Friday, March 27, 2020

Wanda Swenson on Everyday Self-Care and the Art of Pain Relief

In this interview, Wanda Swenson talks to Alexander “The Engineer” Lim, host of AuthorStory by, about her book, The How of Ow: Everyday Self Care and the Art of Pain Relief.

“Just take a deep breath.” ~Wanda Swenson

Wanda took up physical therapy in part to know about her own injuries, as she had some knee injuries from practicing judo for years as well as a back injury prior to even starting judo, as well as to know about how the body heals. Wanda eventually wound up in orthopedic therapy, after initially considering pediatrics, which became “a good occupation” for her to follow. That said, Wanda became a therapist at a time when pain science was being applied to how physical therapy was done. (Wanda points out that physical therapy was born out of the 1920s polio epidemic, as a way to help those who were afflicted with polio recover.) Wanda remarks that orthopedic physical therapy focuses on pain in the joints, while pain treatment is more about the nervous system and how thoughts and emotions affect the pain itself.

Pain, according to Wanda, is an unpleasant sensation which has an emotional experience and component associated with the actual tissue damage. Avoiding it is natural, but chronic pain is not about injured tissue but more about the fear of pain and anxiety associated with uncertainty. She notes it is important to respond to pain, rather than ignore it, and that it is also important for people to know what to do when pain hits. Wanda’s own injuries inspired her to investigate what to do when pain hits, and this enabled her to help out those who had chronic pain from injuries similar to her own.

Where injuries are concerned, Wanda remarks that some sort of weakness is always involved. According to Wanda, one of the misconceptions about pain is that a pill will make the pain go away; and this is false, in that all the pill does is make one not care about the pain as much. Another is that somebody other than oneself can fix one’s pain, as it is up to one to do what needs to be done - such as strengthen and move one’s muscles and body to ensure the proper coordination amongst all of these - to manage or eliminate the pain.

Emotions can make a pain feel worse or better, Wanda remarks. In the past, people believed that there was a “pain center” somewhere in the brain, but research has shown that there is no such thing. As pain is a subjective experience, Wanda notes that using pain scales for patients to describe pain might be important, but also using a scale which “catastrophizes” pain. The questions related to this scale are related along the lines of, “How often do you think about this pain?” and “How much has this pain changed your life?” This scale indicates how prone one is to chronic pain, with those who give higher rankings being the ones to most likely experience chronic pain. That said, having an emotional reaction is part of the process, but acknowledging and recognizing one’s thoughts and being present to these, as well as taking a few deep breaths, triggers a relaxation response, in contrast to the fight-or-flight response that pain automatically brings on. This can enable one to handle one’s perception of pain and enable one to do what needs to be done to recover.

The present opioid crisis in the United States was one of the inspirations for her writing her book. Wanda remarks that, up until the 1990s, pain was under-treated, and part of the impetus of that time was to make pain the fifth vital sign (in addition to heart rate, blood pressure, temperature and respiration rate) for physicians to take note of, even though, as she notes, “Pain will not kill you.” Oxycontin was given as a pill to relieve pain, as it was supposedly non-addictive, and from then it became socially okay to be on pain relief medication, which led to opiate-based drugs being increasingly used to manage pain. Opioids, however, make pain worse, as these affect one’s sleeping patterns and digestive system, in addition to one focusing more on one’s pain rather than on such other things as doing the things one loves.

Another inspiration for the book was the ageing population, as moving one’s body is just as useful and just as important in one’s old age. The book has a lot of exercises and advice on how to move one’s body and thus reduce pain. Prior to all her realizations that are the basis of her book, Wanda focused on the physical aspects of physical therapy, but over time, as the demands on physical therapists increased, she found she couldn’t spend as much time with her patients as she used to, so her practice shifted towards educating a patient and empowering them with what they can do for themselves. This meant that she did less manual therapy and still got good results.

Wanda notes that the book came out of her own deepening understanding of pain. Wanda’s writing of the book was the result of years of “brewing,” and grew out of her desire to tell her patients more about how to help themselves. The first person she mentioned the idea of the book to was a patient who was a writer, and the latter told her that writing the book was a good idea. Wanda later mentioned the idea of the book to several others, all of whom agreed that writing it out would be a good thing to do. She began working on the book after retiring in 2013, and finally wrote it out after years of work. She admits to being “surprised” by people who she hadn’t seen at all but who have read the book, people who have gotten something out of it to relieve the pain they feel.

One of the exercises that Wanda swears by is Postural Isometric Lengthening, which is for any problem with the spine, shoulders, neck and back and which can be done in any position. The intention of the exercise is for one to get as tall as one can. The essence of the exercise is for one to pull one’s belly in and then keeping one’s shoulders one and back while taking deep breaths. This exercise works the coordination amongst various muscles and is helpful for everyday activities.

Wanda notes that, no matter what one’s age, one can always strengthen one’s body, as our bodies have an innate ability to heal.

Purchase from Amazon: 
The How of Ow: Everyday Self Care and the Art of Pain Relief by Wanda Swenson