Healing through Pain

November 08, 2020

Hello! I've missed blogging!

This blog post is going to be a big metaphor. Who doesn't love a good metaphor?

So the past year for me has been a crash course on pain. You can take the 'crash course' bit literally since the pain I'm dealing with resulted from an actual 10-foot high bouldering fall about a year ago 💁‍♀️ (Recap: broken humerus + ankle injuries: torn ATFL and CFL, split tendon [peroneus brevis I think?], bone bruising between the talus and tibia - these were misdiagnosed [undiagnosed really], and mistreated).

I've been undergoing different types of treatment for the ankle - physio, acupuncture, etc. It's been a long and frustrating journey but I'm finally on the right path to recovery as I'm seeing results from treatments I've undergone recently.

What has most been effective is this treatment by a guy I will henceforth refer to as 'Kungfu Man'. Friends who are regularly in touch with me will know of this iconic figure. The ways of Kungfu Man are, in some sense, mysterious, other-worldly. Magical, even.

I got to know about Kungfu Man through an uncle - as you do (uncles and aunties form an extensive network and diverse source of info, worthy rivals of the Internet).

Kungfu Man's treatment is interesting. It is hard to give it a name (he doesn't really have a name for it himself) because it isn't mainstream, what he does is probably not validated by empirical evidence like most accepted forms of medical treatment are in the West. Kungfu Man claims to be a tissue specialist, and apparently his treatments aim to restore the function of damaged or inhibited tissue. He does this by 'tearing them up' and 'restoring bloodflow' through the tissues, which encourages healing.

Essentially, Kungfu Man is like a deep tissue masseur but because his treatment aims specifically at tearing your tissues up, it feels far from relaxing / therapeutic, and it all hurts like fk. His instruments of torture include his elbow (and it's various points and edges), his fingers and nails (yes you read that correctly), his palm. It's almost like his treatment won't work unless you're in pain (not exaggerrating - KF Man says if your muscles are 'rigid' some place and it doesn't hurt when he applies lots of pressure there, it means the area is 'numb' and your blood isn't flowing properly - meaning to say, rigid muscles hurt when pressed. And KF man is all about tearing up your rigid muscles haha). That's just the nature of the treatment. It's a literal case of 'no pain, no gain'.

So you have to be able to deal with the pain - 1 to 1.5 hours of it. You shouldn't tighten up your muscles in an effort to avoid the pain - the muscles have to be at rest in order for him to really work at them in a structurally productive way. You shouldn't turn your limbs away from him so that it hurts less - they have to be in the right position so he can get at the right area. If you tell him you can't withstand the pain, he'll have to apply less pressure, which makes progress slower than if he could apply more pressure given your higher pain tolerance.

What's crazy is that, if you let him do his thing, it really does work. Yes, it fkn hurts. Immediately post-treatment, I'm often covered in bruises, the area that he's worked on is often swollen, I might be limping, but after a few days, when the muscles recover, my ankle seems to have more mobility, it really does feel better. And it's been getting better and better since we started (about 16 weeks ago?). That's because his treatment aims at returning damaged tissues to their normal state and function, compared to relatively gentle approaches like conventional physiotherapy where therapists don't really get into the area so invasively. According to KF man, with these more mainstream treatments, although the pain may go away over time (since you're probably icing it all the time, not running on it as much, etc), the full range of mobility or function of the limb may never be restored because no one has gone and done deep tissue work to actually fix the damaged internal structures - which is exactly what KF man does, and believes is super necessary for proper recovery and restoration.

(Note: I don't claim to know anatomy and biology and physiology like medical experts but this is what I've learned over time from KF man, and from some of my physios as well. And intuitively it just seems to make sense to me.)

Interestingly, although this may all sound a bit dodge (as things do when they deviate from mainstream science and information and empirically-validated data, since society gives so much emphasis and significance to all that), KF man has been the only guy to be able to straighten my arm significantly, and in a fairly short amount of time.

Rewind -
So the broken arm was fixed via surgery, but what happened was, there was tissue build-up at the elbow joint and hardening of surrounding muscles (probably due to the lack of use and mobility when my arm was in a sling?), which caused the arm to bend - it could not fully straighten. It felt like there was a hardened lump at my elbow joint blocking the arm off from straightening.

