Three Questions with Meghann Koppele Duffy

Episode 31 - Rethinking Injuries: A New Lens on Pain, Recovery, and Agency

• Meghann • Episode 31

Share episode

Pain isn’t weakness leaving the body… It’s information your brain is begging you to notice.

In this episode of Three Questions with Meghann Koppele Duffy, I want to rethink the way we approach injuries. Instead of chasing pain-free perfection or trying to “push through,” I explore what really happens when we stop outsmarting our own brains and start listening to what pain is trying to tell us. We’ll talk about why ignoring pain only makes it louder, how neuroplasticity actually works, and why true recovery begins with curiosity, not control.

In This Episode You’ll Hear:

• Why the “push through” mindset keeps us stuck in old patterns

• How to work with your brain instead of against it

• What real recovery looks like when we prioritize safety and sensory input

Whether you’re a movement professional or just tired of fighting your own body, this episode invites you to rethink what progress, healing, and resilience actually mean.

Links & Resources For This Episode:
Find a Neuro Studio Teacher Near You
Connect with me on Instagram
Connect with me on Threads

Meghann Koppele Duffy: Welcome to Three Questions where critical thinking is king, and my opinions and research are only here to support your learning and deeper understanding. Hey, I'm your host, Meghann, and I'm so honored you clicked on Three Questions today to talk about injuries. So I'm gonna keep today's episode on the shorter side because I'm not gonna talk about any specific injuries.

I want us to kind of step back and look at a big picture of everything. So let's get right into question one. So why do we keep trying to outsmart our own brains? What do I mean by that? So when it comes to pain, why do we think pain doesn't matter? Why do we think when pain happens? That, oh, I just need to work harder.

I'm not doing enough. I need to do more. Pain is weakness, leaving the body, all those dumb ass things that we tell ourselves, or maybe that pain isn't high enough to do something about it. So I have a rule with my clients when they're even at a pain level. One, I need to know that information because pain is an output.

So when there's even a little bit of increase of pain, that's the brain's way of communicating with me, that, hey, this is not what I need right now. This is not a new movement pattern. This is the pattern that is going to lead to more pain. And you know what's so funny? I see this with clients all the time.

They'd be like, oh, no, no, it's not that bad. I can deal with it. And I'm like, no, but that's not it. That's not what we're trying to do here. I'm not looking to make you more mentally tough by asking you to not listen to what your body is telling you. That doesn't make you weak if you acknowledge your pain.

Now, the flip side of that coin, because I argue both ends of the conversation, is what if you're in chronic pain and you're always in pain? Me saying that, it's like, yeah, but I always live in pain, so either I don't do anything. Or I live with pain. Now I'm gonna give an opinion. Here it is my podcast. I do think there is a way to get you out of pain, but we need to find a significant enough sensory input that can regain your brain's focus so we can create a new movement pattern.

Is that easy? No, it's not. However. If we still allow pain to happen, it's an indication that we're moving in the wrong direction. Okay? So what I want us all to ask ourselves is why when we feel a little bit of pain, we ignore it until it becomes a big problem. I'm asking the question because I'm curious.

I do it to myself too. I joke that I have a low tolerance of pain, but it's more so because I know if I'm feeling pain, I can either nip it in the bud now, or in six months from now something significant is going to happen, and every time I ignore that pain, well, it usually happens like every five or six years.

I get some like weird injury that my body's been giving me clear signs for years, yet I've been ignoring it. Now I'm still relatively young. I'm 43, so I can still. Adjust and luckily this is what I do for a living, but as we get older, it's harder. And I know when I was younger I was like, ah, it's gonna hurt now, but I'll deal with that later in life.

I'm fine. I'm resilient. That's a problem. Okay, so I'm not gonna give you solutions how to deal this problem. I want you to ask yourself why you choose to ignore your brain. I say this all the time to my clients. You might be the smartest person in the world. Probably the smartest person in this room.

