Pain is part of the human condition. During our lifetimes, we all experience a few episodes of acute physical pain. Not many of us will escape the kind of pain we feel after stubbing a toe, spraining an ankle, or stepping barefoot on a piece of glass. But fortunately, for most people, acute pain tends to be as short-lived as it is severe.
This type of pain is normal; it’s healthy pain. Healthy pain is an indicator that something is wrong or is doing damage to our body. Healthy pain is part of an essential warning system—without feeling the sharp pain that accompanies a broken limb, for example, we would carry on using it until we caused even greater damage. So in situations of injury, pain functions as a protective alarm, warning us that our house is on fire and we must take action to save it. Once the fire is out—once the broken bone has healed or the torn muscle repaired—the pain should recede.
This acute pain is completely different from the type of pain that comprises four of the top 10 reasons why Americans consult doctors and other health-care providers: chronic pain. Often, chronic pain is the fire alarm that won’t shut off. This enduring, unrelieved pain is a major global health-care problem, a disease in its own right. For sometimes mysterious reasons, this pain may start gently but, over time, become stronger and stronger. We might visit several different doctors in our search for the cause of the pain, but the truth is, many times the root cause is easily overlooked. It may be something as simple as sitting hunched in front of a computer all day. Or that bicycle accident we had a decade ago. Or something else—we often just don’t know.
PAIN AND DEPRESSION: A TWO-WAY STREET
Pain and depression tend to go together, for both biological and psychological reasons. When you’re in pain, you understandably tend to feel more depressed; when you are depressed, your body actually has a heightened sensitivity to pain. The factors involved are complex and often misunderstood. For example, imbalances in certain neurotransmitters, such as serotonin and norepinephrine, are linked to both depression and pain—a fact that can lead some to believe “it’s all in the head.”1 But both conditions are also characterized by systemic inflammation, a risk factor for heart disease, diabetes, and many autoimmune conditions. And research has proved that the worse our painful physical symptoms are, the more severe any related depression tends to be.2
We need to take this connection extremely seriously. In a recent review in the journal Current Psychiatry Reports, Scottish researchers found that up to 50 percent of chronic pain patients also suffered from depression related to the pain, and 17 percent suffered so badly that some days they wanted to die.3 A Canadian study found that people living with pain had double the risk of suicide, compared with people without chronic pain.4
These statistics are tragic to me. People need help, right now.
The program in this book can help you recover both mentally and physically; exercise is a proven remedy for both pain and depression. But please be gentle with yourself and realize that sometimes exercise is not enough. Be sure to talk about your physical and emotional health with your doctor; getting the help you need for either pain or depression will automatically help both.
None of the standard medical approaches are designed to permanently relieve non-disease-related chronic pain. It seems to persist even with visits to massage therapists, physical therapists, osteopaths, chiropractors, and other specialists. These passive treatments feel good and provide temporary relief—but the pain usually returns within hours.
According to the National Institutes of Health, chronic pain is the most common cause of long-term disability in the United States. Chronic pain is a life-altering, life-limiting daily state for one in five U.S. adults. The American Chronic Pain Association lists lower back problems, arthritis, repetitive stress injuries, headaches, and fibromyalgia as some of the most common sources of pain.
The price tag of chronic pain is staggering. In the United States, the cost of chronic pain in adults, including health-care expenses and lost productivity, has been estimated at $560 billion to $630 billion annually. (That’s billion with a b!) Then there is the incalculable toll on individuals and families. A survey of almost fifty thousand Europeans found that 27 percent of chronic pain sufferers said their pain made maintaining their relationships with family and friends very difficult, if not impossible.5 Chronic pain sufferers experience deficits in all kinds of cognitive functioning, including perception, thinking, reasoning, and memory. According to the European Journal of Pain, 61 percent of those with chronic pain are less able or simply unable to work outside the home because of their pain.6 One Canadian study found that arthritis pain shortened sufferers’ working lives by an average of four years.7
Sadly, due to their inability to diagnose or treat so-called mechanical pain (or non-specific musculoskeletal pain), many doctors believe that some degree of pain is normal and that we should be prepared to tolerate it. And millions of people do just that, year after year. Too often people turn to doctors who have little training in pain management and who tend to freely prescribe drugs, including opioids, in response to complaints of pain. Even if you put aside the serious risk of overdose and death, opioids can also increase the risk of accidents, disrupt your periods (if you’re a woman), lower your sex drive (whether you’re a woman or a man), trigger sleep apnea, cause constipation, and contribute to heart and lung problems. Many doctors simply aren’t educated about the risks. In fact, a recent Canadian study found that veterinarians receive five times more training in pain management than medical doctors do.8 And a European survey of patients suffering moderate to severe chronic pain found that one in four patients said their doctor never asked about pain or, if pain was discussed, the doctor did not know how to treat it.