By the time I went to KF man to have a go at it, I'd seen multiple physios and gone through physical therapy, shockwave therapy, acupuncture, blading, etc. The arm would sometimes be straight immediately after treatment, but the effects were usually not significantly lasting. The tissues would feel like they hardened / stiffened up again.

Let me just give you a pictoral journey.


ORIF in left humerus - 6 weeks or 3 months post surg? Can't rmbr. But this was my arm relaxed I think. Notice the reduced angle - probably 150 degrees at worst??



 

Back to Malaysia 👇

New physio - she started going hard with the stretching, where she pretty much pushed on my forearm and while clamping down my upper arm to force things to straighten. The stretching hurt soooo bad but something in me knew the straightness wouldn't last - and it didn't. She also introduced blading, to soften hardened muscles, and eventually shockwave therapy. 

This photo below was taken immediately after hardcore stretching, and although we would achieve hyperextension / full extension, that probably only lasted like 5-15 minutes? She wasn't doing much to soften surrounding tissues, just going hard with stretching - almost trying to force the joint to open up. I was also stretching my arm pretty much everyday - I would warm up the area with a hotpack, then massage the bicep and elbow joint area, and do a stretch to extend the arm using a 5kg dumb-bell with my elbow joint over a foam roller.



This is what it looked like first thing in the morning, that was me trying to extend it to full capacity 👇 This was probably one of the really good days (I don't have many pics of when the arm was at a really small angle!!). We were at a plateau for a long time.





Enter: KF man


7th June

☝ That look on my face is called disbelief. This was the morning after he worked on the arm, one of the first few times (maybe even the first???). I remember the tissues (e.g. bicep?) feeling looser, I didn't have to force the arm to extend. It finally felt like the right kind of progress. Very exciting.


12th June

After a few treatments, he told me to start stretching the arm - that's part of the philosophy. You tear the muscles up, and then to stretch them so that they can lengthen out. Compared to the previous physio, who never introduced much deep tissue work to tear up the muscles first, this made a lot of sense to me. But it was a different kind of stretch from what we had been doing previously - KF man said the muscles had to be relaxed, so I couldn't stretch it like how I used to with a dumb-bell because my muscles would be engaged in that position.

So I started tying my brother's karate belt to my arm, and threw the other end of the belt over his pull-up bar. Imagine someone looking like they're about to commit suicide via hanging, but instead of tying the rope around my neck it was my arm HAHAHA. This way, the muscles would be somewhat relaxed, and I could take advantage of gravity and my body weight to stretch the muscles out. ☝ This photo above was the result after one of KF man's sessions + stretching. Pretty much 180 degs. And although it felt better than ever before, it wouldn't last suuuper long. Eventually we decided to scrap the hanging stretch as we thought it probably wasn't yielding much results.


27th July

Compare this to the 7th June pic. Lots of progress in just under 2 months. I think at the time, KF man went away and did some research, because one day he came back and said women's joints hyperextend at a sideways angle???? (Sorry medical folk, don't hate if there's no evidence)

I think at some point, we found that most of the surrounding muscles which he had been working really hard to release, had been loosened. So he started stretching my arm in a different way, sideways (this is hard to describe, and maybe not that important haha). Basically, all the release we had worked hard to do coupled with this stretching meant that if I wanted a nearly 180 deg angle, I could just do this stretch on my own for a few minutes, and that could be achieved.


30th October

This is right now, literally as I'm writing this post. Basically straight.


I know it's all just angles and it's probably not very significant to an onlooker but MAN did I have to endure the pain and doubts of 'shit will I ever have a straight arm ever again?????' which is not as big of a deal as like losing your whole arm but it's still not great, and boy did KF man have to experiment and do trial and error and use his intellect and put in the manual work.

I think we're both very satisfied with the end result, and I'm definitely not gonna fuss about the last few degrees off from 180. This is good enough, and I count myself lucky to have found an alternative treatment that worked when continued sessions mainstream physio - and I know this firsthand - had no ideas / solutions for me, and probably would have failed (my ortho even told me not to waste my energy getting it fully straight).


So yeah - no pain, no gain.
That's definitely how it was with the arm, and that's how it's going with the ankle as well.

I've had to endure pretty much guaranteed (unless KF man is having an off-day where he just doesn't have enough strength) intense physical pain twice a week for about 16 weeks (or more?) now. What's been really interesting about this whole process is the mental aspect of things.

