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“I ache in the places where I used to play” – Neuroscience nugget No. 18

By David Butler Neuroscience Nuggets 13 Jan 2016

Flexion, rotation, snakes

I am just shy of 60 years and I was doing some painting on the weekend in a place where I knew there were tiger snakes. With a combination of spinal flexion, rotation, tiger snake apprehension and a host of other contributors, I suddenly experienced sharp, breath taking, swear enhancing low back pain. No wonder people become so fearful of pain! I hobbled away, thoroughly pissed off, lay on the floor and a lyric from Leonard Cohen came to mind;

“I ache in the places where I used to play

The power of context and meaning

For me, this lyric can be a Neuroscience Nugget – a reminder of the powerful aspect of the context and meaning of a pain or an injury. Because we do often ache in the places where we used to play – knees that carried us as we ran across the baseline like Roger Federer, shoulders that lifted our children and loved ones, or backs that swayed easily as we danced and grooved. Maybe sometimes we also ache for the times when the part was in all its glorious use. When this happens, it’s easy to get angry with the part; to reject it, to seek quick, invasive answers to problems with the part. Maybe we disembody it.

A reminder to see the whole person

I’m not suggesting that a young clinician immediately asks someone if they ache in the places where they used to play… But to think of the nugget as a reminder to see the whole person and their rich history – to avoid the inherent disembodiment that comes with just treating a part or a place. If you think about it, really good graded exposure to activity is really just about playing with the aching parts and places in different ways and contexts, as you learn to love again the body and all its places, that were once a vital part of so much play and life.

Here’s Leonard Cohen performing Tower of Song in 1989



“Now my friends are gone and my hair is grey

I ache in the places where I used to play

And I’m crazy for love but I’m not coming on…”


-David Butler


“Neuroscience nuggets”

Neuroscience nuggets are information nuggets – pieces of biological information based on statement or metaphor that can be used as educational analgesia, explicit education or part of overall story telling. We have collected over 100 of these for a book and will release them regularly on NOIjam.

Get a double dose of Neuroscience Nuggets in special three day, combined Explain Pain and Graded Motor Imagery courses in Townsville, April 29 – May 1, or Noosa, June 17-19.


  1. So true. Well said. We need to learn to accommodate, even ‘befriend’, the vulnerabilities arising from the ageing process, or even from chronic pain conditions at an earlier age. Expectations of ‘normal’ functionality can actually increase the disappointments that usually accompany any realisation of ‘reducing’ functionality. Anyone, who hasn’t been forcibly familiarised with the mindset adjustment requirements of adapting to new limitations, will probably have difficulty grappling with something they perceive as ‘resignation’. In some situations, a little resignation is actually a positive, helpful, and more pleasant way of moving forwards.
    Regarding the low back pain, something I’m familiar with, I’ve always found it helpful to be seated when attending to any work below hip level. A normal 5 ltr paint tin usually does the trick. Simple but effective !

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