Several years ago the book The Inner Game of Tennis was first brought to my awareness on a Tim Ferriss podcast.   Many of you have likely heard of, and potentially read, this book as it was first published in 1974.  It is regarded by many as a classic in sports psychology and it piqued my interest on the subject of coaching and communication.  But as is often the case I filed the recommendation away as, I’m interested, and I’ll get to it at some point.  

 

After a recent speaker at a conference recommended the book again as the book all coaches need to read, I figured this was my sign to finally water the seed that was planted more than 3 years ago. 

 

And I’m glad I did.  It only took an afternoon (it’s a short 134 page read) but Tim Gallwey’s insights are timeless and generalizable far beyond athletic performance.  In fact as a patient of mine this week put it, the book is no more about tennis than the Zen and the art of Motorcycle Maintenance is about motorcycles.  It is a guide to more effective self observation, focus and action to facilitate your body’s innate intelligence.  Not surprisingly Gallwey’s Inner Game concept has grown to optimize performance and learning for individual’s, companies and teams from all over the world.

 

As I was reading I couldn’t help but connect the dots to 2 steps we commonly use in our clinic to help patients build resiliency and better manage their pain.  This process has stood the test of time, building better athletes, more productive executives and more successful people in general, and can help you take better control of your pain immediately.  

 

Step 1: Drop the (negative) judgements

 

One of Gallwey’s central tenets is that our ego, Self 1, has the tendency to put unnecessary limitations and barriers on ourselves which prevent us from optimally utilizing our innate natural ability.  We do this to ourselves by judging our situation as good or, more commonly, bad. 

 

If you are a golfer for example you have likely found yourself criticising a bad shot.  Let’s say you hit a poor iron approach shot to the green.  Your shot doesn’t go the way you intended and you start to evaluate what was wrong with the shot.  After evaluating several similar shots you are likely to start generalizing telling yourself you are terrible with your irons and maybe more broadly as you are a terrible golfer.  As Gallwey writes: “first the mind judges the event, then groups events, then identifies with the combined event and finally judges itself.  

 

These self limiting patterns of thinking are also common when we evaluate how our body feels and what’s happening to our body.  Thoughts such as 

-my knees are sore can lead to “they must be ruined” or 

-my back is always tight so “my disc must be deteriorating” or 

-my neck hurts because “my posture is always terrible” 

 

These negative judgements of our circumstance make it harder to make positive progress.  Going back to the golf shot example, it is much harder hit a good iron approach shot when you are trying hard to not to hit a bad shot.  You have mentally handcuffed yourself.  

 

The same can be said for these self limiting beliefs about your body.  You end up trying so hard to make your knees never feel sore or protect your back so you don’t “throw it out” or chase the fix for your posture that you handcuff yourself from making meaningful positive progress.

 

To build on the posture example lets say you are stuck to your desk or computer for long hours and you have neck pain associated with your work.  Your internal dialogue may go as follows: half way through my day, my neck starts to hurt.  It must be my bad posture.  You place negative judgement on your posture and your posture becomes the enemy.  Naturally you go on a wild goose chase for the latest gadgets and guru’s to fix that posture.

 

Your whole mission to fix your posture started with telling yourself that your posture is bad.  Instead of asking questions about why your neck might be sore, you added a personal value of thoughts and feelings to your neck pain that concluded that there was something wrong with your posture.  What if instead of labelling your posture as bad, or your knees as ruined or your discs as deteriorating you let go of the judgement and instead observed your experience for what it was?

 

Given time and encouragement to observe what your neck is being asked to do and what messages it is sending you, patients in a similar situation often say:

-on days I’m not stuck to the computer my neck feels better

Or -if I take lots of breaks from sitting my pain isn’t as bad

Or -when I take some time to do some simple stretches it helps my neck feel better  

 

By evaluating the objective demands on the neck as the primary issue and not judging your bad posture as the problem leads to a different thought process and often very different treatment approach.      

 

So be critical, be analytical and ask good objective questions (a good guide/therapist will help you do this) about your sore knees, tight back and your neck pain, but let go of the negative judgements and labels you place on them.   

 

 

Step 2. Narrow your focus  

 

Step 1 is to quiet the ego-mind.  But it is difficult to just stop negatively judging your situation without replacing it with an active focus.  Gallwey states as one achieves focus, the mind quiets. 

 

Focus means keeping the mind present in the here and now. 

 

If you watched the masters golf tournament on the weekend you may have heard the commentators talking about what Dustin Johnson was likely telling himself as he held a 4-5 shot lead down the last couple holes: focus on your breathing.  Don’t control it, just bring your attention to it.  This is a common strategy employed by athletes to stay in the here and now and to not get carried away thinking about the past or the future.   

 

I’m a squash player and I once had a coach tell me I wasn’t watching the ball well.  Coaches say this type of thing to their athletes all the time, but it was what he told me next that helped make a breakthrough.  He recommended I practice seeing two tiny yellow dots on the ball.  If you’ve played squash or have seen a squash ball you’ll know how small these dots are and how impossible this must seem.  If you’re holding the ball in your hands facing the right direction a couple feet from your eyes, sure no problem, but in the rhythm of a game?  Are you serious?  I spent alot of time trying to find these little dots, and you know what, when I was really dialled into looking for these dots I was able to occasionally catch a glimpse of them.  

 

Gallwey uses the example of tennis player’s focusing on the seams of the tennis ball to help watch the ball better.  By practicing to narrow your focus on something specific, like the dots or the seams on a ball, naturally over time allows one to see the ball better, rather than just watch it.  

 

I’d be lying if I said “now I always see the squash ball better”.  However instead of just negatively judging myself for not keeping my eye on the ball I now have a clear strategy to help me combat the issue.   

 

So how does this apply to helping us manage pain?

 

There are many forms of training that can be employed here including cognitive behavioural therapy techniques, breathwork and meditation and our area of specialty: movement and exercise.  

 

It is not entirely accurate to conclude that movement and exercise in general will be helpful in managing pain.  That broad stroke conclusion can frequently lead to frustration. 

 

Just as a coach recommended I focus on the yellow dots to help me watch the squash ball better, a good therapist or coach will use a specific cue to direct your attention to help achieve a broader goal.

 

Cues can be visual, such as “Nose to zipper” for better alignment in a movement or exercise, or auditory, such as “run quietly” to manage impact forces when running, or kinesthetic, such as “hips to ceiling”, to effectively finish your bridge exercise.  These are all sensory based cues to help narrow your focus.  

 

Lets zoom out for a second and see this in action.  If for example your goal is to make your knee feel better when walking, you can’t just try harder to protect the knee and not feel the pain.  It just won’t work in the long run.

 

We may recommend building better strength, balance and control in your leg to help with the issue.  One exercise we may consider might be a step down, for example.  While prescribing this exercise specific cues such as “nose to zipper” or “stand tall” or “bum touch wall” or “drive the ground away” may help direct your attention to better execute the movement.  

 

As time passes this narrowed focused attention will enable a broader focus of sensing how your body feels doing an exercise or movement.  Improving your ability to become aware of how your body feels is an essential building block in the rehabilitation process.  

 

Starting with a positive narrow focus will more effectively help build the overall goal of better strength, balance and control to help your knee feel better when walking.

 

For some patients, this 2 step process will come naturally and others will need some help.  A good therapist can help you win the inner game of pain.