A Tale of Two Cups

I’ve mentioned before that I love to use analogies when talking to my patients. The following are two examples of when I get creative and decide to whip out the pen and paper to illustrate my education stories.

The first cup/glass we will call the “pain cup”. The pain cup represents a measurable space in which all of the information your brain has to deal with that could lead to an output of pain is stored. When the cup gets full and begins to overflow is when a person has pain. There are a host of factors that add their individual liquids to the cup. Nociception, stress, anger, depression, lack of sleep, central sensitivity, poor diet, previous experiences, negative beliefs, etc are all factors that can add liquid to the pain cup. Drop by drop the cup fills up and when the danger threshold is reached, out comes the patient’s pain pouring over the edges. In acute pain the primary liquid tends to be nociception; as it should be. However, as chronicity sets in, all of those other factors can swing to be the largest contributors to the cup. I let patients know that we are going to try to decrease the amount of liquid in their cups with exercise, manual therapy, relaxation, and education so they will end up with more available “wiggle room” in their cups.

 

 

The second analogy involves a cup/glass as well. However, this analogy isn’t about taking fluid out of the cup, but instead about getting a bigger cup that can hold more liquid. I use this cup analogy when explaining to patients and clients the importance of gaining strength. I explain that their body is a cup and every time they train/exercise/do the activity that had led to their injury they are pouring water into the cup. Once the cup gets full and begins to overflow is when the tissue has reached its maximum tolerance and begins to have issues. When we strengthen our muscles, bones, tendons, connective tissue we are making our cup bigger. Bigger cups hold more volume. More volume mean mores activities/exercise/training before the cup gets full, overflows, and leads to injury.  

 

These seem to go over really well with patients and make complex topics easy to understand for anyone. Would love to hear feedback on these or if you guys already use them/similar ones!

-Jarod Hall, PT, DPT, CSCS

 

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