There is a purpose for my ultrarunning, and it is mainly to share hope.
You may have seen the tagline I was using for the September upandrun: ‘ultrarunning to understand pain and share hope’. Here is why.
Ultrarunning to understand pain
Running for long distances means being on your feet for hours, moving along. On the journey, you discover much about yourself — you find out what is under the hood.
Under normal circumstances, we use our resources to deal with challenges as they arise. Life is full of uncertainty (more than certainty), twists and turns. That is the way.
What we can do is to focus on controlling the controllables. What can we control? Our approach and attitude.
Suffering comes from the way that we think about any given situation. Prior to this, it is merely a situation. This has long been realised by philosophers and others.
Life is a journey — cliche yet true. How do you approach the journey? How do you deal with things when they don’t go your way? The style that you use will determine whether you see it as an opportunity (to learn) or an obstacle?
Ultrarunning is the same. You set out on a journey that will be full of unknowns. When you are trotting along and feel great, it is wonderful. What about when you are in pain, feel sick, are hit with fatigue and hunger and thirst and more? How do you respond? How do you keep going?
The concept of the pain cave describes the place you can go. It is dark.
But, there is ultimate learning about oneself in the pain cave to the point that many embrace the experience.
Pain is inevitable on an ultra.
You become your own experiment (n=1) as you examine your perceptions and thoughts shaped by the very actions you are making. When you change the way you move, your thinking changes — embodied cognition at work. Thoughts are very much grounded in the state of our body, and the state of our body is determined by the focus of our attention. Expectations also play a significant role — we see the world that we expect to see.
As inevitable pain emerges, the opportunity arises to closely examine the sensations and how they change. Different perspectives and different language all shape the experience. Noticing a shift in running pattern, perhaps leaning forward or the head dropping, one can lift and be taller to notice the change in perspective.
What is the story I am telling myself in these moments? If I alter the words, what happens? I notice how attached I am to that particular narrative and how easy or hard it is to let it go. Bringing my purpose to mind, or a loved one and there can be a sudden transformation of state.
Heavy moments are normal. Body, legs, head suddenly feel like sacks of wet sand — have you ever tried to move one? But you know that this will pass, like all perceptions. Nothing is permanent. This insight alone pulls me back from the mire of thoughts.
Our perceptions and bodily sensations are dynamic — always changing. Life is not static, instead fluid and moving onwards. It is the story that stays the same. The one we have been conditioned to believe is true.
Then you realise that there are infinite stories and possibilities. Freedom.
Ultrarunning teaches you about freedom.
I can examine my own experiences under duress and elucidate my resources my journey continues. The finish line is of course the beginning of the next.
My message is one of hope.
Both the knowledge of pain and what we can do to guide, support and encourage people to live fulfilling lives has grown enormously.
We have much better answers to the questions (start here):
what is pain?
why do we feel pain?
what is the purpose of pain?
what can we do to improve our lives?
Many of the strategies, practices and techniques to transform and overcome pain are taken from the skills of being well, peak performance and strengths based coaching. Over the past 10 years or so, I have called this Pain Coaching.
There is a simple principle. The more you focus on the pain and try to treat it, the worse the outcome. The more you focus on the person and how they want to shape their life, the better the outcome.
Focus on what you want, not what you don’t want. As soon as you are saying, ‘I don’t want this pain’, we focus right back on the pain.
Instead, re-focus on your picture(s) of success and the steps you can take right now in that direction. This is an approach and an attitude. You will need some help, it will be up and down, but
This month sees the return of the 100k + distance as I trot along from Bangor to Chester.
For some time I have been chatting with Jeff, an UP ambassador, about running together. So, I am delighted and excited to say that Jeff is joining me for the last leg — I will be on my last legs, that’s for sure!
Jeff is a great encourager. He is a coach, a facilitator, a writer and much more. Jeff has a book coming out soon, which I know will be superb. I am going to ask him to write a blog about it.
