Stuck?

Client not progressing as you hoped due to persistent pain?

You are trying your hardest to help them, but whatever you try does not seem to work.

We have all been there.

It’s so frustrating.

And we often start blaming ourselves. Or them.

But…..

There’s a way forward

When you understand pain and the reasons why it can persist you will see a way forward.

You become unstuck.

Join my webinar on Tuesday October 19th at 7pm to find out how.

Reserve your place here.

Richmond Stace
The Pain Coach | Pain Specialist | Chartered Physio | Hon Clinical Lecturer

Takeaways

  • What is persistent pain?
  • Why does it persist?
  • What can we do to help people move forward and get results?

Q&A

Bring your questions.

What do you want to know?

What is one question that would make a difference to you?

You can email me before if you like: richmond@stace.com

2 giveaways: where am I going?

I will randomly pick 2 people from those who ask questions (whether answered or not).

They will be invited to a free Pain Coach Mentoring session that will help you take the first step towards your ideal career.

See you there!

RS

Here is the link again just in case: click here to get unstuck

Dealing with disappointment

Roll with it – disappointment

Twice I have pulled out of events this year. It does not feel good.

A deep disappointment and regular waves of regret. There seem to be reminders everywhere.

In May I stopped halfway into a 100k race. I also took a wrong turn that meant I had to run 12k back to the start — 62k total. Should have just kept going, part of me said.

This month I pulled out at 90k along the South Downs Way. Should have slept for a bit and then kept going, bit by bit, part of me said.

That part of me always chimes in.

How to deal with the disappointment?

Three ideas to share with you.

1. Take a perspective

Zooming out, I quickly realised that whilst it matters, there are other considerations.

When you look at the bigger picture of your life and those around you, how does that feel?

2. In that moment, you made the best decision

There are always circumstances. Some things we cannot control and some we can.

What were the circumstances surrounding that decision and action?

What could you control?

3. The art of setting one’s expectations

I spend a lot of time working with people on the skill and art and practice of setting expectations.

When we set them too high and what actually happens comes in low, we feel bad.

Or we push on when we should stop.

Neither works.

What is realistic? You can certainly be positive in as much as you focus on what you can do, but tied with what is possible.

Positive realism.

If you think it might be possible, break the task into chunks and take it steps by step – achievable steps.

Your ideas

There are many other ways to deal with disappointment.

Of course, it is inevitable in life. So having skills to deal with it is better than being surprised.

What do you do to deal with your disappointment?

Do share your thoughts so others can benefit.

RS

Tapering

I used to think tapering meant feet up, hardly any running and lots of eating for a week or so before the event.

Wrong!

For pro advice, you can read about tapering with coach David Roche here. For anecdotal experience, read on.

How I used to taper

I looked forward to the tapering week, sometimes two. Take it easy, occasionally run a few k’s. By a few I mean 3-4. So very little.

It meant a week or so of eating whatever I wanted. Awesome!

Days of sitting around, usually reading. That’s not so bad. There’s always something to learn.

But there was something that quite right. Reaching race day as I did in May this year, I felt heavy. Heavy legged.

My overall programme, which could be named hit and miss at best, was ending with a slothful period.

What was I thinking?

To put on a positive spin, it was a learning experience that has led to something much better.

How I am tapering now

Good training is sustainable training

David Roche

Tapering is part of the programme. With a measured, gradual approach to building fitness, speed, resilience, quality movement, stability and more, I have no need to spend a week or two resting to recover.

Been there…..

The week before SDW 100 miler, my training now looks like this:

  • Saturday: 20k easy on trails, hilly not steep. Run down hills with brakes off (building courage and skill)
  • Sunday: 10k easy + 4 x 30 sec hills (fast & smooth)
  • Monday: rest day, stretching/mobility, breathing
  • Tuesday: 10k easy, core/stability training
  • Wednesday: 8k easy
  • Thursday: 5k easy
  • Friday: 5k easy
  • Saturday: SDW

Feeling rested, ready, and relishing the opportunity to hit the trail next Saturday.

Now that is tapering.

Daily practices

Several times a day I stretch with micro practices dotted through the day – balance, stretch, mobilise, massage gun, roll, yoga pose, mindful breathing.

Most days I will sit and meditate. Other days are micro meditations of a few minutes. I am lucky because I get to practice with people most days as well in the clinic when we look at different ways to change state, create calm and clarity to help overcome persistent pain.

