Today we have Bernie with us and she is a patient that we've worked together for the last two years or so. And she's also a tennis champion and so has some unique pain conditions. So Bernie, tell us about your pain. >> well, I've had several of course being an athlete. I've competed for 40 years so I've had the aches and pains that go along with being an athlete. knees, ankles, elbows, shoulders, which over the years tend to still hurt. And then more recently in the past couple years I suffered an injury to my jaw, which has turned into kind of a chronic pain, condition. I had reconstructive surgery, and still continue to have pain in my shoulders, neck, and jaw area. >> So the pain occurs on a regular basis. Tell us how often it occurs and how intense it is. >> It's every day, all day. Sometimes the degree of pain varies of course, depending upon what I do. But, for the most part, while I'm awake at any time I do have pain. >> So, what kind of impact does it have on your life? What does it interfere with? >> Well, it, it tends to interfere with just about anything you do if you let it. I find that the more I can keep myself busy, and I teach tennis and I'm also a nanny. So I try to keep myself occupied throughout the day, because I find if I sit still or find a time where I might be on a long car ride or something the pain becomes more evident. Because the more I just sit there and do nothing the more I start to feel how bad the pain is bothering me. So I find that if I can distract my mind and my body by being busy I can help control the pain through that. >> So does it interfere with your lifestyle also such as your sleep or work activities? >> It does affect sleep. I do sense the injury to the jaw, I have had a tough time sleeping. And I find instead of laying down to sleep for long stretches of time I grab shorter periods of time for sleep when I've got the pain under control a little better. I find that sometimes laying down causes more pain in the shoulder and neck, so I try to find ways to sleep where I'm not necessarily laying down. >> Mm-hm. >> And that of course, I didn't grow up sleeping that way, so that's been an adjustment. I also find out that there are days when the pain is worse. Where if I've had a tennis match or lesson, something scheduled it might interfere with whether or not I go through with it, or how will I perform the daily task, depending upon the degree of pain. >> So there's a lot of things that you do to keep the pain under control. How do you self manage it? >> Well I tend to use heat and ice, as I found out on a particular day [COUGH] whether or not, which one is going to work. >> Mm-hm. >> I do stretching back, shoulders jaw. I stretch daily, multiple times a day. Just, just about anything you can think of to use. Heating pads, ice packs, whatever it may be on a particular day to try to manage the pain. But, I find probably that stretching is the most useful. >> Mm-hm. Being an athlete, I'm sure you've experienced pain during your tennis matches. How do you know that the pain is just from overexertion or is it from an injury? >> That's a, that's a tough question in that I think some of that has to do with a individual's pain tolerance. You know, as you go in and out of varying degrees of competition, and, and working out, you're going to use muscles differently. You're going to maybe play a long match that's going to put more stress on the muscles. And then you have to decide, you know, is what you're feeling pain just from overexertion like you said or did you injure yourself during the competition or the practice? I think the pain that I think of as an injury may be more related to, did I do something where I actually felt something give. Sprain an ankle, feel a muscle tear, dislocate something. I think at that point I would refer to that as an injury, I have had times where maybe I have strained or pulled a muscle or partially tore a muscle. Where because I was competing at the time, I didn't realize it was an injury and maybe competed through it, and paid for it on the other end. Having competed through some of that, I think even now as I get older, I have aches and pains that are probably related to those injuries that I probably didn't pay attention to when I was growing up competing as a junior. >> And do you have any recommendations for other athletes, in particular younger athletes, in order to prevent chronic pain into the future? >> I, I think you really have to pay attention to what you're doing. I think if you do twist an ankle, if you pull a muscle, if you actually, you know, see bruising in a muscle or an area that there usually isn't bruising. You really need to be concerned, be a little cautious. But I also think you know your body. People heal differently. And, I, I just think that being very aware, and I think being a little bit selfish at times because I've had coaches willing to ask you to push through and perform, when maybe the smart thing to do would be to hold back a little. And so I think, you know, if you are a competitive athlete all the way, probably high school as it's become more competitive through college sports and even now. And on the national level to be willing to say, is this the right thing to do? Should I continue on or what ramifications down the road will I pay for pushing through this. >> Yeah, very good. Is there anything else you want to share with us about the pain? >> I think that pain a lot of it can be controlled through a positive mind set. >> Mm-hm. >> Realizing you know, that it can become what it, what you let it become. If it is a part of your day. You know, try to focus on things that are a little more positive and realize that it doesn't have to be something that is your entire focus all day, every day. >> Okay, well thank you that's good. Mm-hm.