The Myth of ‘Normal’

Every Injury is Unique

One of the most common questions that people ask me when they come for a massage is

  • “Is this normal?” As they point to some aspect of their body or show me a movement they can or cannot do. My response it always the same, I ask them
  • “Is that normal for you?” While this might seem as though I am dodging the initial question it is the only honest answer I can give. There is no normal.

Every body is different and has had different experiences which have shaped it to the exact moment that brought the person into my treatment room. Every car accident injury is unique. What was the angle of impact? What was the speed? Did the person brace for impact? What were the models and years of the vehicles involved? The list can be infinite and those types of questions can be applied to most any injury.

Common outcomes and symptoms

There are common outcomes and symptoms which can be expected from certain injuries and scenarios. For example, most office workers that I see report having a sore back. However, there are a few who don’t report any pain in their back. That doesn’t make those people abnormal it just makes them uncommon.
Using the word common over normal might seem like an unnecessary semantic specificity but it is important to recognize the difference. Our word choice effects how we perceive ourselves and our injuries. When saying something is not normal, or abnormal, we place a negative connotation on that subject.

The nocebo effect

While thinking negatively might not seem like a major issue there has been research done which shows that how we think contributes to how we feel pain and even the likelihood of injury and re-injury. One study [1] looked at the nocebo effect, meaning “I shall harm” which is the opposite of the placebo effect which means “I shall please”.
They found that “negative expectations may result in the amplification of pain (Koyama et al., 1998; Price 2000; Dannecker et al., 2003) and that brain imaging showed that several regions of the brain, the prefrontal cotex and the insula, were found to be activated during the expectation of pain (Chua et al., 1999; Hsieh et al., 1999; Ploghaus et al., 1999; Porro et al., 2002, 2003; Koyama et al., 2005 Lorenz et al., 2005; Keltner et al., 2006).”
By thinking negatively we can potentially be increasing our chances of feeling pain. Our word choices, then, are of some importance. There is no universal normal way to be. There is only what your normal is. If you have never been able to touch your toes then that is your normal and uncommon for the general population, that’s it.

Establish a baseline

If you are unsure of what your normal is or want to become more aware of your body and its movements seeing a massage therapist is a great start.  A message therapist can assess your tissue and movements to establish a baseline so that if something does change it can be measured and addressed before it becomes an issue. Until that happens though, try to stay calm and remember that we’re all normal just in different ways.

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References: 
[1] When Words Are Painful: Unraveling the Mechanism of the Nocebo Effect, Benedetti et al., 2007