Pain continued:

What is in your cup?

The pain cup in another analogy for describing pain perception. In the previous blog we defined pain which may be associated with potential or actual tissue damage. The analogy that pain is the ‘alarm system’ of your body to ensure that we are protected from potential harm either physical, social or psychological in nature.

The water cup analogy adapted from Greg Lehman

Overflowing pain cupThe over flowing water cup analogy describes our body as a cup, with many factors that may drive your sensitivity to suddenly increase and fill up the cup. New or current stressors can be biological, social or psychological in nature that can tip us over the edge and spill our cups, where potential pain may emerge.

When stressors in our life exceed the space in our cup’s capacity, we may have pain.

 

Potential pain contributor examples:

  • Joint changes
  • Joint chemicals
  • Fear of movement
  • Poor sleep
  • Lack of support
  • Anxiety
  • History of pain
  • Habits

Everyone’s water cup threshold is different and we want to understand what individualised stressors make your cup overflow.

Ask yourself:

  • What is in your cup? (The potential contributors to pain)
  • What am I willing to change or address what’s in my cup? (You do not have to address all stressors to help calm things down)
  • How can you build a bigger cup? (To build your resilience to potential stressors)

Pain may occur when we do not adapt positively to stressors in our every day life. The good thing is stressors aren’t fundamentally bad as they allow our bodies to cope better as we gradually expose our bodies to these stressors. Hence there are different approaches that we can take to either calm things down or build them back up.

Pain overflow factors

Changing pain:

  • Which stressors are you willing to change?
  • During your consultation we will work on strategies to help you manage your pain and stressors

Strategies to calm pain down may include:

  • Education and reassurance
  • Activity modifications
  • Avoiding activities that flare you up for multiple days
  • Manual therapy (dry needling, massage, mobilisation)
  • Medication (antiseptics, antibiotics etc)

Podiatrist assessing pain

Building up you cup:

  • Improve mood
  • Improve coping mechanisms
  • Better sleep hygiene
  • Individualised load program

Some conditions may need more specific management strategies compared to others

Dermatological

An ingrown toe nail spicule (spike) may need to be removed before skin tissue healing can occur over using excessive amounts antibiotics if there is not infection.

Musculoskeletal

For an Achilles tendinopathy you may benefit more from calf raises to build up strength rather than swimming.

 

If you are interested in building up your cup, calming things down in your cup or any podiatry related questions feel free to contact richard@quayhealth.com.au

Post by: Podiatrist Richard Ching

Nerissa D'Mello​​

Clinical Lead Physiotherapist
Nerissa’s interest in physiotherapy began after experiencing multiple injuries growing up. Being in and out of clinics sparked her curiosity about how the body heals and inspired her to help others return to what they love. Early hands-on experience with a Scottish rugby club during her masters strengthened her passion for musculoskeletal and orthopaedic rehabilitation.
 
Now the Clinical Lead Physiotherapist at Quay Health, she has a strong interest in helping patients recover without surgical intervention when possible. Her treatment style combines hands-on techniques with exercise prescription, grounded in the latest research to promote lasting recovery.
 
Some of the techniques Nerissa uses are dry needling, VALD ForceDecks and Dynamo for data-driven rehab, taping, and shockwave therapy for stubborn tendon injuries.
 
She enjoys treating a broad range of patients, regardless of age, fitness, or background, and is currently expanding her expertise in women’s health.
 
Patients can expect a thorough, personalised approach focused on understanding their goals, hands-on treatment, and education in a supportive environment.
 
Outside work, you can find Nerissa training for her first full marathon, playing tennis, smiling at your dog, and trying to keep up with all her downloaded podcasts.
 
Clinical interests include:
 
  • Shoulder injuries, including rotator cuff and instability
  • Ankle sprains
  • Tennis and racquet sports injuries
  • Neck and upper back pain
  • Rehab from postoperative hip and knee replacements
  • Women’s health 
 
Languages spoken other than English: Conversational Hindi
 
Nerissa is available at Quay Health. Call 1300 782 943 to make an appointment or book online.

Jamie Belesky

Senior Physiotherapist

Jamie discovered his passion for physiotherapy through his own rehabilitation journey after tearing his ACL as a teenager playing football. Going through that process sparked his appreciation for how effective rehab can restore confidence and performance. He now has over 10 years’ experience working across musculoskeletal and sports physiotherapy in clinics in Wellington, Auckland, and London, including high-performance gym and sporting environments.

His treatment style is evidence-based, hands-on, and exercise-focused. Jamie combines manual therapy with structured rehabilitation programs to achieve long-term results and believes treatment should always be individualised to the person and their goals.

Jamie uses a range of techniques including dry needling, joint mobilisation, sports massage, taping, shockwave therapy, and VALD ForceDecks testing.

Outside the clinic, you’ll find Jamie running, surfing, playing golf, or watching football.

Clinical interests include:

  • Knee and ankle rehabilitation
  • Low back pain
  • Running-related injuries
  • Shoulder pain and instability
  • Tendon injuries

 

Jamie is available at Quay Health. Call 1300 782 943 to make an appointment or book online.