Breathe2Relax
Developed by the Department of Defense's National Center for Telehealth & Technology.
Mindfulness Coach
Managing Pain, Stress, and Physical Symptoms after Injury
Tips and Techniques
It is common to experience physical pain after a traumatic injury. The job of pain is to act as a form of protection to help us avoid further damage to our bodies after we have been injured. Though pain can be beneficial, it can be very uncomfortable and difficult to manage! Time, rest, medications, massage, acupuncture, and/or physical therapy can help reduce physical pain levels.
We want to help you develop tools to manage your pain. See the tips and techniques below for information about several techniques and exercises that research has shown to help people manage pain. There are many options! Try a few out and see which ones work for you.
Stress and other physical symptoms are also common after an injury, and can include or cause things like muscle tension, restlessness, and even difficulty breathing in some situations.
The techniques below have been shown to help people manage pain from injuries and other medical problems, and many of them have also been shown to help manage anxiety, stress, panic symptoms, and other physical reactions!
Having these in your “healing toolkit” will give you tools for managing several types of challenges.
If you are interested in a free mobile app for managing pain, check out the Department of Veterans Affairs “Pain Coach” app.
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One of the biggest problems with pain is that we often end up thinking about nothing but the pain. While this is understandable, it makes our pain experience worse. So, find ways to focus on other things! Listen to music you enjoy, look at or create art that you find interesting, read a comic book, play a game, or call a relative. Taking mental breaks from focusing on your pain and stress is an important tool.
Deep breathing, also known as “abdominal breathing” or “belly breathing,” is an important skill for managing pain and stress. Breathing is a centrally important part of our daily life and our health, and it is often taken for granted! If you pay attention to your breathing you can learn important things about what you may be experiencing internally. For example, different breathing patterns may help you be more aware of feelings of anxiety, panic attacks, muscle tension, depression, fatigue, headaches, and many other sensations. Learning breathing exercises can help reduce pain and discomfort, increase relaxation, and gain more awareness about your body and your feelings.
Check in on how you are breathing:
- Notice how you are currently breathing. Close your eyes, put one hand on your stomach at waist height and put another on the center of your chest. Notice the experience of breathing. Take your time. Notice which hand rises more upon inhaling.
- If you notice that your abdomen is relatively still, you are likely breathing mostly through your chest. Chest-breathing may result in less oxygen reaching the brain. This type of breathing is linked with anxiety, light-headedness, numbness, weakness, heart palpitations, and shortness of breath.
- Practice abdominal breathing, or "belly breathing" - the natural way to breathe. Babies and sleeping adults breathe with their abdomens. This type of breathing is deeper and slower than chest-breathing and can normalize heart rate, muscle tension, and other stress- and pain-related symptoms.
Tips for abdominal breathing:
- Concentration on your abdomen moving in and out as you breathe.
- Set an external reminder to check in on your breathing several times per day (for example, set an alarm on your phone).
- Exhale forcefully to empty your lungs. This will automatically result in a deep abdominal breath. Repeat as needed, especially if you notice that you continuously chest-breathe.
- Try these “belly breathing” techniques in several different positions. Some people find it easier to get the feel for abdominal breathing while laying down. Others find it easier to learn if they practice while sitting or standing. See what works for you.
If you are interested in learning more about relaxation breathing, check out these free apps:
National Center for PTSD’s “Mindfulness Coach” app.
"Breath 2 Relax” an app developed by the Department of Defense.
Progressive Muscle Relaxation (PMR) is a tool for teaching your body to be more aware of muscle tension and to relax muscles. Engaging in PMR can help reduce pain levels (especially neck and back pain) by reducing blood pressure and increasing relaxation. To practice PMR, you focus on bodily sensations in each muscle group, focusing on one muscle group at a time. This is done by tensing and then relaxing your muscles to teach your body how to recognize when muscles are tense. For example, tense one part of your body (e.g., your toes or calves) while keeping the rest mostly relaxed. Engage in abdominal breathing while tensing the muscle. Release the tension and notice the sensation. Over time, you will be able to build your awareness about each of your muscle groups and the sensations of tension versus relaxation within each.
