The Edge

In today’s newsletter, I want to discuss a powerful concept that applies to both life and health. A common description I use when talking to a patient about exercising an injured joint is to stretch the joint up to the edge of pain; not into pain but just to the edge. This simple phrase reflects a profound neurologic truth that controls how we process input from our senses and the world.

Our brain has automatic defaults that regulate how our attention is distributed from moment to moment. Something that appears to be completely within our comfort zone or zone of familiarity gets very little attention. Even very complex activities like driving a car can become so habituated that our attention can completely drift off and yet we will still get to our destination. We suddenly notice that we are where we were intending to get to yet we don’t even remember the trip there. On the other hand, when we encounter something novel and threatening, we can remember immense amounts of detail about our encounter. Fear, especially of the unknown, grabs our attention. Pain does the same thing as fear. It grabs our attention, and our brain processing up to a point. That point is when our brain decides that it can not figure a way out of the fear or pain. Then it goes into fight or flight mode to get away.

This edge I am describing is the place where learning and creative problem-solving take place. When we are comfortable, we have no reason to expend the brain energy to solve a problem or learn something new. That requires a lot of effort. Likewise, when we go into helplessness we retreat from thinking and go into pure reaction to engage our fight or flight mechanism. It is in that narrow band between our comfort zone and the chaos of the unknown that we engage our capacity to create a new relationship with something previously unknown but similar enough to us to try something new. I call this the edge.

Our muscles and ligaments have a very similar response to their world. When some area has been injured and movement produces pain, our natural response is to freeze. Movement creates pain, so don’t move. This is very logical, but not very practical. We need to move. We experiment with tiny movements to find what we can do that does not trigger pain then restrict ourselves to this tiny range. The problem is this does not work. Injury stimulates the formation of glue-like scar tissue to protect the injury, and scar tissue contracts. It is kind of like shoe laces. You lace the shoe up then tighten the laces to tie everything tightly together. This limits movement even more and our range of motion decreases. If we keep completely avoiding pain, eventually the joint gets frozen.

The answer to this is to operate on the edge. Move the joint up to the edge of the pain and then gently push into the pain region just a little bit. You are looking for discomfort but not actual pain. It is in that zone of discomfort that you stimulate healing. If you push too far and into pain, the area will react with a spasm to protect the injured tissue. But if you only push gently into the pain area, you signal to the body that you want to rebuild mobility in the area rather than just glue it all together with scar tissue. That gentle push stimulates nerve growth and blood vessel growth into the site of injury without freaking it out. This is a key point because freaking out triggers inflammation and inflammation attracts white blood cells that attack the injured tissue even more. A little of this is valuable to munch up and carry away tissue too damaged to be repaired, but too much causes excess destruction. Everything in the body has to be in balance – not too much and not too little.

This same process takes place when you want to build muscle by lifting weights in the gym. Too much lifting tears down the muscle tissue and creates inflammation. This might make you look more muscular by causing swelling in the muscles, but it makes the muscles weaker. Conversely, lifting light weights does not signal to the body that you need more muscle. Instead, it tells your body that you need more endurance. To achieve this the body builds more blood vessels to improve oxygen flow to the muscles and carry away waste products. To increase muscle strength you must convince the body that you do not have enough strength without damaging the muscles. You do this by using just enough weight to be able to lift the weight 5 to 10 times and reach muscle exhaustion. This is the edge for muscles – that zone a little bit outside your comfort and ability but not so far out that chaos ensues and damage occurs.

This pushing the edge of your capacity concept applies to almost every arena in life. You don’t improve if you stay inside your comfort zone where you are fully capable. Without challenge, you never advance. But on the other hand, if you take on a challenge that is too far outside what you are capable of then you will fail, and failure promotes hopelessness and a lack of further effort. Remember back when you were learning to read? If you mastered your first-grade reading material and then never tackled anything harder, you would not be able to read any better today than you did in first grade. Likewise, if you got to second grade and the teacher handed you a medical textbook and told you to read that, you would have failed and still would be reading at first-grade level today.

Life is about the gradual development of skills and abilities. It is not about being comfortable. Comfort is simply the first stage of decay. Life is about growth. This principle is reflected all over the body in how things work moment by moment inside of you right now. There is no such thing as a complete balance where what and who you are at this moment is enough for the next moment. There are no rest plateaus in life. You are either climbing uphill or sliding downhill. I hear the lamentations about this truth every day from patients. It usually sounds like “This getting old stuff isn’t for sissies.” At a certain point, you start feeling the sliding downhill a bit much. But occasionally, I have an older patient who is still full of life and energy. Curiously they are usually dancers. They come in to see me because of the same aches and pains I see in the younger folks; activity-related pains. I have a few of these senior patients who tell me about the 30-mile bike ride they took yesterday. They are proof that physical decay is really about not staying challenged.

Mental decay is very much like physical decay. Staying mentally challenged is key to keeping your mind young. The mental challenge is all about embracing new learning opportunities. There reaches a point where refining old skills loses the reward of the release of neuron growth-stimulating hormones in the brain. You need new challenges. Take up a new hobby, learn a new language, learn to play a new instrument, learn to dance, etc. These are new challenges. Some benefit is gained by doing crossword puzzles and Sudoku, but the benefit is limited. Probably the biggest challenge to the brain that keeps it young is to form new relationships. So many seniors are alone. Falling in love is the best medicine.

The physical, emotional, mental, and spiritual truth of challenge versus decay opposes the widespread drive most people have to secure safety and stability to be comfortable. I hear this desire from people as much as how much they hate getting older. This desire conflicts with reality, and as a therapist-patient of mine said to me last week “Reality always wins.” I am not saying comfort is bad in itself. Comfort is like comfort foods – they are delicious and need to be taken in small quantities or they screw up our health. The ability to deeply rest and be at ease is a powerful skill all in itself. I strongly recommend learning this skill. However, being a couch potato is not a healthful skill. Eating junk food is not a healthful skill. Ignoring your relationships so you can spend your time on your phone is not a healthful skill.

Live life on the edge. That is where you can feel life and where life can support your health. The pursuit of comfort is the pursuit of gradual decay. Fully enjoy the moments of comfort when they happen, but don’t make them your goal. Make living life your goal.

Take care,

David

Ellen 

Amber Elliott, owner of Elliott’s nutrition took Ellen and I out to dinner at Mystique dinner theater Monday night as a late birthday present for me. Mystique was all set up for Halloween with an Edgar Allen Poe theme. The magician for the evening was a wonderful storyteller. He wove the theme for the night into his act quite well. Good times were had by all. Here are Amber and Ellen consuming the appetizer, apple rings and caramel sauce.