ARTICLE: Injured? Blame René (Descartes!)

When my famous namesake put pen to paper to write his “The Description of the Human Body” (1647), he likely had no idea that some day he would be made partly responsible for the injury crisis sweeping the world of fun running as well as competitive running. Yet his idea that there is a separation between mind and body, what we call “dualism”, and that the mind does not follow natural laws, still causes confusion today and presents a barrier to understanding that runners need to overcome to heal themselves.

“It’s the mind, mate”

Flash-back to Gloves Boxing Club, London, last Autumn: I’m trying to go into a deep squat but a burning pain in my right knee prevents it. “There’s something wrong with my knee,” I say. “It’s in your mind, mate",” Tony Riddle replies and moments later proves his point when I jump from a step into a deep squat with no issues.

What just happened. I ponder but then it becomes obvious. Whenever we have pain (burning sensations, numbness, sore spots etc.), we immediately attribute it to a structural physical breakdown or generation of tissues or the presence of some damaging object in the area (damaged bone, foreign objects, a thorn). This is one reason “nerve damage” feels so scary to us – we cannot identify a “culprit” that causes the pain.

So when we are told, as I was, that my pain is caused by my mind, we instantly recline a bit from the argument. “Woo-woo”, we think (ghost stories), and begin to wonder if the practitioner in front of us is a mystic. We can blame Descartes for this reaction because once someone says “brain” or “mind” we somehow think “unscientific”. The reality has since been proven to be very different and as runner we need to understand this to help get to the true source of most chronic injuries.

No degrees of separation

Recent advances in neuroscience, notably those by erudite author Sam Harris, have shown conclusively that no separation exists between mind and body. Dualism is dead. Your mind is entirely physical and is at the centre of all physical interactions in the body.

So, when you feel pain in your right ankle, your mind is responsible for that sensation, either directly or indirectly. There is nothing mystical about it. But what does it mean for injury treatment and prevention and why does the mind do this? First, we need to understand the role of the mind in the body.

Because the mind is part of the physical body everything that happens to the body affects your mind this includes stress, poisoning, cosmic radiation, being hit by a blunt object, the food you eat and the things you do. At the same time, the mind, or brain if you prefer, controls everything that happens. It regulates temperature, it sends out inflammatory and anti-inflammatory responses, nerve signals and maintains certain levels of different chemicals in the body.

To take a simple example: a stressed mind will trigger different physical processes than a non-stressed one. A frightened mind will tense up different muscles than an aggressive mind. These reactions are generally in the subconscious and primitive parts of the brain and your conscious mind may or may not be aware of them.

A mind-focused approach to injury

So how can we trace most common running injuries back to the mind? First we need to understand the basics of a discipline of medicine called “evolutionary medicine”. Parts of this branch of medicine deals with how the body (this includes the mind) chooses to defend itself against threat. If you catch a virus, the body will try to “fry it out” by triggered a fever. If you rupture a muscle or tendon, the body will inflame and immobilise so healing can occur. If you are constantly stressed and taxing your adrenal glands too much, the body will shut them down enforce rest. Should you overheat during exercises or be pushing your muscles to a dangerous limit, the body will turn off motor neurons in the muscles.

All of this is regulated by the mind. Unfortunately, these defensive responses can malfunction. One example of autoimmune diseases but a more common is fevers progressing to lethal levels – in order to kill the infection, the body kills the host.

So when Tony Riddle told me that my problems originated in my mind, he was not calling me delusional or  labelling me a hypochondriac. Rather, he tried to point out to me that the pains in my ankles and in the knee were defensive reactions triggered by the mind. But defenses to what?

The threat of movement

The human mind always seems to maintain something called “homeostasis” which just means maintaining a stable internal environment where the organism functions ideally. Once infected with a disease, for instance, homeostasis comes under threat and the body will respond to restore it.

When you put yourself under threat, a similar thing happens. Picture this: you tape up your battered ankle, place your custom-made orthotics into your newly bought ASICS Kinsei, strap on your compression socks and go for a run. One thing is troubling your mind: the pain you have been feeling in your ankles. Nervously, you start running. Because you are wearing thick soled shoes, and besides, you sit 8 hours per day so running is not really natural to you any more, your heels keep striking the ground on the outside and huge rotational forces work to stabilising you with each stop. You instantly feel some discomfort but try to breathe through it and relax yourself. It doesn’t seem to be working, the pain is slowly intensifying and now you are getting anxious. You try to modify your gait, forcing yourself to land differently on the foot, away from the source of pain. Eventually, it’s too much, you walk home and decide you need a break from running. The next day you get an MRI scan done. It shows some mild signs of inflammation but nothing else. Yet you are in pain. What is happening?