I also have crew for this one. Jo, my wife, has agreed to drive along the route and keep me supplied. She will be ably assisted by Chico.
Here’s the plan:
Drive up to Anglesey on Sunday. Set off around midnight, wrapped up and be-torched.
Make my way along the coast line through the night. Meet Jo and Chico at dawn with fresh supplies.
Have a beer and a pizza.
Lie on the back seat and be driven home.
To raise awareness: pain is one of the largest global health burdens affecting millions and costing billions.
There is much we can do as a society.
It starts with understanding pain. From there, people can feel educated, empowered and enabled to move on and shape a positive future.
This is the purpose of Pain Coaching, an approach I began pioneering around 10 years ago.
Recently I started using Wholy Me organic products: the drops and the balm.
The drops I use each day, morning and evening. The balm I apply, using self-massage, as needed. This is quite often as I usually have some aches and pains from training and running.
I have no other me to compare, however, my own experience is certainly one of overall calming and soothing on a day to day basis. The balm relieves my local soreness. It is a great combo.
Recently, I had a chat with Celine from Wholy Me on Instagram Live. I shared my thoughts and experiences. The Wholy Me Instagram page is here.
Here’s the blog that Wholy Me wrote about our conversation.
I will certainly be taking my drops and balm with me!
Please share so that we can give hope!
Over the past 5 years there has been a significant increase in the understanding of pain as a perception. This enables us to offer a wide range of practices, exercises and ways to help, guide and support people along their journey to improve their lives.
See the Resources tab on the site for articles and talks, and more on the Specialist Pain Physio site; podcasts and blog (Richmond’s clinic site)
We started the tour in Johannesburg, then on to Durban and finally to Cape Town. It was a whirlwind. Each event drew local physiotherapists, kinesiologists and other healthcare professionals together for a burst of education, socialising and presentation of the product range.
The organisers and sales teams created a positive vibe, which made the delivery of the pain talks a pleasure. I also had the opportunity to gain an insight into the pain problems that exist in South Africa by talking to the therapists.
We can be optimistic. Our knowledge of pain is expanding at a fast rate directly via pain science but largely from related fields. This was a message I tried to get across.
Therapists can choose to see people’s potential and strengths. Through this lens, the possibilities open up and we can help and encourage patients to shape their own positive futures.
The three days of talks in three cities was energising. It did not prepare me for a mountain though. Or the heat.
For the first 10k I was guided up to Lion’s Head by Nicola from Energy in Abundance. We set off on the trail chatting about life, running and philosophy. The photos tell the story.
Nicola hooked me up with South African ultrarunner Linda Doke for the Table Mountain part of the adventure. Incidentally, Nicola made all the arrangements by email beforehand so I just had to turn up. I would recommend this if you are a runner wanting to explore the area. You’ll be taken safely on the best routes and experience the awesome views.
We set off along the bottom of the mountain to reach the point of ascent. Apparently the weather was to be the best of the season today. It was. The flip side was the heat, which I was not prepared for having come from the English winter. This together with the steep climb took some effort. The reward was the magnificent view and a tin of coke. I love coke on long hot runs. And coffee.
Leaving the cable station and heading off along the stony trail, we also left contact with humanity except for a few lone souls we met. Three in total over the coming hours. It was a rugged and jagged terrain, yet covered with green resilient flora. We stopped to look at some of the plants that thrive on the mountain top.
There was little shelter from the sun. We knew the temperature would be rising so I had plenty of water on board. Of course this warmed up against my body.
When Linda mentioned stopping at the dam for a dip, I couldn’t wait to get my feet in and refresh. What a moment it was, to step into the reddish water, tanned by the fynbos plants beneath the surface.
The five dams are entwined in the history of Cape Town. They feel remote, sitting above in stillness like a meditating hermit. Some say that they have been forgotten (read here). A small dedicated museum at northern end of the Hely-Hutchinson Reservoir houses the original steam train. It was closed and did not look like it would open any time soon.