However, you are not smarter than your brain. It's your brain. And they look at me and they're like, well, she does have a point there. It's a little, hold on man. Let's follow her logic here. But it's true. You are the expert at your own body. I love when people, you know, this has happened to me where people will critique my movement and tell me to move differently, and that hurts.

I'm doing it the way I'm doing it because that's what feels better to my body. Um, this has been, listen, my background's in biomechanics. I respect biomechanics. I love it. It's gotten me here, but it's only a piece of the picture. We assume we know what's better for people's bodies. Nothing pisses me off more than Pilates.

Teachers critiquing people's movement, like they know better than that person. The arrogance. It's comical, but, that says more about them. When people are moving and they're not in pain, I want you to be like, interesting. Or if you see someone moving and it's like so jarring to your eyes, I want you to say to yourself, wow, that's what their brain thinks is the best option. Interesting. How would I give their brain another option?

Because listen, bad posture over time is not good. I'm not saying to walk around with shitty alignment is ideal. It's not. But what I'm saying is you gotta meet people where they're at. Their brain thinks that's the best option. Interesting. What can we do with that information? So when you're in pain, that's your brain's way of communicating with you.

There's a ton of research. You know, we're looking at pain science, and I hate when people are like, oh, so the pain's in my head? No, no, no. It's not that you're imagining it. Okay, but there's not actual major damage where you're feeling pain. It's usually nine times, you know, I don't wanna say nine times outta 10.

A lot of times it's an overuse injury, so that most efficient movement pattern that you are using is no longer serving your brain. Your brain might be wrong. Your brain might be overreacting and being a helicopter mother, it doesn't matter. Your brain is gonna put out that output until we can give it more information to feel safe and create a new movement pattern, and creating a new movement pattern's not easy. Try learning a new language. People take movement for granted. They want me to, you know, someone's like, oh, I, I don't wanna do all these exercises. Well, do you wanna walk better? Yeah. Do you wanna be outta pain? Yeah. Well then you've gotta do these exercises. Neuroplasticity doesn't work because you say it three times, like Beetlejuice.

Neuroplasticity only works when you are able to repeat that movement pattern. And what most people do is they don't repeat movement patterns. They do different movement patterns every time, or competitive plasticity, which is such a pain in my ass. Competitive plasticity is neuroplasticity. But if you don't change the movement pattern with new, unique sensory input, you are reinforcing the old pathway, right?

So that's just gonna become stronger, more efficient, and lead to more pain. It's complex, it's hard. Please don't, don't think, I mean, it's easy. So with your injury, why are you trying to outsmart your brain? I want you to think when it comes to pain, that's your brain talking to you. You don't need to like what it says, but you need to say, okay, say more.

And I want you to change your mindset. If your shoulder hurts, stop moving it. Ask yourself, how can I support this shoulder? How can I move nearby joints, diagonal joints, joints far away so that those joints do more and my shoulder has to do less? How can we support the area of injury? Don't be arrogant to think that based off your knowledge of the body, you can just shift your shoulder and reteach it.

I mean, God, if that was the case. I would never have injuries. Nobody would. Right? We've gotta deal with what the brain's giving with us and say, okay, I don't like this, but this is what we got. Let's change that. Let's change it at the level of the brain. Question two, what would change if we stop trying to fix injuries?

What would change if we stopped trying to fix injuries?

Think about it. And the other part of that, what if we focused on supporting the body's recovery process? Like I just talked about, the whole body's connected. Most people get shoulder injuries, not because the shoulder's the problem, because the diagonal and the hip underneath it. We're not stabilizing enough.

The glute wasn't active enough. The lat couldn't fully express itself. That inhibited the arm movement, or they can't differentiate their acromioclavicular joint from their glenohumeral. Those are just two joints of the shoulder of the shoulders made up of four joints. Those joints are so effing close together, they are hard to differentiate.

Most people aren't using the most mobile joint in their body, which is your glenohumeral. That's the ball on the socket shoulder. I see so much over mobilization at the AC joint. Acromioclavicular,, that's where your clavicle, the end of your collarbone, meets the acromium process of your scapula. And lemme tell you, the scapulothoracic, all these people worried about upper rotation of the scapula are totally overdoing it.

