How would you describe your perspective? Would you consider yourself a “glass-half-full” or “glass-half-empty” type of person? According to the Cambridge Dictionary, “glass-half-full” people tend to view the world more optimistically, while “glass-half-empty” people see the world more pessimistically. For example, an optimistic person might see half a glass of water sitting on the table and think “I’m thrilled this water is here because I’m so thirsty!” A pessimist might see that same glass of water and think “Oh no, I’m so thirsty and all that’s here is a half glass of water!” These comparisons show us the differences in how people see the world or - their perspective. Neither perspective is “bad” or “wrong” as both can serve a purpose and more importantly, both can be changed. In fact, someone’s “normal” perspective can change depending on what’s happening in their life.

Changing old beliefs and barriers

At Hinge Health, I help participants reduce chronic musculoskeletal (MSK) pain through our sensor-guided exercise therapy, personalized education, and remote 1-on-1 coaching. As a first step as their Health Coach, I help people change their perspective regularly to begin to heal. It’s exciting to help people make that shift, but also witness the magic when it happens. Each day I talk to people who come into the program with certain perspectives they’ve adopted based on what their body, mind, or others are telling them.

Here are some examples:

• “I’m too old, so I can’t do it.”

• “I don’t like exercise, so I doubt I’ll be able to stick to it.”

• “I’m in too much pain to move, so I know I can’t do it.”

• “I heard that surgery is the best option, so I’m going to plan for that.”

• “I tried physical therapy in the past and it didn’t work, so I’m sure this won’t either.”

• “I already have an exercise routine, so what I’m doing will work just fine.”

• “The last time I bent that way I threw out my back, so I’m not doing that move anymore.”

• “I’m too busy, so I can’t see when I’d have time to do this.”

I help Hinge Health participants break through a wide variety of potential barriers and beliefs before they can move forward. For example, I frequently hear movement equals pain and pain equals harm. Their body has taught them this belief and it’s continually reinforced with every pain signal resulting from movement. This limiting belief can be very debilitating not only physically, but mentally and emotionally as well. It can sometimes bleed into almost every aspect of their life affecting mood, relationships, the health of their body, and the choices they make.

By the time people with chronic pain enter into the Hinge Health digital musculoskeletal program, they’ve already tried every trick in the book with little success. This may include passive coping techniques such as pain medicines, injections, massage, and ice/heat therapy. While these therapies can be helpful for a brief window of time, they aren’t typically considered long-term resolutions for joint pain. As a result, people end up feeling desperate and hopeless when the pain creeps back in.

How Dania reduced her chronic knee pain by changing her perspective

To give you a clearer picture of how this might present in real life, let’s take a look at a day in the life of one of our Hinge Health participants. Meet Dania, a 43-year old woman who said: “my knees felt like they were 90 years old.” She was referring to the pain she felt before starting the Hinge Health Knee Program. She felt frustrated and annoyed that she suffered from debilitating knee pain at such a young age. It kept her from doing the things she loved like softball, going to the gym, running, and walking her dog. Also, it embarrassed her to walk with a limp.

She often took over-the-counter pain medications along with ice and steroid injections to relieve the pain. She received multiple injections in her left knee over the years and one in her right knee in December 2019 due to having a torn meniscus, bone spurs, arthritis, and loose bodies. Until recently, she was scheduled to get injections in her right knee every 6-8 weeks for as long as she could tolerate. The next step would be surgery. Having had reconstructive surgery on her left knee in high school and then an arthroscopic surgery on the same knee in 2018, she knew something had to change otherwise her right knee would have to go through the same thing. To complicate matters, her doctor advised even if she had arthroscopic knee surgery on her right knee, she likely would have to get a full knee replacement by the time she turned 50. This was unacceptable for her. She knew there had to be healthier ways to manage her pain, but she was initially unaware of alternative options. It’s around that time she found out about Hinge Health’s sensor-guided exercise therapy and remote 1-on-1 coaching through her employer.

After changing her perspective to overcome past fear and old beliefs, and pushing her body through pain and 20 weeks of hard work, she shared the following thoughts about her journey:

“ When I first started I thought ‘Okay, I will do this to give it a try but I doubt anything can replace surgery.’ Today, I know without a shadow of a doubt that I was wrong. Not only was I wrong but I have canceled my surgery plans for August/September and I canceled all my cortisone shots after the first one (which I had before starting Hinge Health). I have not taken a Tylenol, Advil, or any other medication for knee pain/swelling since I began the program and I honestly don’t see why I ever would again by doing my program. I can’t even remember the last time I put ice on them.”

4 steps to change your perspective to reduce chronic pain

You and your members can do what Dania did and change perspectives to overcome chronic pain. Once someone has decided to commit to Hinge Health’s at-home digital care and sensor-guided exercise therapy, as a health coach, we work with them to create sustainable behavior and mindset changes. Here are 4 steps to help you and your members’ shift their perspective to address chronic joint pain and start feeling better.

