When it comes to persistent pain (and I am pretty certain that there is no damage) I like to test my clients perceptions about their pain.
For example, one of my clients has pain when raising her arm overhead. She knows the exact point at which the pain will start.
She shows me.
Lifting her arm I can see her focusing on the point at which she can feel it. "There" she says as her hand lifts just above shoulder height.
I talk to her for a little while and then throw a tennis ball at chest height at her asking her to "catch".
She catches it with no pain. Why would she? After all, she only gets the pain when her arm is raised higher than her shoulder.
She throws it back before I return it again, this time above the point at which she feels pain. She would need to experience the pain in order to reach high enough for the ball. Except the pain doesn't happen. She catches the ball and returns the ball to me with a look of confusion.
I throw again this time ensuring that she would have to reach high for the ball. Again, no pain.
I then ask her to lift her arm again and tell me when she feels the pain. And sure enough there it is.
Another client of mine is experiencing knee pain when she squats in her right leg.
Initially the pain was when squatting heavy. Now it's pretty much any time she bends her knee.
I ask her to let me know when she felt the pain come on as she squats down.
"There" she says grimacing, after squatting down in an extremely slow and controlled manner.
I ask her to do it again. "There".
"This time" I say, "I want you to continue to squat whilst counting back from 100... out loud".
Her face tells me that she thinks I'm crazy. But she does as I ask anyway and continues to squat down and back up. No pain.
"100, 99, 98, 97, 96, 95, 94, 93, 92" She's back standing, staring at me. There was no pain.
"What the? Is it psychological then?" she asks. I shake my head and ask her to squat again continuing where she left off at 91.
"91, 90, 89, 88, 87, 86, 85, 84, 83, 82"
Again, no pain!
You see when it comes to persistent pain, we have the tendency to focus way too much on the pain. This causes an increase in the sensitivity of the area which means that we experience pain all the more (and even by just thinking about it in some cases!).
I need my clients to move in order from them to desensitise the area that they have the pain coming from. But the problem is that they are so afraid to move because of the pain, that they keep it protected all the time.
But when I distract them by throwing a tennis ball or by getting them to have to think about something other than their pain, the pain is no longer happens. They then start to realise that their pain is more to do with sensitivity.
Yes it's all well and good me explaining that pain does not equal harm for them (which I also do). But to SHOW them, for them to experience it for themselves, that's worth a million words.