Dr. Sean Pastuch

I spent more time failing fast in the first ten years of my 20 year career as a trainer and rehabilitation specialist than most people experience in their entire lives. I have founded eight companies, closed four, and left two with only life experience and knowledge to show for it. When I look back on the ten years of struggle, I'm grateful for them because they showed me how hard I am capable of working to achieve the success I desired. I was overworked, and underpaid, but the lessons were coming in fast. I wanted to enjoy a great marriage, and I wanted to be a present father, without compromising on my business ambition, and so a lot had to change. 

Over the next ten years I made myself undeniable, and the only option for athletes who wanted to get out of pain without going to another doctor, or missing out on their sport. I earned the privilege of helping an olympian medal when their whole games were at risk due to a shoulder injury, I helped more than 40 athletes compete at the CrossFit games including several games champions, and I helped a veteran pitcher in MLB avoid a career ending surgery to land one last seven figure contract. What was most surprising about that whole experience to me is that I found it was great for my ego, but not close to as good for my soul as working with the people no one had ever heard of. 

​The title Live More. Hurt Less. seems to deliberately put “living more” before “hurting less.” Why is that distinction so important, and what happens when people make eliminating pain the prerequisite for getting their life back?

The prerequisite of eliminating pain before getting your life back is akin to suggesting you will be confident when you are in a relationship, you will take care of yourself when you have enough time, or that you will invest in yourself when you have money. Each of these is disordered. When we live more, it's hard for the pain to hurt. 

One of the biggest challenges with chronic pain is fear: fear of making it worse, fear of reinjury, fear that something is seriously wrong. How can someone distinguish between pain that is an important warning signal and pain that doesn’t necessarily mean they are causing damage?

We need a framework that blends the subjective with the objective to put people back in the driver's seat of their own lives. In "Live More. Hurt Less." I break down the following four rules for decision making around pain. On a scale of 1-10, a 4 or less is generally safe to move through. The same is true if the pain is staying the same or getting better the more we use the body part. If the pain stops when we discontinue the activity it's very unlikely we did damage, and if the next day pain is not elevated, we know we hit an effective dose of movement. 

You talk about learning to trust your body again. For someone who has spent years thinking of their body as fragile, damaged, or unreliable, how do you begin rebuilding that trust?

I believe the best place to start is with a strong purpose for doing it at all. Sometimes we have to overcome our fears with something more important than the risk we think we're taking.

Many people with chronic pain gradually create smaller and smaller lives without even realizing it. They stop exercising, traveling, playing sports, picking up their grandchildren, or saying yes to plans. How do you help someone recognize that pattern and begin expanding their life again without pushing too hard, too quickly?

One of the first things I ask people to do is to make two lists: things they would start doing today if they woke up without pain, and things they would stop doing if they woke up without pain. Then we look for the simplest item in each category they feel like they could try today. Typically this becomes the kind of slippery slope people enjoy sliding down. 

You’ve spent more than 20 years working with people in pain, and you’ve had your own experience with it. What did you once believe about pain that you no longer believe today, and what changed your thinking?

I used to think pain was a purely physical problem. It's much more than that. That hit me like a ton of bricks when my five year old daughter asked me to carry her on my shoulders and I couldn't. That's when I realized pain was robbing me of an entire life I wanted to live, and the pain of missing out hurt more than my neck. That's what finally propelled me to find a solution. 
 
There’s an enormous industry built around treating pain: doctors, physical therapy, imaging, injections, medications, surgery, alternative treatments. Where do you think the traditional approach gets chronic pain right, and where does it sometimes unintentionally keep people stuck?

More than 20% of the developed world suffers from chronic pain, I think the traditional approach gets it wrong more often than it gets it right. Pain is inevitable, suffering is not - that's the paradigm shift we need. The physical resolutions neglect the identity changes that coincide with loss. 

You emphasize movement and exercise as ways to build a more capable body. But “exercise” can be intimidating to someone who already hurts. What does building capacity actually look like for a person who may be afraid to move?

Swimming in the ocean can be intimidating, but walking through the wet sand rarely is. Everyone needs to start with the level of exposure that feels trivially safe, and progress from there. What that looks like is going to be different for each person. 

The book addresses the mind as well as the body. When someone is constantly monitoring their pain, worrying about the next flare-up, or catastrophizing every sensation, how does that mental cycle affect their experience, and what can they practically do to interrupt it?

We find what we are looking for. The simplest way to interrupt a negative thought cycle is to actively look for reasons to be optimistic. 

There’s a fascinating identity question underneath this book: “Who do I want to be on the other side of pain?” Why is identity part of recovery? Is it possible that after years of chronic pain, people have to learn not only how to move differently, but how to think about themselves differently?

Identity is part of recovery because injury changes beliefs in an instant. It robs us of confidence, spontaneity, and joy. When we loved the version of ourselves who we were prior to getting hurt, there is a mourning period we go through, and we experience every phase of grief. There is finality to that. Learning that you can actually get back to an even better version of yourself requires revisiting and unwinding all of that grief. It's a monumental task. 

If someone has been living with chronic pain for five, ten, or even twenty years and has already tried almost everything, what would you want them to understand after reading Live More. Hurt Less. that might give them a fundamentally different way of looking at their future?

They had tried everything, and that's why those approaches failed. Trying isn't enough, we have to become our own solution. 

---

Website
Instagram
​YouTube
LinkedIn

Purchase the book HERE.