The glenohumeral is not centrated and not moving. That is the more mobile joint, but it's hard because it's hard to differentiate. So rather than trying to micromanage joints that are already overworked and underpaid. What if you supported those joints? Get the full body to work together. Use my four quadrant stability model.

Works every time.

Now no, I have all this research, but I don't know if it's gonna, I don't know if it's gonna convince you guys, not that I'm trying to convince you.

Let's talk.

So many people have injuries. So many people, I don't know anybody who's not, doesn't have an ouchie. They're doing their best. They're going to the gym. They're trying to do all the things. Okay? It's not as simple as just a list of exercises or doing exercises. It's really understanding how your brain and body work and can bring in sensory information.

A lot of people don't respond well to proprioceptive information. That's basically touch base cues, pressure based cues, positional based cues, but the whole fitness industry is based off proprioceptive cues. My body use works best when I use peripheral vision based cues. I'm not really great with gaze stabilization, never was.

Peripheral vision, very strong. Okay. Everybody has an asset how their brain works, so if we take more time to tap into that. So how can we better understand ourselves and our client's nervous system? Where are our strengths? Where are our weaknesses? And stop over concentrating on joints that are injured.

I can almost guarantee, and there's like opposing joint theory, all that where they don't, they don't really explain the whys. It's because everything is connected fascially, and normally if your shoulder hurts, your opposing joint is either not stabilizing or mobilizing in a way that it is fascially and muscularly pulling on the diagonal joint.

That makes it angry. Problem is just doing simple mobility drills are not necessarily building awareness, right? So say I'm trying to do supination and pronation, which is turning your palm up and down. You can see me on YouTube. Okay, I've got my arm resting on my knee, but when most people supinate and pronate watch what I'm gonna do, I moved my elbow off my knee, so I'm actually mobilizing a bit at my AC joint and my glenohumeral, maybe a little scapular thoracic, but I'm not fully doing supination and pronation, which, confuses people. 'Cause you're saying, Meghann, I thought you said we were supposed to move as a whole system. Yes, and in order to move it as a whole system, our brain needs to know what's available. So if you're not mobilizing or moving a certain joint, your brain won't think it's available, so it won't be utilized that in the full system movement.

This can be complex. And this is where I feel like physical therapy and corrective movement and corrective Pilates have gone wrong. They have isolated things so much they forgot to learn how to teach people to put it back together. Then the fascial people love that. However, just queuing fascial does will not necessarily open up shift or give the brain enough safety to mobilize a joint.

We need to do it all. This shit is complicated, but let it be this exciting and so much more to learn. We're never done as humans, so when you think you got everything figured out, man, there's always something new to learn. And question three, I want you to ask yourself, this is more for my movement pros listening, but I'm gonna reframe it for my non-movement pros.

If you could rewrite the most common rehab advice floating around or on social media, what would you say instead?

What would you say instead? Oh, if your low back hurts, do this. And now, I hate when people poo p people trying to help on Instagram. Do you know how hard it is to explain something in one minute in a way that's meaningful and impactful? It's not easy. Also, yes. I just shared one minute of probably 43 years of experience, right?

However, that one minute is not what's gonna unlock it. There is no one exercise to fix low back pain. There is no one exercise to fix foot drop or frozen shoulder. To me, it's understanding how to identify the unique sensory environment and figure out how to remain focused with a specific sensory input so we can do repetition.

Could you ever do an exercise and it's like, oh my God, my back didn't hurt, and then you try to replicate it the exact same way. You can't. Then I'd be like, oh, my back hurts again. Yes, because you were focusing on the output, not the input, and all queuing in the fitness industry, with the exception of Neuro Studio teachers.

Is all based on the output. Mobilize your thoracic spine, mobilize this, move that, no, no, no, no, no. We give specific sensory cues. Focus on the sensory. Focus on the thing that's gonna get you the goal. They tell you this in life, if you're focused on the end goal and not. Focused on what's gonna get you there.