1. Go from resistance to acceptance and action. It’s not always easy to create new habits as sometimes change is met with ambivalence or resistance, even if the change would be considered beneficial. How do you go from one of these thought states to one of acceptance? We’ll go deeper into this in the next few sections.

Resistance is the refusal to accept or comply with something. Ambivalence is having mixed feelings about something or not knowing what to do. It’s important to identify what thoughts or feelings you’re having if you want to change your mindset. Here are a few common themes of why people are resistant or ambivalent about changing behaviors:

• It’s a lot of work

• It’ll take too much time

• Okay with the status quo

Here are some ideas that might help you get to a state of acceptance and action:

• Make a pro vs. con list. Let’s say you are trying to decide if doing exercise therapy is worth it. You can draw up a list of the pros and the cons of doing exercise therapy. Then, you can look at the pros and cons list to help you decide whether or not it’ll be a worthwhile investment of your time and energy.

• Make it easy. The easier it is to start the behavior the more likely you’ll be to do it. All-or-nothing thinking does not apply here. Anything is better than nothing, so try to learn to be okay with small steps.

• Make it convenient. Keep all needed items together in a visible location and ready to go. If there are unnecessary barriers in the way of getting it done quickly, it’s easier to talk yourself out of doing it.

• Make it desirable. Reward yourself with some type of non-food reward such as watching your favorite TV show afterward or buying yourself a pedicure after doing the exercises 5 days of the week. The more excited you are to get the reward, the more motivated you’ll be to change the behavior.

2. Reflect on what’s motivating you to change. Is your motivation coming from within? Examples might be feeling stronger, sleeping better, or improving your balance. Or maybe you’re more motivated by external factors such as verbal recognition, having an exercise buddy, or buying yourself something as a reward. Most of the time, it’s likely a bit of both. Sometimes the motivator can even seem like an external motivator, like buying a new dress for yourself if you reach a certain weight. But if you look a little deeper, it’s a little bit of both. The dress itself may be a component of why you want to achieve a goal, but the reason behind why you want the dress is internally driven (sense of pride for a job well done, for instance). If you haven’t taken the time to really think about what’s motivating you, it might be a good time to do that to help you shift into a more open mindset to change your perspective. Once you do this, you will be more likely to make the changes needed to see improvements.

3. Shift how you think about your body. Many people at this point might not have the confidence in their body’s ability to perform to see change. It can help to think of the therapy exercises as similar to the daily movements you do throughout the day. When doing squats, for instance, you are mimicking getting up and down from a chair. Sometimes thinking in terms of what you do daily might help you realize you are more capable than you’re giving yourself credit for. I hear people say “I can’t do squats” and I might ask “What do you do to get up and down off of a chair?” Also, it can be helpful to observe small improvements over time vs. all-or-nothing thinking such as “I still have pain” or “I’m pain free.” Small improvements might be no longer tossing and turning all night in bed, being able to bend your joints a little easier, or walking without assistance.

4. Think small and incrementally challenge yourself. Take small steps and then gradually build on them. Maybe you do a few exercises a day, see how you feel, and then expand to more exercises. Or maybe you start once a week and then build up to several times a week.

Taking baby steps is progressive and allows you to incrementally challenge yourself more over time. It also allows for your perspective to change slowly along with each small success. Each time a small step forward is taken, it reinforces your body is strong and adaptable--ultimately increasing your confidence. As your confidence builds, you’re more willing and eager to push yourself harder. This starts a positive feedback loop. That’s when the success stories start pouring in!

The magic of changing your perspective

Here are some examples of comments I’ve heard from people who’ve gone through this perspective change in the Hinge Health program:

• “I can’t believe I was able to go biking with my grandkids for the first time ever!”

• “I just realized that I was able to get off the floor without grabbing onto something.”

• “This is remarkable! I can’t remember the last time I slept through the night.”

• “I no longer dread using the stairs at work.”

• “I can’t believe I was able to do a lunge!”

• “Fitting the exercise therapy into my schedule was easier than I thought.”

• “I don’t really need to carve out extra time to do the workout, I just need to maximize my time. I’m now doing it while drinking my morning coffee.”

• “I thought my family responsibilities were going to inhibit my ability to do the exercises, but I actually have my family doing it with me!”

• “I used this program as a starting point in my weight loss journey and I’ve now lost 10 pounds!”

These are examples of real stories we hear every day from people using the Hinge Health program. It’s important to pay attention to what you’re telling yourself daily. It can play a significant role in how you feel physically as well as mentally and emotionally. What are you telling yourself?

Through sensor-guided exercise therapy and remote 1-on-1 coaching, Hinge Health offers a holistic approach to reducing chronic back and joint pain. To learn more how the three pillars of exercise therapy, education, and behavioral health drive long-term outcomes, Request a demo below.