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Physical therapy and the neurotag

—Sledge Morgan

It is very likely that you or someone you know quite well has had physical therapy at some point in the past. These experiences vary considerably from person to person, from clinic to clinic, and even from incident to incident. Usually, most people have good experiences with physical therapy, because it helped them to rehabilitate from injuries that were limiting their daily functional activities; however, others have not been so lucky. At times, physical therapy can seem difficult, complicated, and even downright terrifying. These perceptions are manifest as a phenomenon called a “neurotag.”

The concept of the neurotag was developed by David Butler and Lorimer Moseley, two of the world’s leading pain science researchers and was outlined in their book “Explain Pain.” Essentially, a neurotag is the way the brain processes a stimulus with respect to a person’s past experiences, expectations, and even system of values and morals. Ultimately, we attach neurotags to a great many things in our lives. For instance, if someone has a history of being bitten or scared by a dog, it is quite likely that he or she will cringe whenever confronted by a dog no matter how docile the animal might seem.

It is the same way with pain. If you have ever had the experience of “throwing your back out” when bending over to pick something up from the ground and then having to spend the rest of the day crawling around because every time you try to stand it’s like there’s a six-hundred pound gorilla punching you in the back, you know that from there on out every time you need to bend forward to pick something up from the ground, the thoughts and emotions (including fear) surrounding that previous experience start spinning around your brain and in severe cases can even elicit a pain response.

It is the responsibility of your physical therapist to identify any neurotags that you have associated with pain, movement, or both, and then to educate you about them accordingly. Physical therapy should be focused on restoring good movement patterns that are not classically associated with pain. For people who are struggling with pain, either acutely or chronically, exploring these new ways to move and challenging your system within reason can lead to very important gains that allow for improved quality of life and also can help to reshape those neurotags into healthier, less limiting components of their lives.

It is the role of your physical therapist to ensure that those experiences are conducive to healing, and this involves not just good evaluation of your physical body, but a good understanding of the role your brain plays in injury and recovery. This understanding must then be incorporated into the development of your specific treatment plan to ensure maximum benefit from the course of therapy.

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