Understand Pain Talk & Workshop 22nd May

Richmond at The Understand Pain Workshop

The Understand Pain Talks and Workshops are our way of getting out into communities and listening to people: the voices of society. A suffering society. At UP, our purpose is to contribute to society by showing people practical ways of reducing their suffering by living their best lives.

Understand pain and move on to live a fulfilling life

On Wednesday 22nd May, Richmond will be talking and running an UP workshop in New Malden.

This event is free, although we always welcome donations to fund our going work.

Click here to get your place

 

Training so far

Richmond Stace in Glasgow
Running in Glasgow

Touch wood things are going pretty well. Training is totalling 70-80 km per week with 1-2 longer runs, interspersed with shorter dashes and trundles. As a trainer friend said to me once, ‘Just get to the start line without an injury and you’ll be ok’. There is some truth in this of course, but with the Brighton Marathon coming up soon, followed by the two ultras in May and July, the mileage is key.

If you’re interested in running, the following  section outlines my plan. Feel free to skip on!

#upandrun ~ hashtag on Twitter to follow and tweet

Last week I set myself a plan to run 1 x 30 km and 4 x 10 km, totalling 70 km. It felt good and was easily slotted into the working week. This week I am practicing two longer runs back to back and will continue with this trend. Today was just over 22 km and tomorrow I will do a minimum of 30 km on slightly tired legs. Either side will be a few 10 km runs when I try to push the pace.

Map of Brighton Marathon

There are 5 weeks until the Brighton Marathon (Sun 14th April). The last week or so will be tapering and fuelling. Prior experience of ‘the week before’ tells me that I need a good plan. This includes plenty of mindful practice, imagery, easy movements, eating well and rest. I have found it to be a twitchy time with a unique restlessness of mind-body. This will be a good test.

Map of the Isle of Wight Challenge

Soon afterwards comes the Isle of Wight Challenge. There will be a few weeks of continued training with back to back longer runs and again the tapering a week or two before the 2-day event at the start of May. A longer gap before Race To The Stones (July) means resuming the mileage in warmer weather.

One of the pluses of these ultras is the scenery. I have been to the Isle of Wight and enjoyed the spectacular views from certain well known spots. The Challenge allows for the experience of the complete tour! That excites me. As does the route from The Chilterns, across the top of the North Wessex Downs, along the ancient path–5000 years!

Map of Race To The Stones

The Brighton Marathon #upandrun is a joint project, UP and CRPS UK. The money we raise through sponsorship, the quiz night (details soon), auction and raffle will support our on-going work to make a contribution to people’s lives and to encourage society to revise the understanding of pain.

Further, look out for the run of UP workshops. The aim is to offer these across the UK if we can raise sufficient funds. You can support us << here >> . If you suffer chronic pain or know someone who does, you’ll understand the importance of this project.

RS

Next challenge: Race to the Stones

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For some time I have been eyeing up the idea of ultra running. Having spent the past few years training for and completing several marathons and half-marathons, the urge to take it onto another level overcame me. I booked myself a date with Race to the Stones.

An old friend completed the 100k run this year. I went down to collect him and watched the runners coming in. There was such a great vibe! Much like a mini-festival; relaxed, encouraging, inspirational and lots of smiles…in amongst some pain of course!

The course follows an ancient path. We will be running and walking in the footsteps of Vikings, Romans, dragons and Kings — not in fancy dress I hasten to add!

Journey from the Chilterns to the mystical North Wessex Downs past mighty iron age forts, ancient monuments and through some of Britain’s most stunning landscapes

As ever, the run will be for Understand Pain, #upandrun. You can keep an eye on progress and other running events here and on Twitter and Facebook and Instagram.

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Race to the Stone 2019

On we go!

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Beachy Head Marathon 2018

 

UP 6 Week Programme go-ahead

There’s been a lot of work going on behind the scenes at UP. One project that I have been creating is a 6 week UP programme to be delivered to NHS patients. The beauty of the programme is that whilst the content is based upon the latest thinking in pain and associated scientific fields, the actual practices and tools are really simple.

The aim of the UP Workshop is to help people to understand (their) pain and to lead fulfilling lives. This is achieved by following certain principles during day to day living, towards a picture of success.

