The Three Stages of Recovery

11 April 2019

Ever stubbed your toe? Bumped your funny bone? Twisted your ankle? If so, then you know all about the stages of recovery from pain. Below is an outstanding article by Jason Silvernail, DPT. Read along, and keep your last injury in mind for comparison.

When you experience pain, your nervous system goes through three separate stages. You move through these stages every time you have pain, without exception, as long as you are alive.

These stages are:

1. Withdrawal 2. Protection 3. Resolution

Professor Patrick Wall MD described these stages years ago, and said that there was an instinctive response to help resolve pain. Let’s look at them a little closer and see how each of them are different but necessary for recovery:

Withdrawal is your nervous system’s way of removing itself from the painful stimulus, to reduce any damage it might sustain. Ever close your hand in a door or a drawer? Then you know all about withdrawal – you moved your hand back quickly without thinking about it. This is a reflex action your body has hardwired in to protect you. This is the first stage of response, and it is instinctive – it happens without your conscious awareness.

Protection is your nervous system’s way to try to ensure no further painful stress and possible damage occurs. When your hand got pinched, you grabbed and held it with your other hand, right? That’s your system’s natural protective response, and it is instinctive – it happens without your conscious awareness.

Resolution is your nervous system’s way to restore normal mobility and function to the injured part. Resolution restores the blood flow to the injured tissues so healing can take place. When you hurt your hand, and you shook it back and forth to help recover, it’s just instinctive – it happens without your conscious awareness.

Most people who have a persistent pain problem are stuck in the protection phase – their system is still trying to protect itself, and it’s not able to move toward resolving the problem. When you’re stuck in the protection phase you may feel stiffness, coldness, and muscle spasm in the area. You may feel as if the body part does not want to move smoothly.

Practicing corrective movement helps you move out of Protection and toward Resolution, and when you are doing the corrective movement successfully you might feel warmth, a softening, and a relaxing feeling as blood returns to the irritated tissues, mechanical stress in the tissue is reduced, and the system becomes less sensitive. This movement can be prescribed by a health care provider or it can be a natural kind of moving and stretching around to restore mobility and blood flow.

Many people try to fight against the protective response of the body - they try to deliberately change their posture or positioning away from the protective response so they can “look normal” again. Some common protective responses people fight against are a slight shrugging of the shoulder blade to protect the neck and shoulder area or a shift in the low back to the left or right to protect that area. This is usually a mistake - your attempts to force this are not likely to help - use the movement therapy instead. Don’t directly fight your body’s natural protective responses - help your body move toward resolution and the protective response will naturally reduce. Remember what to look for with successful therapy: a reduction of the protective behavior (less stiffness, loss of motion, coldness, muscle spasm) and a freedom of movement.