Insights from my latest podcast with Dr. Tawny Kross, Physical Therapist specializing in Chronic Pain.
After working with countless patients stuck in chronic pain cycles, Dr. Tawny Kross, a physical therapist specializing in chronic pain, has seen one discouraging pattern again and again: people finishing rehab, getting “normal” scans, but still living with pain. Often for many years.
And perhaps the most heartbreaking part? “They start to believe the pain is their identity,” she explains. “They think they’re broken for good.”
THE MYTH ABOUT PAIN
The most common, and misleading, assumption Dr. Kross sees in her practice?
That pain equals injury.
“It feels intuitive. You’re hurting, so something must be damaged,” she says. “But science tells a very different story. Tissues heal and they usually do so within six to eight months, even after significant injury.”
So why do people still hurt long after their body has technically healed?
“It’s often not the tissue,” she explains. “It’s the nervous system, stuck in a protective mode, sounding alarms even after the danger has passed.”
Pain, in these cases, isn’t a sign of damage, it’s the body’s warning system running on old programming.
A BODY THAT THINKS LIKE AN ECOSYSTEM
Dr. Kross recalls working with a veteran who had dropped a heavy block on his toe. It was bruised, swollen, clearly injured, but he felt no pain there. Instead, his knee, perfectly clear on every scan, hurt so badly he could barely walk.
“This is such a powerful example,” she says. “It shows us that pain and injury don’t always line up. The body doesn’t work like a machine with isolated parts. It’s an ecosystem.”
That ecosystem includes far more than joints and muscles. Dr. Kross lists the factors she sees influencing pain every day:
- Sleep quality
- Nutrition
- Emotional state
- Stress
- Previous experiences with injury
- Beliefs about the body
- Physical load
“When we look at pain through a single lens, like a scan or diagnosis, we miss the full picture. You’re not treating a torn muscle. You’re working with an entire system.”
“IT’S NOT JUST IN YOUR HEAD” IT’S IN YOUR NERVOUS SYSTEM
The brain plays a crucial role in how we experience pain, but that doesn’t mean it’s “all in your head.”
“Pain is 100% physical and 100% psychological at the same time,” Dr. Kross says. “You can’t separate them.”
She recalls treating veterans with deep emotional trauma tied to old knee injuries. In one session, she asked a patient to move his knee just five millimeters. He refused, he couldn’t. When she asked him to simply imagine moving it, he broke down in tears.
“It’s biology,” she says. “The nervous system remembers and protects. Sometimes even the thought of movement is enough to set off a flare.”
THE “GOLDILOCKS ZONE” FOR MOVEMENT
Many people trying to heal make one of two mistakes: they either avoid movement out of fear, or they push too hard and too fast.
“I see people grimacing through stretches, thinking ‘no pain, no gain,’” Dr. Kross explains. “But what they don’t realize is their nervous system is taking notes.”
When the body senses danger, even subtle danger, it protects. So if a stretch feels threatening, the body might temporarily allow it but then snatches that range of motion back to stay safe.
“That’s why we work in what I call the ‘Goldilocks zone’, just enough challenge to promote change, but not enough to trigger alarm bells. That’s where the real healing happens.”
HEALING IS NOT A QUICK FIX. AND THAT’S OKAY
“In our culture, we want fast solutions. Pop a pill. Do one session. Move on,” Dr. Kross says. “But chronic pain is a complex problem and it requires a layered solution.”
Long-term recovery, she emphasizes, is possible, but it asks for:
- Trust in the body’s natural ability to heal
- A shift in belief: pain doesn’t always mean damage
- Respect for the nervous system’s thresholds
- A focus on whole-person factors: sleep, stress, emotions, and more
- Consistent movement within that Goldilocks zone
“If someone needs the same treatment over and over just to feel a little relief, it’s probably just managing symptoms, not solving the root cause.”
THE PATH FORWARD: FROM FEAR TO TRUST
Healing from chronic pain takes time but it’s never out of reach. “The nervous system adapts. The body regenerates. It wants to heal,” says Dr. Kross.
Even for those who’ve lived with pain for decades, change is possible. The key is shifting from fear-based movement to trust-based movement.
“Your diagnosis doesn’t define you. It’s information, not a sentence,” she says. “With the right tools and support, people can build a new relationship with their body. One built on respect, trust, and hope.”
Want more insights from pain specialists like Dr. Tawny Kross? Follow for upcoming conversations that challenge old assumptions and help you move toward lasting recovery.
mila aleshina
curator
STOTT PILATES INSTRUCTOR, FRC MOVEMENT SPECIALIST, ELDOA PRACTITIONER
“It’s not enough to just get fit, you should be building a body that helps you enjoy your hobbies and activities without limitations.”
