Understanding pain and injury with Dr. Rachel Zoffness (part 1)

Today we have pain psychologist Dr. Rachel Zoffness on the show to teach us about pain & injury. Rachel teaches pain education to medical residents, serves on the pain education faculty at Dartmouth and is the co-president of the American Association of Pain Psychology. She is also the author of The Pain Management Workbook, an integrative, evidence-based treatment protocol for adults living with chronic pain. In part 1 of this 2-parter, we dive into the science of pain both acute & chronic. We break down real-world examples of how a biopsychosocial brain interprets pain and what turns up & dampens pain signals. (Apple users: Click ‘Episode Website’ for links to..) Check out Rachel’s personal website here You can also buy the Pain Management Workbook here Please also follow Rachel on Twitter & Instagram Click here to learn more about the PHT video course & to receive your 50% discount If you would like to learn more about having Brodie on your rehab team go to www.runsmarter.online  Or book a free 20-min physio chat here

Understanding and Overcoming Proximal Hamstring Tendinopathy: A Comprehensive Guide


In today’s episode, we delve deep into the world of pain and injury with Dr. Rachel Zofniss. Welcome to our podcast, dedicated to helping you overcome the challenges of proximal hamstring tendinopathy (PHT). Our goal is to provide you with a comprehensive understanding of this condition, evidence-based treatment options, and dispel common misconceptions. I’m Brodie Sharp, an online physiotherapist, recreational athlete, and a chronic PHT survivor. Whether you’re an athlete or not, this podcast aims to empower you with the knowledge and strategies to conquer this debilitating condition. So, let’s equip you with valuable insights and actionable takeaways in today’s lesson.

The Bio-Psycho-Social Aspect of Pain

In this episode of the Run Smarter podcast, we revisit our previous interview with Dr. Rachel Zofniss, a pain psychologist. Understanding pain is crucial when dealing with conditions like PHT. Dr. Zofniss emphasizes the bio-psycho-social component of pain, breaking it down into three key aspects:

1. The Biological Component

The biological aspect involves what’s physically happening in your body. It includes factors like tissue damage, inflammation, and system dysfunction.

2. The Psychological Component

The psychological aspect deals with how you think and process thoughts related to pain. Emotions, stress, and mental health play a significant role in shaping your pain experience.

3. The Social Component

The social component revolves around the social context and understanding of pain. Social support, interactions, and the environment can impact your perception of pain.

Pain as a Warning System

Dr. Zofniss describes pain as the body’s warning system, evolved to protect you from potential harm. This warning system functions by assessing various inputs from your environment and body to determine whether pain should be triggered. However, pain can sometimes malfunction, leading to chronic pain conditions.

Chronic Pain and Its Complexities

Chronic pain is a different beast altogether. When pain persists for an extended period, the brain and nervous system can become hypersensitive, amplifying pain signals. Dr. Zofniss explains that chronic pain often involves a complex interplay between biological, psychological, and social factors. Emotions like anxiety and depression can exacerbate pain, making it even more challenging to manage.

The Perfect Storm: Pain and Negative Emotions

For athletes, especially runners, an injury can trigger a perfect storm of pain and negative emotions. Running isn’t just physical; it’s a coping mechanism, an identity, and a source of social connections. When an injury strikes, it can lead to anxiety, depression, and a sense of loss. Negative emotions and the absence of coping mechanisms can amplify the pain experience.

How to Interpret Pain Signals

When dealing with pain, it’s essential to distinguish between acute and chronic conditions. For acute injuries (lasting three months or less), rest and repair are generally recommended. However, chronic pain often involves sensitization processes in the brain and nervous system. Over time, the brain can become hypersensitive to pain signals, causing amplified responses to non-dangerous stimuli. In such cases, it’s crucial to focus on gradual movement and activity rather than complete immobilization.

The Disconnect between Hurt and Harm

One critical concept to grasp is the difference between hurt and harm. While pain typically signals harm or danger, it’s not always the case. Chronic pain can decouple the relationship between hurt and harm. In some instances, you may experience pain without any underlying dangerous injury, or conversely, no pain with a severe injury. Understanding this distinction can reshape your approach to managing and rehabilitating injuries.

In our next episode, we’ll explore practical strategies and coping mechanisms for chronic pain, along with insights from Dr. Rachel Zofniss’s pain management workbook. Stay tuned to gain a deeper understanding of pain and how to regain control of your life despite chronic pain challenges.