It's quite cool when you look into it, because if you practise meditation and have done long enough sits where you experience bodily pain, then you would have had to learn how to deal with that in your mind - because a lot of the problem really is in the mind. Bodily pain is just a sensation - it's the mind that 'doesn't like' it, amplifies it with aversion. It's like the anticipation of pain is worse than the actual experience of it, which is temporary.

Ankle treatments with KF man are essentially a session of meditation on pain. I mostly have to close my eyes and get into my body (wherever he's working on specifically) and just be hyperaware of what he's doing and where it hurts. 

Weapon 1: bare awareness & softening

I think for me, bare awareness is the first weapon. If I can just feel the pain, and let it be painful without getting involved and 'owning it' and making it MY PAIN, then there's not a lot of problem around it. I've noticed that's usually only effective for low-level pain though. When the pain starts to get sharp and unpleasant, I have to actively soften the area where my body instinctively tenses up when the pain gets a bit much. 

Something interesting I've noticed though, is that there are moments of relief between the moments of pain - it's not like he's going at the most painful spot in the ankle for 5 minutes straight (that kind of strength and pressure is probably quite hard to sustain as well for him haha). There are seconds / moments that are pain-free, but I think because the habit of the mind is to either cling to the previous moment of pain, or to cling to the next moment of pain that is yet to come in tense anticipation, the process feels 'unbearable' because the mind conceptualises it all as just too painful - but actually that's not how it really is if you allow yourself to take a good look. I've tried to actively relax and let go when those (albeit brief) pain-free moments come about, and just feel the relief, and only deal with the pain when it comes. I think letting go periodically helps make the whole process more bearable.

Weapon 2: BREATH

Another important, powerful weapon in the arsenal is the breath - breathing through the painful area and around it, through the whole body. The breath is soooo powerful srslyyyyyy. It's cleansing and brings relief. 

I don't know if I ever mentioned this on here before but I told some friends that when I broke my arm, I had to lie on my stomach in this awkward position, with my arm in two pieces, for like 40 mins waiting for the ambulance. The pain was no joke man, and small movements would induce sharp pain. I think my friends who were with me at the time were trying to distract me by talking to me about other stuff, but the more they did that, the more drained I felt because the pain from the arm would be nagging in the background. It felt like my attention was all over the place and causing the mind to lose energy. So I had to go inward and look at the pain and breathe through and around the pain mannnn. The breath honestly saved me!! I think at the time I felt, if I hadn't cultivated a meditation practice before, how difficult would it be to deal with the pain.. That experience showed me that I had a refuge immediately accessible to me - the breath. 

The same is true for KF man's painful treatments. When things are too painful to handle with bare awareness and softening, the breath is a reliable tool. It creates space around the pain, and in fact brings a level of comfort and relief to the experience. There's not much more to say here - maybe you can try it out for yourself!
(Maybe a bit TMI but I've also used breath meditation to deal with period pains [and I think sitting just helps with blood circulation in general?], and it really does bring a lot of relief [although temporarily]. I might start the sit with cramps but when I start bringing the breath energy down a pathway down and through into the abdominal area where there is pain, there's a lot of relief. At the end of the sit, there's basically no pain. 

I don't know what to tell you - I have no scientific explanation for this. It just works. The breath seems to scatter the tension within the body? Anyway. I often tell Dara I don't know how girls deal with period pains without meditation).

Weapon 3: patient endurance

The last weapon, when all else fails, is just plain patience and endurance. The kind where you might grit your teeth. The voice in your head screams 'I can't take this anymore', telling you to tell KF man to stop, or telling you to punch him (sometimes that desire really does come up man!!!). But you don't because this is the exact spot that needs to be worked on in order for things to be released further - where it hurts most. And if this spot is left untouched, I will never go beyond the progress that I've seen up till then. It's really hard sometimes. I do struggle with this when the pain is too sharp and too intense - I struggle to keep the area relaxed, which KF man can probably sense, and as a result he probably turns down his intensity, which is not ideal for making progress. Struggle's real.