Recharged, dripping and grateful for the simplicity of fresh, cold water, on we went. To the right appeared the sea. As the reservoir had, it looked so tempting. There was the feeling that I could dive off the mountain into the blue. Later and warming up, I thought of icy drinks on the beach that I could see. The sounds from the people on the sand wafted up on the wind, yet we were a long way from any form of significant rest. Linda kept me going. Plodding along. The initial climb had taken a lot out of me.
We made a descent down a gorge towards Hout Bay and Llandudno. We chatted about the latter and how it bears no resemblance to the North Wales version. Both have their charms.
This was a bit of a scramble over loose scree before reaching a more defined path around the peak we were navigating. I had to navigate a few tricky points, expertly advised and encouraged by Linda. To many they would be easily traversed, but with a fear of heights I had some extra sweat to manage.
I realised that I had taken something from the Snowden experience in September. Looking back now, I know that these experiences have pushed the balance towards a greater confidence.
There is much to love about mountains: their strength, enormity, resilience, their danger and unpredictable bedfellow in the weather to name a few. I continue to be attracted to the challenge of ultra trails in mountainous regions. The mystery they offer and the contrast to my local running spots draw me in.
The final push up a long jeep track to us to the edge of the park. Across from the parking lot was a smart looking restaurant and bar. Linda assured me they would serve a smelly, dusty runner, and they did. I sat outside amongst the casually dressed Cape Town diners, mostly families, and enjoyed a pint of icy coca-cola reflecting on a tremendous day of trails.
Big thanks to Nicola for organising the tour and to Linda for guiding me and running at the slowest pace that she has had to endure for a long time!
Contact Nicola here for information about guided runs around Cape Town
Read about Linda’s running here. She also coaches runners.
I was very pleased to be asked to speak at the Adcock Ingram Sports Science & Rehabilitation division launch roadshow — a whistle-stop tour of South Africa.
Innovative TensCare CEO Neil Wright asked me whether I would give a series of talks in South Africa (Johannesburg, Durban and Cape Town). He had heard that I bring an ‘edge’ to the topic of pain. I like to think so, but only in terms of challenging out-dated thinking that holds us back. What a great opportunity, I thought. A chance to spread important messages via Understand Pain (UP) and to learn about how chronic and complex pain is addressed in South Africa.
The new Adcock Ingram division was being launched to local physiotherapists, chiropractors and biokineticists, and the theme of the events was pain. How could I resist? Adcock Ingram are engaging with therapists and clinicians in a new way that is generating a great deal of excitement. This is based on creating great relationships and distributing high quality products that compliment rehabilitation, including the range of devices from TensCare.
Both the team putting on the roadshow and the attendees were buzzing! The feedback from the people in the audience was very positive. There was a thirst for quality pain education, and it would be great to follow up with full Pain Coach workshops.
In my experience, TENS is under-used for chronic pain. Whilst TENS will not solve the problem, it can offer relief that helps the journey forwards. As an inexpensive and simple form of self-treatment, it is a good option. The key is that the user understands how it works and how to best use the unit. This can take some time and practice, but with instruction, discovering the right parameters can be found more swiftly.
I shared the stage with Nick Martichenko from Canada. Nick spoke about the use of tape and the understood mechanisms, whilst I focused on pain and pain coaching. I entitled the session ‘The Challenge of Pain’ as a doff of the hat to Pat Wall, the founder of modern pain biology, who wrote a book of that name. It was Wall’s work that resulted in the development of the TENS machine.
Three days, three events
On the road…
The roadshow put on by Adcock Ingram was very high quality from start to finish. They really wanted to make sure that every detail was covered. This was appreciated by the attendees who were most enthusiastic about the event. There was a new precedent being set, and the beginning of a new engagement between Adcock Ingram and therapists/clinicians.