I am not a doctor—but I am a firm believer that the topic of pain should be a routine part of our health checkups, and that we should expect our doctors to be able to offer solutions beyond medication. Living pain-free should be a human right. The preamble to the World Health Organization’s constitution—which was adopted in 1948 and has remained unchanged ever since—defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”9 I agree wholeheartedly with this view—it’s the only way that pain is going to get the respect, attention, medical research, and treatment options it deserves. Unfortunately, many research dollars dedicated to investigating pain are focused on pharmaceuticals, not long-term relief. But we don’t have to wait for the medical establishment to catch up—we already have plenty of evidence that our bodies hold the keys to a pain-free life.
Our Body’s Built-In Pain Relief
Traditional approaches to anatomy and health have taught us that the human body is the sum total of many independent systems:
The brain and nerves function as our nervous system.
Muscles, bones, and soft tissues comprise our musculoskeletal system.
The glands and organs that regulate our hormones make up our endocrine system.
The heart and blood vessels, which pump blood and oxygen to every cell in the body, form the cardiovascular system.
The organ systems, combined, are the engines of life.
Every moment of our lives depends on the complex interaction of these systems. And for a long time, the connective-tissue system—the bands and sheets of fascia under the skin that attach, enclose, and separate our muscles and organs—were seen as the supporting structure for the other systems, which did the real work of keeping us alive and healthy. But the more we learn about the integral role that fascia plays in our overall health, the more we’re starting to see that the best way to keep all of these systems functioning properly is to keep connective tissue healthy, strong, and flexible. The closest thing that we have to a universal cure-all is regular exercise with correct form.
Every bite of food we eat and every thought we think creates a ripple effect within the body. We know that if we eat refined carbohydrates, for example, our pancreas will release more insulin to help our cells absorb the sudden increase in blood sugar. On the flip side, we also know that if we take a moment to pause amid a stressful day to take a few deep breaths, our circulatory system will carry extra-oxygenated blood up to the brain and to all of our muscles, helping us feel calmer, sharper, and more energized.
In much the same way, each time we twist or turn, bend or lift, the stretching triggers changes in our connective tissue, and different messages start careening throughout our body. Doctors used to believe that many of these messages were carried exclusively by the nervous system, but new theories suggest that connective tissue also plays a critical role in this messaging network. Because not only does our connective tissue support our musculoskeletal system, it also provides the actual building blocks of our organs. Researchers now believe that this tissue could function as its own “meta-system” within the body, constantly connecting with various regions and coordinating the messages and activities of each bodily system.
Most of us have never given much thought to our fascia. We may have a vague idea that fascia fills in the gaps in our body, but new research suggests that this connective tissue is not passive at all. Recent studies by Dr. Helene M. Langevin, director of the Osher Center for Integrative Medicine (jointly based at Brigham and Women’s Hospital and Harvard Medical School) and a professor of neurological sciences at the University of Vermont, have found that connective tissue not only lengthens and changes in response to pressure from the outside—such as stretching or the insertion of acupuncture needles—but also lengthens and reorganizes itself from within. Dr. Langevin’s studies have shown that when needles are inserted into the collagen of the fascia during acupuncture, connective tissue “grabs” the needle and twists around it. Then, a few moments later, fascial cells located a few centimeters away from the needle extend and fundamentally change their composition in response.
Let’s take a moment to let that sink in: not only is this tissue being moved by an outside force—it is also moving and stretching and changing itself from within.10 Amazing, right? The idea of self-stretching tissue suddenly makes our fascia seem a lot more active and dynamic—and essential to our health—than we once assumed.
While it’s incredible that connective tissue has the ability to react to movement, the only way to trigger this self-healing reaction is just that: with movement. The more we learn about Essentrics, the clearer it becomes that this type of exercise is exactly what our connective tissue needs to facilitate internal changes. And perhaps most exciting of all is the idea that these changes may actually be a self-healing mechanism that the scientific community has been trying to pinpoint for centuries.
Sound far-fetched? Consider some other self-healing mechanisms in the human body that we take for granted:
If we cut ourselves, the wound will eventually close and the skin will grow back.
If we break a bone, it will fuse itself back together once it is set properly.
If we get a cold or the flu, our immune system will send in white blood cells to fight off pathogens and we’ll recover after a week or two.
We know that our body holds the ability to heal itself. And we also know there are things we can do to help support its healing processes, and things we can do to hurt it. We know that if we slather a cut with an ointment and cover it with a bandage, we’ll protect it from infection. We know that if we rest and elevate a broken bone, allowing our circulatory system to carry nutrients and waste products to and from the site of the injury, it will heal faster. We know that if we eat healthy foods and drink plenty of water, we’ll give our immune system the tools it needs to fight off viruses or bacteria.