Mindfulness is the practice of intentionally paying attention to the present moment without judging your response to what is happening. One application of mindfulness that has been shown to be especially effective in treating chronic pain, blood pressure, and migraines is meditation. During meditation, a person works to increase awareness of their thoughts by focusing on the present experience. We have a whole section with tips and information about mindfulness here on our website- click the link below.
[Click here to learn more about Healthy Thinking with Mindfulness]
You can use your own brain to help cope with pain that you might be experiencing! You can use your imagination to visualize relaxation spreading throughout your body. When you do this, you may begin to actually experience what you are imagining! For example, researchers have found that stressful experiences or medical conditions (including stomach aches, constipation, headaches, and chronic pain) may be worsened by focusing on them. Instead, creating positive mental images to focus on, rather than focusing on our symptoms, can stimulate different areas of your brain and decrease your experiences of pain.
To practice visualization, move to a cool, quiet place. Relax your muscles using the methods described in the Progressive Muscle Relaxation section. Engage all your senses as you visualize a calm scene. For example, imagine hearing twigs gently snapping as you walk through the woods, and the sound of a small stream bubbling nearby. Or, if you are a beach person, focus on your favorite aspects of being at the beach - maybe the feeling of warm sand on your skin, or the sound of the waves landing on the shore.
If you would like some help getting started with visualization, click the link below to see some pictures that can be used as inspiration for visualization practice. As you look at these, imagine being in the scene and involve all your senses- clearly imagine the sounds of the scene, the feel of the wind, and the smells in the air. Enjoy!
Autogenics training is the practice of creating a relaxed state by mindfully checking in with your body and focusing on themes of warmth and heaviness. You may find it helpful to practice belly breathing when using this exercise.
To practice autogenic training, check in with your breathing. Tell yourself, “I am completely calm.” Focus your attention towards your arms, repeating “My right arm is heavy” to yourself six times followed by stating “My left arm is heavy” six times (each time taking about 30 seconds). Next, state “Both arms are heavy” six times in the same way as before. Follow these statements with “I am completely calm.” Continue this pattern as you attend to your heartbeat (“My heartbeat is calm”), your breathing (“My breathing is calm”), your abdomen (“My abdomen is warm”), and your forehead (“My forehead is cool”). Follow each statement cycle with “I am completely calm,” or whatever words best inspire relaxation in you. Notice the heaviness of each part of your body. Notice the warm feeling that takes over your body as you sink gently into your chair.
Many people find that they feel better when they step outside to get some fresh air. Enjoying natural and outdoor spaces can help you to decrease stress and inflammation, which may help improve pain levels. Nature can help trigger the systems of our body that cause relaxation, allowing us to feel more balanced and centered. If you have access to green/natural outdoor space (for example, parks or trails near trees or plants), try getting outside and enjoying the sunlight. Consider exercising in outdoor environments if you are able (see our section on exercise for more information). If you live in an area where accessing nature is challenging, try to create that space for yourself. Consider bringing indoor plants into your home or planting a small garden.
Humans have evolved to be active and to spend a lot of time moving around, but most of us spend a lot of time sedentary. Exercise releases chemicals that can naturally reduce pain and stress. Have you ever experienced a sense of contentment and well-being after getting some exercise? Then you have experienced this chemical process in action! An example of this is the “runner’s high,” though you do not need to run to receive this benefit. Though it may seem counterintuitive that movement might help with pain levels, and it is important to work with your medical providers as you create an exercise plan, there is research to suggest that exercise can reduce pain! In fact, both aerobic (walking, running, swimming) and resistance (weight lifting) exercises have been shown to decrease muscle tension and improve overall health. If you’re struggling to get started, try beginning with easy activities that you enjoy and can do with a friend; for example, evening walks around your neighborhood. Though exercise may need to be modified depending on the type and severity of your injury, talk to your medical provider about what kinds of physical activity may be appropriate for you.
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