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Currently we are towards the end of the design phase. This involves deciding upon the content and how it will be layered week by week. Whilst the aim is to deliver knowledge, skills and know-how, we will also be measuring the effects together with a cost analysis. Such data will be important for scaling the Workshops to address the huge problem of chronic pain that exists in society (€441bn per year, SIP).

RS

 

 

Sanjay’s story of overcoming pudendal neuralgia

Sanjay on his bike has overcome pudendal neuralgia

A story of overcoming pain and pursuing a purpose

Sanjay came to see me about a persisting and most troubling painful problem that is common in cyclists, pudendal neuralgia. We worked together towards his picture of success, following the principles of the Pain Coach Programme. As ever, the focus was to understand pain and move onto live a fulfilling life.

The old tale ‘good, bad, who knows?’ illustrates the continuity of life, or impermanence, as we live life’s ups and downs. This is such a narrative here as you read about the joy of cycling, the suffering caused by the pain and the consequential limitations, the freedom of overcoming pain, the birth of an idea and the use of strengths to create something new, with purpose.

Here is Sanjay’s story in his own words.

Cycling passion

Most keen cyclists have experienced the addictive nature of being on a bike, the sense of freedom, speed and the happy effects of serotonin. I always loved riding my metallic blue Raleigh Grifter as a kid and unfortunately didn’t have an opportunity to upgrade to a bigger bike once I out grew the Grifter.

Many years later I rediscovered cycling again when my arm was twisted by colleagues at work to take part in the London to Brighton charity ride. I loved the experience and fell back in love with cycling again. My time on the bike increased and the challenges got harder.

It took a few years to build up the confidence to join a cycling club, but when I did I never looked back. I met an amazing group of new friends and inspirational people.

Saddle sore

I would generally ride a few sportives every year and managed to get a saddle sore after a sportive a few years ago. I’m not very good at staying off the bike and didn’t help the healing process by getting back on the bike before it healed properly. This led to a persistent saddle sore. After various antibiotics creams and tablets the sore still persisted. I had based most of my free time and social life around the bike so found it challenging mentally when I wasn’t able to ride.

One day at work I suddenly developed a pain around my sit bones that extended down my leg, it felt like a strange pain, almost electric and was worse when I was sat down. As if the saddle sore wasn’t enough I now had another issue to deal with.

Search for treatment

Over a period of a couple of months, I saw 5 different doctors and 4 different physios and still didn’t have any improvement or diagnosis. At times, it felt like the pain was getting worse and I was spending a lot of time on my feet to avoid sitting. Depression was starting to sink in as a result of the pain and inability to do the normal things that I enjoyed doing.

I decided to get an MRI scan done and this showed inflammation at the point of pain near the sit bone. This provided some hope so I then started treatment with a physio to treat this condition and after a couple of months the pain just got worse. Next stop was a pro-cycling team physio and doctor who both worked together to finally give me a diagnosis. It wasn’t the news I wanted to hear, a trapped pudendal nerve. Also known as Pudendal Nerve Entrapment (PNE).

I turned to Google for advice and struggled to find any good news about recovery from the condition. The doctor suggested cortisoid  injections or a powerful antidepressant with the side affect of numbing the nerves. Knowing that these options were just masking the root cause I started working with a clinic that specialised in nerve injuries including the pudendal nerve. They had knowledge of the injury and I did have some progress however after months and months of treatment, I had only around 10% improvement and still couldn’t sit without pain.

Richmond

I was very low during this time and began searching for answers again. I came across Richmond Stace’s pain physio website and something seemed different about Richmond’s treatment. I quickly booked an appointment. I walked into Richmond’s office very depressed and without hope and walked out with the belief that I could recover. Richmond had a different approach to anyone else that I had seen. He helped me understand the cause of the pain and that knowledge led to empowerment and therefore belief that I could overcome the pain. Richmond provided tools including visualisation techniques, motor pattern training and mindfulness practices.

Richmond provided a programme of treatment and adapted and progressed the plan based on my progress. I started sitting again very quickly after treatment and running again after only a few weeks. I was back on the saddle for short periods after a few more weeks and back on the road riding again after a couple of months. It felt amazing to ride again after 8 months off the bike and gradually over time the pain completely disappeared.

