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Hey fellow athletes!

Have you ever seen a child screaming at the mall or park? 

Did you think they just broke a leg?

…but really they’re just hungry or tired?

Thats because a child’s emotions are expressed without a filter.

As we mature, we develop a filter. This filter is shaped by our family, friends, and our personal experience with injury. This can affect how we feel pain. 

This is because our own response to pain is altered (filtered) by our perception of the pain.

Many things can filter the “pain experience”

Do you remember the last time you were injured? Did you laugh? Cry? Call a friend? Or rub some dirt in it?

How did your friends and family respond when you were injured as a child?

Did they take you outside, hose you off, and tell you to get back to playing?

Or did they respond by coddling you, preparing band aids & placing a warm towel over your head?

Don’t get me wrong- if you’re bleeding all over the place or have a bone sticking out of your arm- that is clearly something that needs attending to…

As an emergency medical responder I’ve attended a LOT of bleeding injuries at tournaments and practice!

One persons response to pain might be worlds apart from another person even with the same type of injury.

There are many techniques to address pain. Some interventions include biofeedback, physical therapy or even psychological therapy in some cases of chronic pain.

For the rest of this article will discuss a physical therapists perspective on the pain experience and how we can work together to resolve it.

So, how does the pain experience tie into treatment of patients?

My experience working with athletes from the performing arts at Celebrity and Royal Caribbean cruises, combat sport athletes, crossfit athletes, obstacle course racers or just the every-day gym goer who is looking to stay fit & healthy, has shown me that a big part of the pain experience can be addressed with physical therapy.

While pain relief may happen relatively quickly (on average of 6 sessions), the actual healing of the injured body part might take  a bit longer.


Now, this does not mean you will have the same level of pain you initially felt throughout the entire healing process. Usually after the swelling goes down & some properly prescribed exercise, you will feel significantly less pain, more movement and greater strength.

Remember that pain is a personal experience, not a reflection of actual tissue damage.

So… How does that pain relief happen even if the tissue is not 100% healed?

What we need to discuss is a three step process of what happens when you’re injured.

First. Your brain receives signals that some type of tissue damage occurred. 

Torn tendon, ligament, broken bone etc… 

Second. Your brain then tells the muscles in that injured area to reflexively contract to protect the joint from further damage.

Its a protective mechanism. And thats ok for a short term response- so that you do NOT make matters worse!

Your brain is smart!

But problems come up if this has been going on for longer than the healing is taking place. The muscle can waste away, and so can the bones, tendons, ligaments and even your nerves!

That is not a good thing!

Third. Your now-constantly-contracted-muscles pull on the bones differently. The joints will not move as smoothly. This can cause premature contact with the bones that are part of the joint.

This can result in additional pain, sending signals back to the brain to maintain excessive muscle tension leading to poor joint movement.

And now that you can’t move your arm or leg as well, your brain starts to literally rewire itself!

Brain: Lets lift the arm up to get that cup

Arm: Lets do it!

Pain: NAH, don’t think so!

Brain: Ok, we’ll just keep doing it your way Pain

Arm: Well this sucks…

This injury cycle can cause painful contact of bones, tendons, ligaments, bursa or labrums.

Supraspinatus impingement (pain in the front of the shoulder when reaching overhead) or femoracetabular impingement (FAI, pain in the front of the hip when squatting, lunging, or otherwise bringing the knee to the chest) are two very common injuries I have successfully treated over the years.

Shoulder impingement is very common in overhead athletes like volleyball, baseball, swimming as well as crossfit & Olympic lifters.

So you get this “recycling effect” of pain leading to abnormal muscle recruitment that causes poor joint movement which in turn tells the brain that something is going wrong because theres this *pinching* pain in that area… 

This vicious cycle needs to be stopped, and it can be addressed at any one of these steps:

Muscles can be relaxed, which will help relieve tension on the joints, restoring normal movement patterns.

This can be done with stretching, exercise and manual therapy including massage, mobilization of joints or foam rolling. 

Joints can be mobilized or manipulated, kinesiotaped or blocked. This will affect how and where the joint will be “moved” to.

Brain-training, or coordination exercises can help restore the brain-body connection. This can be done with mirror therapy, biofeedback, or even visualization practices.

Many of these techniques can be coached & patients can be taught how to address their own pain or limitations. This leaves them in the drivers seat. The owner of their destiny.

If you want to end your pain, improve your strength & movement- give us a call and we can help you get started.

Ready to get rid of your pain and return to a healthy & active lifestyle?

Call now to set up a complimentary assessment.


Dr. Cory Abbate

Doctor of Physical Therapy

BS Exercise Science

Certified Orthopedic Manual Therapist

Emergency Medical Responder

13944 SW 8th St STE 202

Miami FL, 33184



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