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.

Riccardo Erba​

Senior Physiotherapist

Riccardo’s passion for physiotherapy started while working with patients recovering from strokes, multiple sclerosis, and brain injuries. Seeing how vital movement is inspired him to explore the connection between the brain and body. Over seven years, he developed a holistic approach combining manual therapy, education, and sport-focused rehab.

His treatment style is evidence-based and tailored, blending hands-on therapy with corrective exercises and advanced technologies. Riccardo believes every patient deserves a personalised plan that balances pain relief and long-term improvement.

He uses techniques including spinal manipulation, mobilization with movement, dry needling, Class IV lasers, shockwave therapy, and VALD ForceDecks.

Riccardo enjoys helping clients who want to understand their bodies, relieve pain, prevent injury, and improve performance.

Outside work, he loves hiking, climbing, and following ball sports of all kinds.

Clinical interests include:

  • Headaches and neck pain
  • Shoulder and elbow conditions
  • Hip and knee rehab
  • Shockwave and laser therapy

Languages spoken other than English: Italian

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