Pursu

During the time I was having treatment with Richmond, my contract finished so I was no longer working. Richmond mentioned a book called ‘Screw Work Break Free’ by John Williams. I quickly bought and read the book and felt inspired to pursue something more meaningful. A few years earlier I had dreamt of creating my own natural and eco-friendly cycling nutrition brand and this felt like the perfect opportunity to start making the dream come to life.

Pursu nutrition bars cycling

As I was spending more time on my bike over the years I realised that most of the sports nutrition options on the market were highly processed, high in sugars and gave me stomach issues. I started making my own bars with real food ingredients and they tasted so much better plus my stomach was much happier.

The path to taking the products from my kitchen to a manufacturer was not an easy or quick one, there were many obstacles and the ability to adapt was key. I stuck to my values throughout the process and that included only using the best quality real food ingredients, sustainability and creating an inclusive brand that inspires people to ride and get involved in sports whilst eating well.

Pursu will be launching in March 2019 and the name has been inspired by the Pursuit cycling events and represents the Pursuit of better nutrition, the Pursuit of goals and ambitions. The launch bar packaging will be 100% home compostable and is made out of bio-based materials. In addition we have partnered with a great charity called Recycle (re-cycle.org) who supply unused bikes from the UK Africa to help improve lives through the power of bicycles.

It seems like a long time ago that I wasn’t able to see a way out of the constant pain. Not only did I recover completely, an opportunity to pursue a dream also came my way. Before I met Richmond, there was little hope for recovery from PNE. I know there are other cyclists with the same or similar conditions and I hope my story provides hope to them.

You can keep updated with progress and competitions on Instagram @pursunutrition and sign up for a launch discount at pursu.co.uk.

 

 

Marathon day

The sun is not up yet, but we are. As ever, you seem to be waiting for the day, and then it is upon you.

We arrived in Eastbourne last night, welcomed by the most enormous moon as we followed the coastal road, Beachy Head on the right in the dark. In places I had to drop down to third gear to climb the hill, thinking about how we would be running those very same hills in just over 12 hours.

I am fortunate that a old pal has done the Beachy Head Marathon before. He also introduced me to a fellow runner from his club who has done it ‘5 or 6 times’. Casual. I would definitely remember how many times I had done it! So it can’t be a big deal; right? I was invited to a 20k warm up, which I politely declined. 44 is enough today thanks. The next piece of advice was gold: at the start, walk until you hear the bagpipes and then start running. This was followed with, yes, the first hill is a bastard. Righty ho!

Time to climb into the kit and grab some brekkie. There’s always something special about putting on the shirt, and representing something far bigger than oneself. You remember that the run is representative of a huge need in society and is one more step forward in raising awareness.

Look out for the pics on the way round, and maybe some live footage.

See you on the other side!

RS

Pete and I

Sharing a purpose

Pete and I share a passion and a purpose. We discovered our shared purpose over a number of conversations at dinners and conferences. More recently Pete and I recorded our chats, ‘pain talking’ (see here, here and here) to share our thoughts. There will be more to come, much Moore!

Our purpose: to change the way people and society thinks about pain. Why? Read on…

Pete Moore and Richmond Stace Pain Toolkit and The Pain Coach
Richmond Stace (The Pain Coach) & Pete Moore (The Pain Toolkit)

Today Pete is giving the Sir Michael Bond lecture, an annual British Pain Society event. The talk is unsurprisingly titled: Pain self-management; first choice or last resort? Punchy and to the point, as is Pete. And this is what the pain world, which is in fact the whole world with pain being a ubiquitous experience owned by only the first person, needs to jolt the right actions.

Pete and I could be considered outspoken, disruptive and bringers of change. However, not everyone is comfortable with change. We meet resistance. Not so long ago I spoke to a large group of mainly doctors, presenting some of the latest thinking in pain. The feedback was a fascinating mix of love and hate. Clearly some were hankering after change, recognising that the current predominant model has failed. One who only had courage with his or her feedback form accused the thinking as snake oil. I would love that person to sit in front of the likes of Karl Friston, Andy Clark, Mick Thacker and try to run with that argument!

But this is the reality. We have clinicians practicing old ways that refuse to change their thinking. This is of great concern as the millions across the globe continue to suffer (needlessly) as a result of the misunderstandings of pain. The situation must change: this is the purpose of Pete and I.

