What the heck does that even mean??
I first heard this original concept from Erik Meira (The Science PT) and it struck a chord with me. Especially as he notes in his "Load It" article how it is a very unspoken part of the "loading" that we apply to a system. So let's try and break it down, critique it, and see where it's applicable for us as clinicians.
CRITIQUE: Following up from the allostatic load post from earlier this week with the "cup analogy," I had a very good conversation with @corkinetic. While stress theory is a great starting point and clinically valuable to understand, it is certainly a overly simplified application as it deals with the emergent and individual process that is pain. That being said, here is how I utilize and understand this concept of "Psychological Loading."
We talk a lot about "loading" in rehab, but as @physio_praxis eloqeuntly put the other day in a helpful flow chart..."Do you even load??" Often times, clinically, we are constrained by pain and tissue status to truly "load" at appropriate % of RM, so does that mean that submax exercise and loading is useless? Def not. Here's why👇 ⠀
When we "load" in rehab some of the following things can happen as they relate to psycho-emotional factors:
-Decrease fear-avoidance through "violation of expectation." (ex: "I can't deadlift! It's bad for my back!" *Does Deadlift variation* "Woah! That didn't even hurt, what the heck?")
-*Potentially* if a patient has a higher "Psychological Threshold" one might say they would have more resilience to the MULTITUDE of different stressors applied to the system.
I should be explicit: WE ARE NOT PSYCHOLOGISTS...HOWEVER...properly educating patients as it deals with MSK pain and injury is ABSOLUTELY within our scope. And the research is quite clear in stating how KINESOPHOBIA and FEAR AVOIDANCE are two of the biggest perpetuators of long term persistent pain. So if we can get these wins by getting our patients moving, and educating them, well then, that's huge town! ⠀
What are your thoughts on this concept? Valid? Over simplified? Hit me and lets get some discussion below! #JustLoadIt