Good vs. Bad Movement

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Good Vs. Bad Movement

Is there such a thing as good or bad movement?

Is it a good idea to label movement in this way?

Can defining movement in this way contribute to fear of movement?

Think back to the last time you became injured while performing a specific activity. Can you recall the details of the event? Likely yes. Can you describe the exact motion that brought on your pain? Probably. You may have thought, “I hurt myself because I didn’t pick up that box correctly. I’ll make sure not to do it that way again.” When events like this happen, our body makes sure to file such important information away in our minds. This pain memory is protective, and designed to help us avoid such painful events in the future. However, when we start to label movements as good or bad, we also influence our brain’s perception of pain, and can in turn contribute to fear avoidance behaviors (1-3).

As a movement professional, I help people understand their current movement patterns and educate them on how to improve their efficiency through therapeutic exercises and movement re-education. It’s my job to educate people how to move well in order to recovery from injuries and decrease risk for re-injury. In this process, I am very thoughtful about how I discuss movement and movement patterns. I don’t believe in defining movements as “good” or “bad”. I prefer the labels “more efficient” and “less efficient”, and encourage such relabeling with my patients. This is especially important when working through pain and regaining confidence to get back to the activities that originally brought on someone’s pain or injury.

When we are fearful of certain movement patterns, our sympathetic nervous system (fight or flight response) becomes heightened, and our brain’s perception of pain increases (1). If this response is not re-educated, the brain’s pain memory becomes altered, and fear avoidance of particular movements becomes the new normal (1-3). In this case, simply thinking about what was once a painful movement can cause someone to be fearful, increasing feelings of anxiety when they are asked to perform said movement, which in turn heightens their perception of pain even before their body has even attempted to move. If we avoid a movement for too long, the brain naturally holds on to the belief that it must be “bad” and therefore “avoided” out of a fear of needing to protect. This negative feedback loop feeds into chronic pain as a result (1-3). Such pain perceptions become difficult to unpack in these longer term cases since the brain’s interpretation of pain has now become less reliable. The pain baseline has been elevated as an anticipatory response instead of needing to protect an injured area during a particular phase of healing. Thus, gradual reintegration of movement needs to be introduced throughout the recovery process in order for our nervous system to learn how to feel safe, and let our body relearn how to build more efficient movement patterns as a result.

Fear avoidance is common after incurring an injury. It’s totally normal to feel afraid of re-injury for a period of time. However, long term feelings of such fear can prevent us from gaining the confidence to participate in activities that bring us joy and connection with others. If you have been avoiding certain movement patterns out of fear of re-injury or pain, movement professionals like me are here to help. Consult with your local physical therapist today! Such fear and anxiety does not have to be one’s “new normal”. Movement is the best medicine.

Sources: 

  1. Vlaeyen, Johan WS, and Steven J. Linton. “Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.” Pain3 (2000): 317-332.
  2. Crombez, Geert, et al. “Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability.” Pain1-2 (1999): 329-339.
  3. de Jong, Jeroen R., et al. “Fear of movement/(re) injury in chronic low back pain: education or exposure in vivo as mediator to fear reduction?.” The Clinical journal of pain1 (2005): 9-17.

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