I was particularly impressed by the way that the sales team approached their work. Selected and led by Juan Schaerer and Sheila Keshav, this group has come together in a short period of time. There was a great deal of positivity within the team, supporting each other, and getting jobs done from start to finish. I was privileged to be able to hear some the individual stories about how they came to join the team.
From a pain education perspective the roadshow was a great opportunity to talk about ways in which we can help people understand their pain and move on to improve their lives. That’s the purpose of UP. I hope that everyone else enjoyed their time as much I did. This was a super start and I will be very interested to learn how this story unfolds.
The Programme is now open to anyone suffering persistent or complex pain.
Face to face or Skype ~ reaching across the globe with Pain Coaching to improve lives
As the project has proceeded, I have been making changes to better suit the needs of the participants. Now I am delighted to be able to offer the programme to a wider audience — chronic pain is one of the biggest global health burdens.
Participants will receive 6 free Pain Coaching sessions: an initial conversation to understand the person’s narrative, clarify what is important to them, what they want to achieve and outline the steps forward. The next four sessions focus on practical tools: e.g./ practices, exercises, strategies, habits of peak performance. The final session is a summary and an opportunity to look at ways to keep momentum.
“I can see the world”, were the words of a person who learned to be upright. Early reflections on the UP OA Pain Coaching Project
I love hearing people’s realisations, uttered as they experience something new, with wonder, curiosity and excitement. This was someone participating in the UP OA Pain Coaching Project, who learned to be more upright and hence had a new view of the world.
It sounds so simple to be upright, yet it takes practice. We can train ourselves to use our body in a more efficient way seeking thoughtless, effortless movement, yet with awareness of having a body. Disconnection with the body for reasons of persistent pain or trauma are common. Reconnection with the body then, is an important part of moving forward, together with whatever is most important to us in our life.
The focus of osteoarthritis treatment is usually upon the area that hurts. This frame of reference needs widening as it is the person who feels pain (and other symptoms), not the body part. Further, the biology of the experience of pain and stiffness, and any other perception, exists far beyond the location of the actual feeling. To feel pain, we need a sense of the body area, a nervous system, an autonomic nervous system, a sensorimotor system, an immune system and more. What we don’t actually need is the body part. Confused?
Consider phantom limb pain. The limb is lost yet the person feels pain in that space. The simple fact is that pain and injury, or pain and pathology, are poorly related. This is why purely addressing the bit that hurts is not adequate.
You may think that in an acute injury this will be enough. I sprain my ankle so I treat and look after the ankle. Many do this. But the body (person) keeps not only the score of the injury and response, it will craft adaptations that can only be addressed by considering the whole person. Failing to do this means that protective responses and habits, formed at the outset, can persist and create further problems or on-going sensitivity. The idea of a quick fix is largely to blame. There is no quick fix. There is only complete treatment and rehabilitation of the person if you want the best outcome.
UP OA Pain Coaching Project
We are a month in, some nearing the end of their course of sessions. It’s been fascinating to look deeply at people’s experiences and beliefs. This project is an opportunity to reflect upon and study Pain Coaching, identifying key moments in conversations and themes that arise.
The purpose of UP is to improve the lives of those suffering chronic pain. Beyond building insights into the coaching process for pain, the UP OA project is a great way of reaching into the community and helping people understand their experience and learn new ways of moving forward.
I will be posting reflections each week.
If you suffer osteoarthritis pain or know someone who you think will benefit, please contact us here, putting OA in the subject bar. We have opened more free places.
UP moves into the 3rd week of the OA Pain Coaching Project. There are more places available if you suffer pain from osteoarthritis…
We started the UP Pain Coaching Project for osteoarthritis pain three weeks ago, and so far it has exceeded expectations. Motivation has been high amongst the participants, keen to learn different ways to improve their lives. Most have signed up for face-to-face sessions at the New Malden Diagnostics Centre, but we can also use Zoom/Skype if you live afar.