Self-management and coaching

Pete has been working tirelessly to engage clinicians and pain sufferers. He shows them that self-management is the way forward using his own story and The Pain Toolkit. An important principle that we must all adhere to is that only the person can ease their own suffering.

Whilst there can be a role for medication and intervention when chosen with good reason and used wisely, the main thrust should always be the person’s understanding of pain and what they do themselves. As I say to each person I see, you are with you all the time so you must be able to coach yourself with clarity and calm to take the best actions.

To understand pain is always the start point. The true insight into the cause of one’s own suffering unlocks the door of potential. This is why Understand Pain exists as a means to deliver the knowledge, skills and know how to society. At UP we have the vision of a world that understands pain. This would mean a huge reduction in suffering, more money available for other social concerns, people would know what to think and do, and treatment would be about encouragement of wise actions by the person.

Getting the best of people

It is always the person who suffers pain (not the body part) and hence we must think about the person and their life. And this is why The Pain Toolkit and Pain Coaching are successful in encouraging and inspiring people to live as a means to managing and overcoming their pain. Waiting for the pain to go before getting back to living just does not work. There is only this moment to take action, right now. The future never comes, so if you are waiting, it will be a long one!

Pete Moore and Richmond Stace
Richmond Stace and Pete Moore

 

Coaching and specifically Pain Coaching seeks to get the best of the person by giving them practical and working knowledge of pain. The focus is upon the person’s picture of success and how we get there step by step. All too often people think that they must just cope, get by, live with it etc. Of course, if this is your best hope then this is all that will be achieved. This is not the fault of the people. It is the problem in society — pain is a social problem. When society changes its thinking, the actions will change. Pete and I: this is our work. And we will keep going, encouraging people to understand, to use tools and practices each day and to build momentum towards a better life.

Today Pete will speak frankly. He will be entertaining, because he is, but he will hit the mark with the fact that self-management is the key ingredient. Without this there is little chance of progress.

I am thrilled that Pete has this opportunity. He deserves the stage and will undoubtedly make an impact. I will try to get there early and get a front row seat! Pete, can I wear a Liverpool shirt?

Oh, and we also both love rock n roll….

UP and running — Beachy Head Marathon 2018

Following the Box Hill 20k trail run, I fancied something along the same lines. There’s definitely something about running out in nature, up and down hills, covering different terrains, and most of all the camaraderie.

So, on discovering that the Beachy Head Marathon takes place on my birthday in October, I felt compelled to sign up to give it a go. And then my wife Jo said she would do the 10K!

On the Beachy Head Marathon, my good friend and experienced marathoner said to me, its a completer, not a competer. I like that idea. Runners of distance get it. There’s a draw to discovering what you can achieve, how far you can go, what its like to be out there for hours and to find out where your strengths and weaknesses lie.

I have only been at this for a few years so would count myself as a novice in the endurance world. However, in this time I have learned a great deal about the rewards of perseverance and how they seamlessly spread into other arenas of life. No matter which step you are taking, there’s always another. But which direction do you choose?

At school we were made to run almost every day. At the time I resisted. Why Sir, I would ask (often). What’s the point of running? I used to think running was just about, well, running. I now have another perspective. My son asks me, why do you run, its boring, why don’t you cycle, its quicker. I understand his view. He is 13.

Running distances seems to suit the middle ages; see all the ultra runners birth dates. As someone said to me, why would you want to go running for hours when you are in your 20’s when you could be out with your friends doing __________ (fill in the gap).

Anyhow, October 27th it is, Beachy Head the place. A stunning backdrop, challenging hills (up and down — I’m not sure which I prefer; up I think!), and a purpose. The purpose as you know is to share a message in society: pain can and does change starting with understanding. Regular readers will be aware of the reasons why chronic pain is the number one global health burden. I am sure that most if not all of us can think of someone who suffers daily. Think about what that is like: the way pain seeps into every corner of someone’s life. It may be you.

There is a desperate need for change in thinking in society, which will underpin the demand for the right kind of approaches to pain. We are still blanketed by methods that do not offer a way forward. This only emerges from understanding and right action. UP is all about both understanding pain and using this knowledge for right and wise action to ease suffering by living.

