Understanding pain and body-mind connections 

I have always enjoyed treating patients who have a great connection with their body or are able to explore this at a deep level. I find this very common in my clinical practice among Pilates and yoga teachers and students as their practices are based on the connection between body and mind (and spirit too). This includes, for example, the ability to accurately detect internal bodily states, heart rates, breathing patterns, body temperature and tensions.  

A powerful exercise to train these skills, which is very often underestimated and used in pain management practices too, is diaphragmatic breathing (tummy breathing). Pilates and yoga both teach this.  

As an expert in pain science and pain management, I know that the mind-body connection is extremely helpful in managing, recovering from and preventing pain. There is a term in medicine that defines this ability to feel and perceive our own body – interoception. There is solid scientific evidence that shows that this ability can make us more resilient and help reduce sensitivity to pain


So at this point, you may wonder how, if yoga and Pilates practitioners are this good with developing and mastering these body awareness skills, I see them in my clinical practice to help them with their aches and pain?  

As often happens in life, too much does not mean better.   

It’s possible that for some people, a high level of body awareness might worsen a hyper-vigilant state that can bring our body’s perception threshold very low, and in the case of aches and pain, make us more sensitive. When it comes to hyper-vigilance of the body, here is another misconception: the belief that misalignments or weaknesses of our body can justify our aches and pain.  


“I saw myself in the mirror and noticed how my pelvis is rotated and my shoulders are misaligned. There must be something wrong with my posture. That’s why I have pain.” 

“If your core is weak, you will end up having back pain.” 

There is no evidence in the scientific literature that misalignment or muscle weakness in any body part (including our back, hips, or shoulders) can end up causing pain. Instead, the opposite is common: we tend to adjust and modify our posture, muscle tones and mechanics due to a protective mechanism led by painful sensations. Much of the time, the obsession with chasing the most aligned and straight posture possible is not only is unproductive but can also be harmful. This distorted picture of our body may negatively affect our body’s perception and, therefore pain, making it worse or last longer.   

I would also like to mention that the only straight and aligned bodies I have ever seen in my career were drawn in the anatomy books, and I have never seen someone perfectly straight in clinic. I believe the body works at its best in functional balance and harmony rather than following symmetrical and rigid lines. Usain Bolt’s back, the fastest man on earth, is a perfect example of how misalignments work incredibly well.   


In conclusion, developing solid body and mind awareness is a crucial step towards creating a more resilient and healthier environment for ourselves. In a world driven by social media, where there is a constant chase for the perfect appearance and aesthetics, it’s good to know that how we see our body also defines how we perceive it. Pain is an “unpleasant” perception and can be affected by the way we see our bodies. Therefore, deeply connect with your body, in a non-judgemental fashion, accepting, understanding and embracing its bio-mechanics and curves.  


Emanuele is a registered osteopath with 7 years of muscular-skeletal treatment experience which is backed up by a Masters in pain science. He’s co-founder and lecturer at the Physical Medicine Academy and his expertise in osteopathy, pain and physical medicine allow him to treat a wide range of issues from the common aches and pains of our daily activities to those of the elite sports environment. See his full schedule at triyoga here.

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