Stepping back through this scenario: firstly, you went into your run with a stressed system. Stressed from the anxiety of a known pain and stressed because a body that is used to sitting down most of the day is suddenly asked to handle the forces involved in running and the extra metabolic cost. By definition, the mind is now already on the defensive, as it wants to remove the extra metabolic cost and reduce the stress. But it get’s worse…

“Stop doing that!”

The moment you take your first step in a shoe such as the Kinsei, your mind is robbed of proper input about the ground beneath it and cannot compensate properly for the forces involved. Suddenly, the heel joint is subjected to greater forces than it was designed to handle. Making matters worse, someone with very poor technique, will cause all such of stress on joints that they were not designed to handle.

Unlike your conscious mind, your unconscious mind picks up on this immediately – it perceives an imminent structural threat from incorrect use of your own body. So the mind does what it has developed over millions of years to do: it defends itself.

Step one is to send pain signals to any weak and threatened point. This is your “orange flag”, your mind telling you “stop doing that”. Keep doing it long enough and the mind raises the red flag, e.g. “ok, the party is over, we’re closing down”. Now you are saddled with a chronic injury that will be labelled achilles tendinitis, posterior tibialis or something similar. No matter what you do, the pain often will not go away.

Every time you try to return to running, the pain is there. As you get increasingly depressed and anxious, symptoms seem to worsen. You are now in a vicious circle. The mind will not allow the joint to be used improperly until the perceived threat is gone. Calcification of an area will remain calcified as a protective measure. An inflamed area remains inflamed, the normal anti-inflammatory response not being triggered. Why would the brain be so stubborn?

The answer lies in correct movement: if you can move correctly, then the threat to the joint disappears. Sometimes, the fear that you have developed, of the pain you feel, takes a while to work out of your system, even after your running style has developed to a point where their is no longer a structural threat coming from your old incorrect movement patterns.

This phenomenon is called “psycho-motive” and all it means is that fear is a form of tension and until you overcome the fear it can impair your motor skills. Luckily there are several known treatments to teach your subconscious, and conscious, mind to relax again, but you need to understand this logic. If you don’t understand it, getting the confidence to work through the pain in the correct way and say goodbye to your fears becomes very difficult because you always carry around the question in your mind “but what if it breaks”.

But my leg is really gone!

So is it “all in the mind”. No, obviously structural damage does occur. Bones break, ligaments tears, muscles rupture or worse. You cannot regrow a lost limb using your mind, of course, the mind is part of the body, unlike what Descartes thought, and thus obeys the laws of physics. The mind can turn off inflammation in a joint, it can release the necessary chemicals to break down calcified tissue, it can increase blood flow to an area and it can turn off tension in muscles. It can even heal all but the most catastrophic physical injuries if given the right time and environment. Most common running injuries such as mild tendon tears or stress fractures will heal within 6 weeks. As a rule of thumb, if it does not heal within six weeks, you are not dealing with a physical injury but rather you are moving or living (or both) in a way that forces the body to defend itself. Until you take notice of its lessons, pain is the result. In a certain way, you are at war with yourself. You conscious mind wants to go ahead, but your subconscious mind knows better.

The first step in healing yourself

Accepting this as a fact will take you a huge step towards injury rehabilitation and in leading you to the right cure. Injections, surgery, pills and other traditional treatments cannot offer a permanent solution if you understand this paradigm. As long as the threat remains, the mind will eventually reactivate the defense response, the “mystery pain”. Bridging this gap in my own understanding was the key to accepting Tony Riddle’s methodology when I met him in London. Perhaps because my personality requires intellectual understanding and conviction, but for anyone, even those who are happy with blind faith, it does not hurt to understand the real pathology of injury.

Unfortunately, this is as far as I can take you in this article. Removing the threat that your mind is perceiving takes a dedicated effort and a neutral observer to identify the specific problems you have. The final step is identifying the drills that will correct the issue and then for you to go do them!