Tame Pain

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

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.

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.

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...

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

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.

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.

04/26/2023

SUMMER SPECIAL OFFER

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

20% OFF ANY PRODUCT/SERVICE - Use code

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.

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...

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.

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.

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

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.

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.

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?

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.

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 👇

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.