Walking. I walk everywhere.

Standing. At home I stand to work. In the clinic, I get up and move around often as a matter of course.

Our mind’s are embodied. Thinking emerges from the body state and the body state can depend upon what we are thinking. There really is no separation. We have just the one experience.

Hence, movement is a fundamental part of being at our best.

Upandrun.

Onwards.

RS.

PS/ If you would like to support the work of St Wilfrid’s Hospice, please donate here. We are over half way to the target, so your help is much appreciated.

The team looked after my dad and us so well in his final days. To help them continue this vital end of life care is so important to our society.

Thanks

upandrun 21

Brick Richmond from Brickrunners

Back on the trail tomorrow for upandrun 21

Tomorrow is my birthday. My present to myself is to run from home to where I was born for upandrun 21.

21 is not my age.

The idea came from the Pegasus Ultrarunning guys. They have created an Ultra Marathon Birthday Hall of Fame.

Of course, the primary purpose is to raise awareness of the problem of chronic pain that besieges so many people across the globe.

It is also to share hope as our knowledge and understanding of pain advances at a rapid rate. As a result we can help people shape positive futures.

Further, ultrarunning is a way to experience one’s own pain and learn — blog here.

The route

It is a mixed bag. A good amount of the trail will be along the South Downs Way as I head from Ditchling Beacon to Eastbourne.

From there I will find my way along the coast to Hastings, where it all began. I don’t remember that day, but I know it happened.

The distance will end up around 80k I would suspect. Time? No idea. I always get that wrong.

One of the beauties of heading off on a long bimble is the loss of a sense of time. I often have no idea of the hour. There is only this moment. Truly present.

As ever, pics will be on social media.

Instagram | Twitter | Facebook

RS

ultrarunning to understand pain and share hope

Heading off to the Menai Bridge for September upandrun

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?

Sunrise from the Little Orme

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.

Sharing hope

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

There is great hope for many. This is my message.

RS

September upandrun

Richmond's route for September 2020

September upandrun ~ Bangor to Chester

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.

Chico will be part of the support crew
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.

Keep going.

Find Jeff.

Keep going.

Have a beer and a pizza.

Lie on the back seat and be driven home.

Why?

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.

Thanks to…

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)

You can see the photos from September upandrun on Instagram and Facebook and Twitter.

RS

upandrun 13 Table Mountain

upandrun understand pain
upandrun 13

At the end of the Adcock Ingram roadshow in South Africa, I tackled Table Mountain for upandrun 13. It was awesome, but much tougher than I expected.

In another time, when we were able to travel, I was in South Africa. It was March 2020.

I had been invited to give a series of talks on the Adcock Ingram roadshow to launch their Sports Science and Rehabilitation division. My host was TensCare CEO Neil Wright.

TensCare logo
Thanks to TensCare for sponsoring upandrun 13

visit TensCare Pain Relief and Therapies for a range of devices for pain, maternity care, continence issues, pelvic floor and muscle stimulation

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.

Richmond and Nick the speakers
Richmond and Nick selfie

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.

Sunrise

View from Lion's Head

Lion's Head

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.

Mountain view
Crossing Table Mountain

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.

Flora on Table Mountain

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.

blue water
Hely-Hutchinson Reservoir

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.

The sea

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.

UP on the road in South Africa

The end of a successful roadshow: Neil Wright (TensCare), Juan Schaerer (Adcock Ingram), me, Nick

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.

Richmond giving Pain Coach talk
Johannesburg audience

TensCare and TENS

TensCare is an employee owned company, distributing TENS and electrotherapy machines all over the world. One of the main reasons to use TENS is for pain relief, in both acute and chronic pain. It is probably best known and most used in maternity care.

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.

 

Nick & Richmond selfie in Durban

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.

Richmond Stace The Pain Coach in South Africa
Cape Town 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.

RS

 

Pain Coaching Project UPDATE

Pain Coaching Project
Richmond Stace | co-founder of UP and pioneer of Pain Coaching

Pain Coaching Project UPDATE

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.

Read here: Pain Coach Project

If you are suffering, or know someone who suffers persistent or chronic pain, sign up today:

Email Richmond here

 

“I can see the world”

Photo by Sarah Egerer

“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.

Richmond Stace The Pain Coach
Richmond Stace

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.

Read here: UP OA Pain Coaching Project

Look out for the next #upandrun ultra on Tuesday on the Cotswold Way

RS