exercise and pain, ask your physio in Bunbury for help

Exercise and Pain

The health benefits of exercise are well documented in the scientific literature.

Some well-known benefits of exercise include: reversal of obesity, boost metabolism, improve muscle strength, increase joint stability as well as preserve bone density. Whilst these benefits are a great reason and motivation for anyone to start exercising, it doesn’t stop there!

Some lesser known, but not less powerful, benefits of exercise are:

  • Exercise is a powerful anti-inflammatory
  • Exercise is a proven anti-depressant
  • Exercise is a proven pain killer
  • Exercise improves cognitive function (makes you smarter)
  • Exercise gives you energy
  • Exercise improves the quality of life

With all these reported benefits, the case is clear that anyone can benefit from exercise. Unfortunately, whilst many of us know the benefits of exercise, and have been recommended to exercise more by your GP, or perhaps your physio, many of us are unsure how to start, or what to do. If you are one of these, this blog post will give you some useful strategies on how to start, and stay exercising.

Particularly if you have been struggling with a niggling injury or are suffering from persistent pain, it can be difficult to know what to do, when to do it, and what to do if the body starts hurting. These uncertainties, and sometimes fear of reinjury or the exercise causing more pain, prevent many of us from exercising. As a result, those who perhaps need it the most, miss out on all the benefits reported earlier.

Luckily with a little bit of help, it is easier then you think to reap of the reported benefits of exercise.

The following insights might help you on the way.

exercise and pain


What to do when pain arises during exercise?

This is one of the most common questions I get asked as a physiotherapist. Pain is unpleasant; hence the normal human response is to try and avoid it whenever possible. This can be an effective approach in acute pain, or injury, but in the long term this avoidance strategy is not effective and results in deconditioning (not to mention all the benefits of exercise you are missing out on).

It is important to realise that if you are new to exercise, that certain sensations are normal, and not an indication of further damage to your body. The key is knowing what is ‘safe’ pain versus ‘unsafe’ pain.

Safe Pain, be confident to slowly increase the exercise.

1). Pain spikes during the activity between 4-7 on 0-10 scale.
2). Pain is no worse after activity and back to baseline within:

a. 30 minutes if you are 4-8 weeks post injury/onset
b. 2 hours if you are 8-16 weeks post injury/onset
c. 24 hours if you are 16 weeks – years post injury/onset

3). Harm check – No change in range of motion, strength

Flare Up, you have done to much and need to slow down a little.

1). Pain spikes during the activity between 4-7 on 0-10 scale.
2). Pain persists after activity by 3 numbers above baseline for:

a. 2 hours if you are 4-8 weeks post injury/onset
b. 24 hours if you are 8-16 weeks post injury/onset
c. 48 hours if you are 16 weeks – years post injury/onset

3). Harm check – No change in range of motion, strength

Exercise and Pain

Stop activity and seek medical advice from your physiotherapist or GP.

1). Severe spike in pain 7 or greater on pain scale that prevents you from performing activity any longer.
2). Pain persists for days or several weeks
3). Harm check – Major change / Loss (over 50%) or range of motion, strength and function.

How much exercise is enough?

The Australian department of health recommends the following:

Doing any physical activity is better than doing none. If you currently do no physical activity, start by doing some, and gradually build up to the recommended amount. The following recommendations are a guide only, the ideal amount is dependent on the circumstances for each individual.

  • Be active on most, preferably all, days every week.
  • Accumulate 150 to 300 minutes (2 ½ to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1 ¼ to 2 ½ hours) of vigorous intensity physical activity, or an equivalent combination of both moderate and vigorous activities, each week.
  • Do muscle strengthening activities on at least 2 days each week.

At the same time try to follow the following recommendations regarding sedentary behviour:

  • Mininise the amount of time spent in prolonged sitting.
  • Break up long periods of sitting as often as possible.

The key to establish an effective exercise routine is to find a starting point where you are comfortable and gradually increase from there. Setting goals for yourself can be a great motivator, as well as congratulating yourself once you achieve these goals!

What kind of exercise is best?

The type of exercise you choose is dependent on the goals you are trying to achieve. If you have pain in a certain area, integrating specific therapeutic exercises to strengthen and mobilise this area might be indicated. The most important parameter to achieve all the benefits of exercise is adherence (sticking with it), so picking a type of exercise you enjoy is the most important.

Other important questions to consider are whether the level of exercise is suitable to your skill level? How easy is it to integrate the exercises into your daily routine? Does this form of exercise help me achieve my goals?

By answering these questions, you will gain a better insight whether you’re on the right track with the exercises you’ve selected.

How can exercise be painless?

When people start a new exercise routine, many are tempted to do too much too soon. You’re motivated and keen to start working towards your goals, and often this results in biting off too much, or progressing to aggressively. This approach increases the risk of developing exercise related pain, a flare-up in symptoms, or an injury. This can put a serious dent in your motivation to exercise and may jeopardise you reaching your goals.

So, whilst it may be tempting to push yourself to the max, a more gradual approach is recommended.

How to make exercise a habit?

The most difficult part in ‘new behavior’ becoming a habit is the start. Exercise releases endorphins, which will lay down memories which make you want to return to it more often. The hardest part is getting started, the following strategies can assist in the process of making exercise a habit:

  • Set aside a specific time in the day to exercise and stick to it.
  • Engage in exercise you enjoy and make your workouts achievable.
  • Find a workout partner (buddy up) to hold you accountable.
  • Engage is 21 consecutive exercise sessions, once you reach 21 you don’t want to miss another workout.
  • Join an exercise group or hire an exercise professional to assist you and hold you accountable.

If you follow these strategies, you will arrive at a place where you feel something is missing from your day, or week, if you don’t engage in exercise. You have established an exercise habit and will start experiencing all the benefits previously discussed, including alleviating your pain.

How long does it take to see the results from exercise?

The period before people start noticing the benefits of exercise is variable and dependent on several factors; for example, your initial stage of health, how consistent you are with the exercise, your mindset, the quality of the exercise as well as nutrition.

Many benefits however are often experienced immediately, for example: increased energy, improved mood, reduced pain and improved range of motion. Other benefits, e.g. weight loss, improved strength, lower blood pressure and improved stamina take longer to achieve. The key aspect here is to make gradual progress over time, slow and steady wins the raise!

The benefits of exercise are too great too miss out on. Yet we see many clients who struggle to make a start. I hope the information in this blog post will provide you with some useful strategies to reduce the barriers to commence exercise. If you are still experiencing difficulties in getting started, or just not sure where to start, discus it with a healthcare professional, such as your GP or a physio. They can offer advice and guidance in establishing this rewarding and life changing habit.

Tyne Timmers,
BSc. Physiotherapy, MSc. Medicine (Pain Management)

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