We take all this for granted—but we haven’t made the same connection between movement and healing our pain. We don’t yet fully realize the power we have to control and cure our own pain. Just as we can encourage our body’s other self-healing processes through small steps of self-care, so too can we encourage the body’s pain-healing processes with small doses of gentle movement.
When you understand how the body works, even on the most basic level, you see how the choices we make can either accelerate or prevent healing. I believe so much of the chronic pain that people are suffering right now could be greatly reduced or eliminated simply by understanding how we can tap into these self-healing mechanisms with gentle, correct exercises. Not only will this help us stay vital during our normal life span, but by practicing specific exercises, we can continue to extend that life span far beyond the one we’ve come to see as normal. But we must act now—without proper exercise, our life span may actually be shrinking, due to our current lifestyle choices.
Pain Can Age Us
We see the signs of “normal” aging all around us—poor posture, lack of energy, diminished vibrancy, unexplained weight gain, osteoporosis, arthritis, and chronic pain. Most of us—including myself, until recently—have begrudgingly accepted chronic pain and muscular atrophy as normal parts of aging. But now we know better: Neither chronic pain nor premature aging (which is often caused by pain) is really normal. Both can be greatly prevented with simple movement.
In my first book, Aging Backwards, I described the results of a groundbreaking study conducted at the University of Pittsburgh in 2011. Using MRI measurements of the muscle tissue in forty high-level athletes, researchers discovered that the lean muscle tissue of a seventy-four-year-old triathlete was exactly the same as the lean muscle tissue of a forty-year-old triathlete with a similar exercise program. The study showed that one of the primary markers of aging—loss of muscle mass—could be completely controlled by movement, and thus that loss of muscle mass is not a guaranteed fact of aging. In fact, the researchers discovered that what was previously considered aging was actually just muscle atrophy.
This study proved my long-standing belief: We are only as old as our muscles are inactive.
A lack of full-body movement tells our cells that they are no longer needed, setting off a chain reaction of cell death. This domino effect gradually impacts all of our bodily systems, weakening our muscles and shutting down our major organ systems prematurely. But if we use the right types of exercise to maintain our muscle mass into our later years, our entire bodies—even those pesky joints that typically fail us first—can stay healthy until we are well over one hundred years old.
But when we do the wrong exercise—well, that can be almost as bad as not exercising at all.
When Exercise Ages Us
Movement is a gift, our very own personal health-care system. Yet because our culture has not traditionally recognized the absolute necessity of movement in the essential maintenance of life, we approach exercise in a disjointed and uneducated fashion. Because we have a limited scientific understanding of what our bodies receive from us when we exercise, we tend to follow a Wild West approach. Some people do a lot of exercise; others do none. Some people follow the fitness fads; others just do whatever their friends are doing. Some people even choose the most challenging program available and train like maniacs, believing that their hard work will reward them with peak physical fitness.
The gung-ho approach may seem consequence-free when we are young and relatively fearless in our twenties and thirties. This means that, unless we learn how to properly exercise early on in our youth, we are innocently yet actively injuring ourselves, aging our cells, atrophying our muscles, literally shrinking away—without even knowing it.
From a diagnostic perspective, it is often impossible to understand why one person is in pain while someone with the identical condition is not. To make matters even more confusing, consider this: There are some people whose X-rays indicate major spinal degeneration, and who normally would be in pain but are in fact pain-free; however, there are others who express extreme pain but have X-rays indicating no spinal degeneration. A possible explanation in the subjective experience of pain may be linked to the fact that some people have more or fewer nociceptors, sensory nerve cells that form the basis of the pain messaging system. Other differences in pain perception are related to levels of depression or stress (see page for more information).
But over the course of a lifetime, no one is immune from pain.
Through our many years, we will inevitably get sick, break a bone, or twist an ankle. We will all experience some degree of illness and pain. And as we know, acute pain is a normal, healthy signal of distress in the body. Yet we should certainly never consider it “normal” to endure chronic pain for months or years. Nothing ages us faster than constant pain and suffering.
Before we let ourselves feel the first creak or ache, we should start protecting our bodies with correct exercise. But even after decades of pounding your joints in intense workouts, Essentrics can help turn back the clock on your body—and turn down the dial on your pain.
The Essentrics Difference
With our fragmented approach to health, we often forget that the body is one unit, and every cell—from blood to nerve, from skin to bone—is talking to every other cell, all at the same time. The simple and profound brilliance of our body’s interconnectivity cannot be overstated: Everything we do, both right and wrong, is registered in our body. Every movement counts. When we truly accept and understand this, we can make simple changes that will help us maintain vibrant, healthy bodies; but when we ignore this, we are at the mercy of accelerated cell death and a possible future of chronic pain.
