Kinesiophobia, or fear of movement, is an issue that affects far too many of us. Often
times, people with chronic pain or a history of injury to a particular body area will develop a fear of movement. Kinesiophobia can exist on a macro or micro level, affecting both overall physical activity levels, as well as movement of specific joints and patterns of muscular activation. Kinesiophobia is often outside of our conscious control, as the fear circuits of our brain (e.g. the amygdala) are involuntary and affect our movement without us necessarily being aware.
How does this happen? Individuals with kinesiophobia may associate certain activities with pain, as this activity may have caused pain in the past. An activity that is a common trigger is bending down towards the ground, perhaps because this movement may have led to an injury in the past. The internalized association between movement and pain will contribute to fear-avoidant behavior, and the individual will continue to avoid this activity due to fear of pain or re-injury. Over time, even after the original injury heals, the individual will still have this same fear embedded in them and will avoid bending down. Now the motor pathways, muscles, and joints responsible for bending down will atrophy, and it will be far more likely to cause injury if the individual were to bend down in the future! The irony is that the fear is what contributes more so to the dysfunction, rather than an issue in the physical tissues of the body.
What can we do about this?
Because fear is a learned behavior, we must "unlearn" the fear, as well as create new neural pathways that teach us that movement can be safe, easy, and pleasurable. Your physical therapist at the Wellness Station will quickly identify what is contributing to your kinesiophobia. Along with providing education about anatomy, biomechanics, and pain neuroscience, your therapist will teach you how to gradually engage in safe movement patterns that will help you gently progress towards your functional goals. It is important that this process is done slowly and gently, as our brains will not be receptive to learning if fear is still present. The tissues of your body will slowly adapt, and your nervous system will gradually learn that previously feared movement patterns can be safe and even easy.
Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team