Fear of Movement

Fundamentally, fear is an emotional response to an imminent threat. It can be a fear of heights, a fear of small spaces, a fear of snakes, or even a fear of injury, pain and movement. Another term for a fear of movement is kinesiophobia – which is defined as “an excessive, irrational and debilitating fear to carry out a physical movement, due to a feeling of vulnerability to a painful injury or reinjury.”

Quite often, fear can be helpful as it is a protective response that stops us doing something silly or putting ourselves in danger. But, fear can also lead
to avoidance.

We have discussed that pain works as an alarm, and how that alarm system can become sensitive and go off when it doesn’t need to. We also know that avoidance and fear can cause this alarm system to become even more sensitive. When you have fear of a movement, which might be based on an expectation that it will hurt due to a previous experience you have had, your alarm system becomes hyper-vigilant and is looking for a potential threat, which can increase your pain or continue to drive avoidance of the movement.

Kinesiophobia, or fear of movement, can happen through two forms:

  1. A direct experience such as pain or trauma – e.g. you hurt your back when bending forward, so you then avoid bending forward because of this previous experience
  2. Social learning – e.g. you have been told by a friend or another health care professional that you should avoid bending because
    it is bad for your back – therefore, you learn to avoid bending.

Why are we talking about kinesiophobia?

A recent systematic review published in the British Journal of Sports Medicine found that a greater degree of kinesiophobia predicts greater levels of pain, and is associated with higher disability and reduced quality of life. How can you and your Physiotherapist or Exercise Physiologist work together to help?

  1. Be receptive to accepting that these factors exist
  2. We have tools to see if Kinesiophobia is present and is a factor
  3. Consider why you believe what you believe – have you been taught something that has caused you to become avoidant of movement?
  4. Work with your Physiotherapist or Exercise Physiologist to start to explore movements that you are concerned about. In a slow, graded and safe manner, you can reduce fear and increase mobility

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References:

Luque-Suarez et al. (2018). Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. British Journal of Sports Medicine.

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