You're never gonna get there. Right? If you wanna learn a new language, you gotta learn the words and practice. You can't just hope you're gonna learn the language, right? Just by hearing it is not gonna learn it unless you're like a language expert. You know? There's some people that can do that, that they're the exception of the rule.

So what would you change to me? What would I change?

You know, I think I would be really changing human behavior. I say this to my dad all the time. Well, guess it's not that bad then, Meghann, what should I do for this? Do that, but we gotta do this, eh, I don't really wanna do that. All right, well then your knee will hurt. Sorry. So I joke with him. Well, it can't be bad enough.

We've gotta be honest with people. Change requires discomfort. Challenge. If you wanna change something like a movement pattern or get out of pain, you've gotta be willing to change shit, and that starts with you. You've gotta be willing to take these concepts and implement them into everything you do, right?

Maybe you use one of my peripheral vision cues and be like, Hey, I wonder if I reach down and get the dishes outta the dishwasher without changing my elbow and my peripheral vision. Maybe that'll help my back. Okay. I say to my clients all the time, I am not your landlord. Treat it like you own it. This is not a rental property.

Right. And I joke with them, but like I secretly mean it. Like, if you want to get better, you have to do the work it takes. It sucks. I wish it was easier. Trust me. If there was a shortcut, your girl would be the first one online. There isn't. But, but, but, but, but, and a big, but like mine is when you find the right sensory input, holy shit, it becomes so much easier.

How do I know that? Because I've experienced it. Movement is actually not difficult when your brain can process sensory input. I am not naturally a good mover, but when I have the right sensory input, I look like an amazing mover. Sometimes I play tennis and I look like a tennis player. And other days I playing tennis, like the guy I hit with was recording me and I felt like I was like performing and not really focusing on what I need to do, which is turn my head to follow the ball.

Because using vestibular, when I turn my head, my pelvis turns more. If I think about turning my pelvis, it doesn't turn more, but when I can initiate from my head and really get my vestibular system involved, everything is like. Chef's kiss better. I wasn't thinking about that. I was thinking about the shot, making it look powerful, making it look good.

I watched the video. I was like, oh my God, I look stiff as hell. I do not look like a tennis player. Please don't post that. And I was like, you know what? Actually post it. That's what I look like. Whatever. 'cause I wasn't focused on what will actually make me flow as a tennis player. And how, why did I come across the vestibular?

Well, I tried other things 'cause I had nobody to assess me. And what was funny is sometimes I hit an open stance forehand. That's when you kind of stay square and just rotate the hips and upper body. I saw Serena Williams do it, and oh man, she's fricking awesome. I was like, I wanna hit like that. Anyway, I'm rolling my eyes at myself for the arrogance that I thought I could hit, like Serena Williams, and sometimes I hit that, Ooh, it's good.

And other times, ew, it's like terrible. And I watched myself. I recorded myself. Probably 70% of the time when I do that, I lean my body, so YouTubers will see it. I lean my upper body, I move my hips and feet, but I tilt my head in the other direction. So vestibular, my balance is going to the left. My brain is having a bit of sensory mismatch, so I can't really get my feet and power underneath me.

But when I pull my head to the right with my racket, I'm able to create that force in power. So if I just focus on that, I hit much better.

Yeah, I know it sucks. Focus on the process. Focus on what's gonna help the change. I get it. This is not new information, but this is what we have to do. If you want change and you wanna change an injury, you've got to do the work. So my goal is to keep this under 20 minutes. I'm at 19. I'm gonna do my summary right now 'cause I have follow up episodes that we're gonna break down specific um, pathologies. So when we're thinking about our injuries, your brain is the expert at your body. You might not like what it says. Ask your brain. What are you trying to tell me? What are you saying? Give me more information. I don't understand. This is not what we're taught in school and in pt. They love to fix problems.