“I realised by the time I’ve got here this week my joints already feel better.” (A participant at their second session)
The free programme consists of 3 interrelated steps
Clarify your picture(s) of success
The types of questions you explore:
What are the real results you want to achieve? (This is your direction)
What is the ideal self you want to work towards?
What is really important to you in your life?
How committed are you to the programme?
How and why is it important to you to make some changes to improve your life?
Understand your pain
What you will understand…
What is pain?
Why does pain persist?
What causes and influences my pain?
What positive action can I take when I am in pain to feel better?
Positive action: exercises, strategies, practices and tools
On clarifying what you are working towards, we design a programme for you. The content will depend upon your picture(s) of success. There is a huge range to draw upon, some of which are daily proactive practices, and others that expand your choices for dealing with challenging moments. All are in line with the results you want to achieve.
Your toolbox can include: movement, mobilisation, sensorimotor training, breathing, relaxation, sleep strategies, periodising your activities, exercise, increasing activity levels, connecting with what is important to you (people, places, purpose), self-coaching and motivation, imagery, how to form better habits, prioritising, mindfulness practice and more.
After a few months of planning, the Pain Coaching Project started today. This is a really exciting time for Understand Pain (UP) and we are thrilled to be able to offer free sessions to people suffering the symptoms and pain of osteoarthritis (OA).
Pain Coaching focuses on the person, their strengths and their potential to improve their life. This comes in many forms as each person will have their own picture(s) of success. For some it will be an increase in walking, whilst for others it maybe to be able to socialise and feel more connected. We all have our ‘thing’. The aim of the programme is to give you knowledge, tools and practices to improve your life.
Starting with a conversation about you, your life and what you want to achieve, we then move into the practical sessions. There are many practices and tools to use, so we choose those most relevant to you. For example, we look at ways to mobilise your body and improve your quality of movement, breathing, planning your days, organising activities, relaxing deeply, building fitness, mindfulness, improving strength and confidence to be active.
If you would like to take advantage of the Pain Coaching Project and see how you can improve your life, book your place now by emailing here, and putting OA in the subject line.
When asked to write a ‘brief’ insight into my story, I questioned whether I could do this. I thought to myself ‘my story is far too complex to be able to sum it up in a short few paragraphs’. But then I realised how throughout my journey so far, when I have been faced with a challenge I step up to the mark, and I make it happen. So, here is my story:
Growing up I was a happy and healthy child who lived and breathed sport. And I was very successful with both my academic and sporting achievements. From the age of twelve I was playing cricket for Kent, representing Kent for Cross Country Running and Athletics as well as participating in any other sport where I could find the time. Life was good as a child, and I loved every moment.
However, in my teen years I developed anorexia nervosa which lead to a hospitalisation in my early twenties. I was in a critical state when admitted to hospital and there was little hope I would recover. However somehow, someway I managed to find some inner strength, determination and drive to want to recover from this illness. And so I began a long journey to restore my physical and mental health. I had a vision of leaving the hospital and being able to return to my sport, and continue working towards my goals of representing Great Britain at either cricket or running (I hadn’t quite decided at that point).
Someway into my recovery I began to experience pain in my back. To begin with this pain was leaving me in tears on any movements. And it soon began to spread, I started feeling pain in my feet, knees and hips. For me this was not only an immense source of suffering, but it was puzzling as previously I had only ever experienced pain through injury during sport. So, like most people we began to get tests, scans and multiple visits to countless health care professionals including physios, psychotherapists, doctors, hypnotherapists, movement specialists, nutritionists, the list was endless. I was in desperate search to see if anyone could shed some light on this unexplained pain. This went on for a good couple of years, all the while my hope gradually fading before my eyes as I struggle to walk for five minutes without breaking down or sit through a coffee date with a friend before becoming in terrible discomfort. This led to a desperate google search, which became a moment I will never forget. I vividly remember laying on my bed one evening, crying and typing in to google ‘success stories of overcoming chronic pain’. And this search led me to Richmond Stace. I instantly knew at that moment I wanted to work with Richmond, to try something different. And what an incredible decision that way.