As I'm writing this I realised that these approaches are similar to the approaches Ajahn Munindo recommends for dealing with defilements: cutting, seeing, burning.
  • Cutting - as in cutting the disturbance off. E.g. when you're focusing on your breath as your meditation object and some thought comes up you just ignore it. You cut it off. (I don't think I'm able to use this for ankle treatment pain though haha - maybe only when the pain is suuuuper mild?)
  • Seeing - when the disturbance is too bothersome to just ignore, you take a good look at it.
  • Burning - patient endurance. "Khanti paramam tapo titikkha" - The Buddha said that patience is the ultimate weapon for burning up our defilements.
Ajahn Munindo said in one of his talks that there's no particular order for how you should apply these methods - you experiment and find what works for you. Sometimes you have to go cutting, seeing, burning. Other times it's burning, seeing, cutting.

The metaphor!

I was speaking to Ajahn H about this whole 'no pain, no gain' thing last week and we agreed that this is kind of how Dhamma practice works as well. In order for it to work, it has to hurt first - sometimes, a lot. 

Unpacking that further - I don't think it's necessarily because the practice is painful in and of itself. I think it brings to your attention the pain in areas where there are problems. This is how it is with the ankle too - for particular structures / areas, KF man says that if the muscles hurt here, then that's because there's something wrong with it; it wouldn't ordinarily hurt if there was no problem. 

That's how it is with some things in life, I think. This has been my experience on an emotional level as well, this year.

Ajahn said in a talk recently that this year has been good for the Dhamma, if not much else. I agree - the pandemic has forced me to address (or at least take a good look at) problems in my mind that have been unaddressed for the longest time. I won't get into specifics on here but I can tell you that when I was in Australia, away from these particular conditions, it seemed like all was well and good. You think you're fine, you know. And then I came home and all the issues I hadn't fully brought into consciousness to heal from them just resurfaced, because all the conditions for them to arise were suddenly there again, and now there was no where to run - no going outward (literally couldn't leave the house) to distract myself endlessly. They were all in my face, and it was all on fire, and I was on fire.

It's like if there's scar tissue in an area that you've injured - unless you press hard into the area, you think there's no probem. But actually the scarred, misshapen tissue is a problem, and when you press into it, you realise there's a lot of pain. You realise it's not okay. I find that interesting because when you really look at the mind, you realise, shit, it is NOT OKAY IN HERE. Things don't just 'go away' over time. Time doesn't heal all things - time may make you forget for a while while you do other things, but it doesn't inherently heal. Effort heals. Wisdom heals. This might be a very scary truth to face, but I think unless you've actively put effort into trying to let go and heal from something traumatic, it probably hasn't gone away - it's probably just that the conditions aren't there for the pain of that trauma to get triggered. So you think you're fine. You think it's all fine - but it's an illusion. It's unawareness, ignorance.

So coming home during the pandemic was a bit like that. It was time to face up to the unreceived pain compounded over years that I never had to face so directly and relentlessly before. I had no choice but to endure. Calm down, soften up, receive, then apply discernment because the only thing that really works at uprooting these things is wisdom and a correct perception of things. I think that's the general approach that has worked for me. 

When the defilements are on fire, I can't meet them head-on just yet. Sometimes I need to bask in the sadness for a bit, lay around, be depressed. Just let myself be on fire, burn a little. Sometimes it hurts so much, my immediate reaction is to distract myself with pleasure, put on some Netflix, scroll on Instagram. Hopefully not indulge and spiral, but just numb myself temporarily (yo man this probs not in the Buddha's teachings but this is my process hahaha). Although in certain situations the anxiety and suffering is so hardcore that I can't even distract myself, I straight up have to cry / let myself freak out.

And then when I've had enough of that, I try to calm things down, turn down the heat first. Try to prime the mind with good concentration, calmness, gentleness. When I get like this what I need to do is lots of walking (or something else, like baking). Walk, get the body moving. That energy in the body needs to go somewhere. Sitting may not help at all because the mind doesn't have enough calmness to meet the flames - it will just hurt more because every thing is magnified when you sit, it's easier to fall into the stories of the mind. This process helps to receive it. You receive the, as Luang Por Munindo calls it, 'unreceived life'. I feel like this stage is where I give myself lots of space.