But what's a big critique about pt? Not all PTs, the PTs are listening to this. You are not the problem. You're part of the solution. I love you. Thanks for being here. But PT doesn't always work for people because they just give them these set of exercises that they can't do, they don't have good sensory and put it actually makes the problem worse so they never do them.

So when clients don't do the homework, guess who I blame? Not the client. Me and my practitioners. I said to one of my, my clients, you never do that exercise. And he's like, Nope. I go, why? It always helps. I don't know, Meg. I go, well, you know what? It must not have helped enough. And he's like, well, no, it's helping.

Like golf game is great. I'm hitting better than I ever have. And I'm like, yeah, but hmm. But then the back, every so often you'll be like, my back hurts. And then we have to go back to the drawing board. So I was like, what if we, what if we change it up? What if we do this instead? And I made it more simple and I said, what if you do this?

And he is like, I'll try it. And lemme tell you, this just happened last week. When I see him on Monday, I'm going to ask him how many times he did the exercise. And if he looks at me, I know that, look, I know it wasn't good enough yet. And I'll go back to the drawing board, I'll admit it. But we've gotta stop looking at the problem and asking why that problem is there.

And for my non practitioner listeners, I'm gonna give you a little secret. When something hurts, move the part of your body that never hurts. You hurt me if something hurts, move the part of your body that never hurts. Okay? Usually that part never hurts 'cause you're not really moving it or not, it's not moving with the rest of the system.

So activate it, move it, give your brain some new intel of that part and see how the part that hurt, felt, and then report back. So that's a little secret. Now number two. I forgot my questions. I had to write them down today. It's been a long week. What do you think would change if we stopped that fix it mentality?

What if we stopped fixing things and thought about support? What would happen? Try it. And if you like, do it with one client and it doesn't work well, you're not great at it yet. If you want to be a better practitioner, you've gotta get in the weeds, you've gotta make mistakes, you've gotta get uncomfortable.

Right. We don't wanna increase client's pain, but get curious. And for my people who aren't practitioners, going back to that trick I just gave you, when something hurts, move something that doesn't hurt. It's the Maureen Koppele theory. That's my mom. When we were kids, I'd be like, ma, my knee hurts. And Maureen would say, we didn't call her Maureen, we called her mom.

She would say, well, don't move that. Which we're like, mom. But she was right. If it hurts, when you do that, stop doing it. You know what clients always do? They're like, it hurts when I do this. I'm like, stop doing it then. But when they do that, I take a step back, I zoom out, I assess all pictures. It's kind of where my ADD brain is an asset.

I'm able to take in a lot of information fast, and I'm like, all right, let's go do left ankle exercises. Why are we doing that? Because when you did that thing that hurts, you mobilized your ankle and had no idea. Let's figure that ankle out so it'll stabilize. They look at me like I'm crazy until they're out of pain, and then they think I'm a genius.

I'm not. I just pay attention sometimes. And question three, what the hell is question three? Oh, if you can rewrite the script, do it. I changed the question to a statement. Rewrite the script. Stop following other people's scripts. Do you wanna be Netflix or Blockbuster? Everybody thought Netflix was stupid.

Everybody thought streaming was stupid. So did Blockbuster and now where's Blockbuster? And if you don't know what Blockbuster is, you have just proven my point. Okay? So stop using a model that's not working for you and your clients. You don't have to blow it up completely, but maybe a little transformation and transformations.

You gotta break some stuff. You gotta put some stuff together. You gotta be willing to say you were wrong. I do it all the time. We just made some changes in, uh, my business. My business partner and I sat down and we're like, this isn't working. This is, let's break some shit. It's more fun than you think. So I hope you have a little bit more.

I want you to rethink injuries. Send me some injuries you're thinking about. Let's talk about those specifically, but give these three questions a thought. Let me know what resonates. Let me know what you're still struggling on. 'cause I wanna hear it. I wanna better understand. 'cause I think when we have a better understanding, I think we can help more people get outta chronic pain.

Because if you're a practitioner, I know that's one of your goals. 'cause it's mine too. So thanks for listening to this one and I will see you next time. 

​