB5QU6P&keywords=the+guide+to+shoulder+pain&qid=1657894392&s=digital-text&sprefix=%2Cdigital-text%2C245&sr=1-1
The guide will be available for download on Kindle on July 20th.
The Guide to Shoulder Pain will be available for purchase on Amazon kindle soon (likely next week but pre orders should be up this week). $9.95

I’ll also be uploading pdf versions to the website (Tame Pain) for download at the same price.

Several more guides will launch in both locations in the coming weeks. Amazon link in comments. Thanks for the support!
It's done. Tame Pain The Guide to Shoulder Pain is out.

54 minute read, 12,662 words, and 67 citations.

Topics:
🖋Anatomy
🖋Utility of imaging
🖋Scapular Dyskinesis
🖋Internal/External Impingement
🖋Rotator Cuff Tears,
and
🖋Management (exercise therapy, injections, surgery, etc)

https://www.tamepain.com/post/the-guide-to-shoulder-pain

Side note - after several people for quite some time telling me I need to charge, I gave in.

I've avoided it long enough ... I started charging for access. Nothing crazy ... $9.95 for outright purchase of this guide alone or $5/month subscription for full access. The subscription price will likely go up in the future due to more content being released so don't wait.

Hope you all find it helpful.
Almost done with the Tame Pain shoulder guide … I should probably charge for this …
As someone with a small following and as a healthcare professional/academic, I want to do my part to ensure those in need of healthcare seeking abortions have access.

With this in mind, I felt compelled to launch this t-shirt: Pro-Choice, Don't Tread On Me through my company Tame Pain.

100% of proceeds will be donated to aid those in need of healthcare seeking abortions. Example: National Network of Abortion Funds

https://www.tamepain.com/product-page/pro-choice-don-t-tread-on-me

If you decide to comment on this post, I encourage respect, open-mindedness, and empathy. Otherwise comments will be deleted.

Edit: Now available in black and white.

Raised: $163.14 as of 07/17

👩‍🎨Original idea and creation attributed to RAYGUNshirts

Those asking for flags - they already have them in their store so go check it out! They also donate proceeds towards abortion access.
Next guide at Tame Pain
Next up - The Guide to Neck Pain
Should be up next week. Tame Pain
Just spent a chunk of today updating the knee meniscus blog. I honestly don’t think there is a more comprehensive guide to the research on the topic available right now … I should probably charge for this … meh … it’ll drop this week. Stay tuned. Tame Pain
Natural antivirals Gene-Eden-VIR and Novirin are better than acyclovir, valacyclovir, and famciclovir drugs. See medical journals.

Facebook: https://www.facebook.com/GeneEdenVIRNovirin
The best antiviral treatments are Gene-Eden-VIR and Novirin. See published clinical studies. Both are listed on the USA NIH database of drugs.
Website: https://lilaccorp.com/
Facebook: https://www.facebook.com/GeneEdenVIRNovirin
𝐈𝐭’𝐬 𝐚 𝐣𝐨𝐮𝐫𝐧𝐞𝐲

Weird feelings with this day. We just turned in our keys to the first location of Shenandoah Valley Performance Clinic.

In 2015 Erica Ray and I moved to a new city where we knew no one.

We planned months leading up to my graduation from chiropractic school to relocate to a beach area further south. Shortly before graduation we realized a strong desire to be closer to family in MD and WV. So we decided on how far we were willing to drive, looked at a map, drew a circle, and began searching for a city. Harrisonburg checked a lot of boxes for us.

Erica began searching for a job in the area and landed a prestigious pastry chef position at a highly rated hotel/restaurant. I searched for jobs in the area, shadowed a few places, but my suspicions were confirmed - my ability to practice the way I wanted would be greatly constrained. It was then I made the decision to open my own clinic.

We ran a gym and clinic out of this location from 2015-end of 2018. Erica has since opened a bakery (Bittersweet Bakery) with Alicia Barger.

We have met many people over the years and although the gym has not continued on, we are beyond thankful for the opportunity to work with and help so many people in the community.

We now move on to the next step of our journey with SVPC at a new location. It’s taken a lot of hard work, the kind of work someone may try and warn you about but difficult to comprehend until you are in “it”. However, I wouldn’t trade this for anything else. Viktor Frankl once said,

“What man actually needs is not a tensionless state but rather the striving and struggling for some goal worthy of him. What he needs is not the discharge of tension at any cost, but the call of a potential meaning waiting to be fulfilled by him.”

The journey isn’t easy but for us, it is definitely worth it and adds a lot of meaning to life.

Thanks to everyone we’ve met over the years and who has trusted us to guide their journey, whether related to fitness or rehab. We are beyond thankful. We look forward to the future, continuing to serve the areas of Harrisonburg and Rockingham county. Cheers!
𝐏𝐫𝐢𝐧𝐜𝐢𝐩𝐥𝐞𝐬 𝐭𝐨 𝐠𝐮𝐢𝐝𝐞 𝐜𝐚𝐫𝐞 𝐨𝐟 𝐚𝐜𝐮𝐭𝐞 𝐧𝐨𝐧-𝐭𝐫𝐚𝐮𝐦𝐚𝐭𝐢𝐜 𝐩𝐚𝐢𝐧 𝐢𝐧 𝐬𝐩𝐨𝐫𝐭

This is an excellent recent editorial by Canerio et al in the British Journal of Sports Medicine (BJSM) that summarizes quite well our approach to these scenarios Barbell Medicine and Shenandoah Valley Performance Clinic.

The title says it all, “There is more to pain than tissue damage”. The editorial provides 8 principles to guide care of acute non-traumatic pain in sport:

1. In the absence of trauma, do not assume that pain indicates tissue damage
2. Do not refer for imaging unless it will directly influence care, or when there is suspicion of serious or specific pathology
3. Explore biopsychosocial factors that may contribute to pain (see photo of Table 1)
4. Deliver positive messages about pain during examination and treatment
5. Improve tissue tolerance to load and sports exposure
6. Use passive treatments only as an adjunct to active management
7. Use shared decision-making to build self efficacy
8. Use an interdisciplinary approach to deliver a unified message

This paradigm shift will certainly take effort and collaboration but is a necessary change.

The authors close with:

“Implementing these principles will require a cultural change within sport and sports medicine. Enormous barriers exist such as vested interests, clinician/coaching silos, pain beliefs reinforced by early access to imaging, treatment expectations and provision of quick ‘fixes’ and conflicting messages regarding training and return to sport for athletes in pain. Even with buy-in from clinicians, coaches and athletes this new paradigm will provide a major implementation challenge.”

Link: https://bjsm.bmj.com/content/early/2020/09/08/bjsports-2019-101705

Thoughts? Comment below for a discussion. Tag someone who needs to read this.
Harrisonburg folks:

Looking for a new space for Shenandoah Valley Performance Clinic.

Preferably downtown Harrisonburg area (near Farmer’s Market and Bittersweet Bakery).

Space needs:
1000 - 1500 sq feet of space
A single bathroom
Hi/low water fountains
Open floor plan
First floor
Move in date: October

If you are aware of a space please let us know!
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