I am very excited. I am excited about the BHM 2018 but also because UP is now registered and ready to go. The immediate plans include the website as an immediate place of contact for quality information about pain, booklets to order and distribute, a little book of pain and online courses. We have raised a good amount of money to fund these projects but of course we need to keep this going with future funding, donations and other opportunities that present themselves. Great times ahead as we pursue this purpose!

Understand Pain

Pain in Spain

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Keynote at the Congreso Fisio 2018

IX UMH Physiotherapy Congress 2018, Alicante

There were several remarkable things about the UMH Physiotherapy Congress in Alicante last week, which I will share below. Before though, I want to state that without doubt, the organisers created a meeting that universities around the globe should seek to emulate. This was a conference that was professionally co-ordinated, filled to the brim with great and varied content, smoothly run, and was attended by an enthusiastic, passionate, sizeable group of 420 professionals and students. The success emerged from the co-ordinated efforts of many individuals, in particular Sergio Hernández Sánchez, Ellana Mckerrell and Roser Bel-lan Roldán.

I was delighted to be asked to speak to over 400 people at the main conference and then run a Pain Coach Workshop for professionals. This was an opportunity to share some of the latest thinking about the global problem of pain, and ideas about how we can go about driving social change together. On reviewing the statistics, it appears that the chronic pain numbers are slightly lower in Spain compared to the rest of Europe (16.6% and 20% respectively). Despite the mild difference, this still represents a major public health issue that needs urgent attention, with the costs estimated at 1.5% of GDP.

“The pain in Spain is mainly on the plain”

This was a conference of the highest quality. The topics, the speakers, the logistics, and the atmosphere were second to none. And what is so remarkable is that the conference was planned, organised and run by the physiotherapy students from UMH. This was as professional as it could be, and therefore the Congreso was a great success as far as I was concerned.

The Pain Coach Workshop was an UP (Understand Pain Social Enterprise) offering, allowing me to work with twenty five professionals who were keen to build on their knowledge and skills for chronic pain. The participants kindly shared their experiences and insights about chronic pain in Spain, and together we worked through a ‘lite’ version of the Pain Coach day.

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Pain definitions from the 5 minute challenge

With a handful of English speakers, we had a fantastic translation team, who really made the workshop happen. They were brilliant as we got into the rhythm of exchanges. In the three hours we looked at the vehicle of coaching as a means to deliver skills and knowledge, together with always seeking to get the best from both the individual and the clinician. From there, we considered a range of practices including those that seek to build wellness, address sensorimotor adaptations, reduce threat and sensitivity and to encourage people to live their best lives, whatever their circumstances. The emphasis of the Pain Coach is upon realising the choices we have in life and how we make the best ones to achieve success and results. The philosophy that runs through the programme is based upon knowledge, wisdom, and compassion.

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Translation in action at The Pain Coach Workshop

This was an important trip for several reasons. Firstly to make new friends in Spain so that we can build upon the successes and create future events that benefit individuals and society. Secondly, we have identified a need that we can meet together with education, encouragement and enablement at both the undergraduate and professional levels. And thirdly, we can tap into the passion that was so clearly expressed in the opening ceremony by Roser and Sergio, to move forwards in a positive and productive way.

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For information about keynotes and Pain Coach Workshops, please contact us: painphysiolondon@gmail.com

CRPS specific Pain Coach Workshop for people with the condition and their carers

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The next CRPS specific Pain Coach Workshop is coming up in Bath — link at the bottom for tickets (free). We had great feedback from the last workshop, but took note of people’s comments and extended the session. This one is longer so we can really tuck into some of the practices, and have the experience together.

The Workshop is by design a positive experience. We very much focus on what we can do and the choices we can make to lead the best life.

Together with specific practices that are important to address CRPS (and other painful problems), we will be looking at the skills that are known to be key for a healthy life. These skills are the best buffer for life’s challenges and hence play a foundation role in overcoming pain. And that is what we are seeking to do. Not ‘managing’ or ‘coping’, instead overcoming and moving to a new level.

The final part of the session is about how we can implement and integrate the practices into our life so that you can make a plan that you can follow in your world and reality.

I hope to see you there!

Click here for details and tickets