My first appointment with Richmond was similar to many, myself walking in depressed and clearly rapidly loosing hope. Yet upon leaving my energy had changed completely, and my mind was fixed, pain can and will change, I can do this. Over the coming weeks Richmond taught me what pain was and I began to understand that I can influence this pain simply by choosing my thoughts, feelings and actions wisely, always keeping them inline with my vision, to be happy and healthy. Richmond provided me with tools such as mindfulness, visualisation, motor and sensory skills, the power of gentle touch and lastly he empowered me to know that I can and will live a fulfilling life.
We worked slowly, acknowledging that i had also been diagnosed with osteoporosis from my eating disorder so we were mindful of this when putting plans and programmes together for me. And the changes in my pain and happiness were incredible. Within a few weeks I was doing things I had longed to do for so long, I was back out walking pain free, I was in the gym, going to yoga, I could swim. Running and cricket were being held back for the time being until my bone density improved but they remain goals in sight. Richmond’s approach was one that was so different to any other practitioner I had seen before, but one that truly changed my outlook on pain.
Four years later, I now have a 1st Class honours degree in Sport and Exercise for Health, I have a distinction from my Masters degree in Clinical Nutrition and Eating Disorders, and I am now pursuing a PhD at Griffith university in Australia exploring the effects of low energy availability on injury risk and sporting performance in athletes. I now enjoy going to the gym most days of the week, I am a qualified yoga teacher who practices most days and I love nothing more than a long walk in nature. There is a famous quote that says ‘don’t look back you’re not going that way’, but I don’t like this quote because for me sometimes looking back is truly remarkable, as it allows me to really see how far I have come. From a place of suffering, from a place where all hope was lost, from a dark depression, to now being in a place where I moved on significantly, I am living a fulfilling life, living an adventure. I would be lying to say I am free from my issues with pain, I still get some periods where I experience pain like I previously did, and occasionally I find myself slipping back into old habits. However, I soon realise this does not benefit me in the slightest, so I turn back to all the tools in the toolbox I now have to overcome difficult times. If I experience an increased period of pain, my instant reaction used to be ‘this is a disaster’ and I would seek out physios, doctors, pills and potions to try to find a quick solution. But through my increased knowledge and understanding of pain I no longer react in such a way, instead I now view these experiences like this ‘ok, I feel you. What is the next best decision I can make that is going to help the situation (whether that be rest, movement, sleep, mindfulness, 3 deep breaths, laughter, food/ drink, meeting a friend) that is in line with my underlying vision of health and happiness’. Ultimately my next decisions always try to reduce the threat level, to reassure my body and mind that I am ok, I am safe. I have leant to observe my thoughts, feelings and actions and change them if they are not serving me well or if they contribute to suffering in any way.
I will never be able to thank Richmond enough for his ongoing help, support, guidance and encouragement during this stage of my life. Not only has he provided me with so many tools to overcome chronic pain, but also I have learnt so much about myself, who I am, what I want, my visions, goals and not to mention to wonderful books I have been guided too along the way. Richmond you are truly incredible and I thank you from the bottom of my heart.
So, for anyone out there who may be in that dark place right now, please trust me when I say, pain can and does change, when given the right environment to do so. Our experience of pain is influenced by our emotional state, fatigue, prior experience, our beliefs, our environment, our anticipation and expectation about pain. This can seem overwhelming however it is also truly empowering because having so many factors that influence pain means there is so much opportunity to change pain, because after all we are always changing. So, in this moment don’t be afraid to leave the shoreline, dive in and explore, along the way you will learn there is real depths to explore. There may be some darker patches, and inevitable challenges, and every now and again you may feel like the waves crash down on you. But trust me there is a shimmering horizon that calls you, and this is a journey that will ultimately take you towards that horizon. So, reach far, reach wide, take those meaningful steps, even if you need to tip toe forward to start, begin now and know there is a meaningful life out there for you too.