Knowledge gives us a choice: we can begin to completely reroute our body’s destiny with just a few small changes. And that’s what I want to share in this book—the knowledge that will set you free from your pain. The Essentrics program is scientifically designed to keep our bodies well balanced and healthy at any age. The exercises are easy to do, take only about 30 minutes a day, and are appropriate for anyone who is seeking a drug-free, sustainable approach to pain relief. Unlike pharmaceuticals, my program has side effects that are actually beneficial and health-promoting: lowered stress; increased energy, strength, and endurance; improved mood; better sleep; and greater physical flexibility. People at any level of fitness—from those who’ve become completely sedentary to elite world-class athletes—have found tremendous pain-relief benefit from Essentrics.
Are you surprised to hear that both completely inactive and highly active people can use the exact same program to get results? Well, here’s the dirty secret about a long-held yet mistaken belief that continues to infect the fitness field: The classic “no pain, no gain” approach should be abandoned in favor of “any pain, no gain.” Imbalanced physical activity has left many avid athletes nearly incapacitated in middle age. Imbalanced muscles are a universal risk factor for pain, whether you’re a new mother who carries her ten-pound diaper bag on only one shoulder or a competitive bodybuilder whose massive pectorals are the envy of the gym.
The Essentrics approach is “no pain, ever.” By following a program whose main focus is correcting imbalanced muscles, you can teach your body how to do all the activities you love to do more easily and fluidly, without ever holding on to pain. Active people can continue to enjoy sports like skiing, golf, or tennis for as long as they like, pain-free. Formerly sedentary people can regain the joy of movement, heal their back or sciatic pain, and build endurance. Overworked executives can release tension headaches and shoulder pain, and have more stamina and mental acuity. With these exercises, anyone can continue to safely participate in the activity of his or her choice—simply by maintaining a well-balanced body in 30 minutes a day.
A FEW CAVEATS
While we will all experience pain at some point in our lives, everyone’s pain is unique. There are some types of pain that Essentrics is not able to address—namely, pain caused by congenital, genetic, or other non-lifestyle-based diseases.
While I am evangelical about the healing power of correct movement, I also know that there are many afflictions for which movement is not enough. Many diseases are painful—of course they are! Pain is the body’s message, warning us that something is wrong. There are many diseases that arise from chemical “imbalance”—such as cancer, inflammatory conditions, blood disorders, and organ failures—that cause extreme pain. Exercising cannot cure this type of pain, as it is not caused by mechanical flaws.
In fact, most disease is not mechanical, but chemical. And as far as we know now, exercise works on the mechanics of the body, not the chemistry. But research is digging into potential mechanisms that might bridge this mechanical-chemical gap, and we may soon learn exactly how exercise can, in fact, help prevent and even cure some chemically based diseases. So stay tuned to these studies becoming more public. But for now, please understand that pain related to chemically based disease must be relieved through treatments given by medical specialists, not fitness instructors. (See the appendix for other healing modalities that can help relieve pain.)
These were lessons I had to learn for myself—the hard way. I, too, have a long personal history of chronic pain. It was only after I’d turned forty that I began to experience the painful toll of the many years I’d spent as a professional ballet dancer. In response to my own pain, I created this approach—and since then, I have been pain-free. As I write this book, I am sixty-six, and I feel even fitter than I did in my thirties. I never want to go back to those years of chronic pain—and, thanks to the gift of Essentrics, I know I never have to.
Exercise Is Medicine
When I developed Essentrics, my objective was to create a safer, gentler, less aggressive method of becoming fit by providing an alternative to the hard-core workouts that had permeated the market—and still do! As a technique, Essentrics is the antithesis of pumping iron and pounding the pavement; it’s slow and gentle, simultaneously stretching and strengthening all 650 muscles in the body as it rebalances all 384 joints.
Almost immediately after I began teaching this method, my first group of students began to share what have since become its two most often cited benefits: I feel so much younger when I do this and I don’t feel as much pain when I do this. Fast-forward almost two decades, and the combination of anti-aging and pain relief has become the sole focus of my life. Over that time, I’ve seen firsthand how Essentrics relieves the most common pain conditions that are presumed to be related to aging: back pain, plantar fasciitis, fibromyalgia, arthritis, and osteoporosis, among many others.
Now, after teaching and hearing from thousands of pain-free students, I have become that much more convinced that the chronic pain that plagues millions worldwide is completely unnecessary. All we need to do is give the body what it needs: a short, gentle, daily workout of pleasurable lengthening and strengthening movements. That’s it!
The human body is a very complex machine, but in its purest state, it is designed to be free of pain. Let’s take a closer look at our fascinating biology—how the pain reflex is intended to work, how our connective tissue holds on to it, and how we can use Essentrics to heal it once and for all.