And then when the mind is receptive and calmer, when the mind is willing to embrace something that could help it deal with the pain, I begin speaking to Dhamma friends, reflecting, listening to talks tailored to my particular struggles. This, for me, is the discernment stage. You're looking for the Dhamma to correct your deluded perception of the matter, which is fundamentally what is causing you this suffering. You are not seeing things in line with the way things are, and your clinging to your own deluded reality or ideal that has remained unquestioned for ages, is what has caused the pain and suffering to fester and remain unresolved. Reflecting with a calm mind, consulting with wise friends and listening to wise teachers is a massive help in flipping around the wrong views that we hold. From my experience, nothing compares to the power of wisdom when it comes to cutting through suffering. When there is understanding, it's like there's an automatic letting go. This can be a gradual thing, or sometimes it can be really instant.

What's interesting though, is that often that hardest part about the whole process is learning to receive the pain. Of course it's unpleasant. And it's counter-intuitive because it requires you to look directly at it, no filter, no sugar-coating, no pain-killers. Delusion and unawareness is like a pain-killer, but it doesn't mean the problems have been resolved. You're just not allowing yourself to be conscious of them, and so they never get addressed.

I love the way LP Munindo talks about suffering. It's such a different approach to the whole practice (at least for me). He says that suffering is 'pain to be received'. I find that so interesting, because it encourages one to meet the pain, instead of avoid it or shy away from it like we instinctively do. It makes it sound like an act of self-compassion - which it definitely very much is - if you are hurting, you first need to acknowledge that pain. It's like a hug - when you go to your friend crying, they receive you and your pain and give you a hug. They embrace you - in both the physical and emotional senses of the word. They hear you. They feel you. Often, our reaction to pain is to 'push it into unawareness (delusion)' because it is too painful / unpleasant to be dealt with. Now, when pain emerges, either because it is old pain that has been brought about by past conditions already in place, or new pain brought about by new conditions, it is our chance to receive it. When we begin to receive it (N.B. the Buddha says suffering is to be known!!), then we can begin to address it. So often we skip this very important first step, we want to 'get rid' of the suffering out of aversion - but actually it first has to be known.

Back to ankle pain - it's funny because KF man thinks that I somehow use my meditation practice to 'shut the pain out', like I'm making myself numb to it, and that that's how I'm able to endure it. It's actually the complete opposite because the more unaware I am of the pain, the more I try to distract myself from it (e.g. using my phone), the more unbearable it is when it's intense and sharp enough. To really deal with it, I have to be completely, fully aware of the pain - which is often less 'unbearable' than it seems if you were just distracting yourself from it, since the immediate reaction to unpleasantness seems to be resistance. When I know it fully, then I can find ways to deal with it. There have been so many times when I feel like, oh hey the treatment is not so painful at this moment, so I start playing around on my phone, and then he decides to get in there with the sharpest part of his elbow or something and it's like NOPE and I have to put my phone away and close my eyes and focus.


"Suffering is pain to be received."


Man, I just love that. The lesson with physical pain can be translated into emotional and mental pain. It's different in that physical pain is grosser and harder to run away from immediately I think, but I think the same principles apply. Distracting yourself from the pain might 'anaesthesise' it temporarily, but it does not help you when the pain becomes intense. And it certainly does not help to address the underlying root causes of the pain. To uproot those causes, one must meet the pain right where it hurts most. And that's up to us to find what works - how do I meet the pain? Metta? Patience? Breath? 

But most importantly before thinking how we go about doing this, our views must be corrected so that we realise that we first have to meet it, receive it, acknowledge it, welcome it, even - and everything else we build around that pain. The stories of 'I can't take this anymore' and 'I don't like this' - they all have to be received as well before we can really look at what is hurting.

So yeah, this year has in many ways been like being held down and bruised forcefully, with nowhere to run. But it's been good, because it's forced me to stare my pain in the face when I otherwise might have just turned away from it, been distracted by life, with the illusion that 'everything is A-okay'. I'm still in this process, and it's still pretty painful, but if nothing else, it is healing.

Much love! x



P.S. We've been listening to so much LP Munindo because he is awesome. I told Ajahn his list of talks are like a personal playlist tailored to my defilements HAHAHA. So for anyone who has a similar temperament to me, struggles with the 'go-fight-win' mentality, is super hard on themselves, thinks your practice should 'look a certain way', etc., I would recommend LP Munindo's talks. He's great at encouraging wise reflection.

Here are some I've listened to and recommend:

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