Exercising: A Guide for People with Chronic Pain

Please note: The following article is a guide only, and is not necessarily applicable to everyone. Please talk to your doctor for recommendations regarding specific chronic conditions before beginning an exercise program.

What you need to know

I work with many clients who have chronic pain. In fact, one of the most common reasons many of my clients have sought out coaching is to ask about their chronic pain during exercise. Questions that I hear asked often by my clients are:

How do I know when to push through?

and

How do I know when Enough is Enough?

There isn’t really a simple answer to this. Whether to push through the pain while exercising or not is very much based on that individual’s situation. First, we need to identify and define a few things.

What exactly is chronic pain?

For those of us that aren’t familiar (and lucky you, if you are not!), chronic pain is characterized as pain that has lasted longer than the body’s typical healing time, which is roughly three months. This can be an acute injury that turned chronic over time from not being properly rehabilitated or addressed.

Or it can be more complicated, like symptoms from a heightened sympathetic nervous system. This can happen after an individual has experienced some form of trauma or has lived with high levels of stress for elongated periods of time. This type of pain is typically under the umbrella of neuropathic pain.

Neuropathic pain can also be the result of damaged nerve fibers. This can be experienced in people living with MS, individuals who have spinal cord injuries, or those who have had an amputation.

Although we still don’t know a lot about neuropathic pain, there are a few things we can focus on during exercise that may help.

habits that can help you with exercising

Body Scan

Practicing a body scan can help keep us in the present moment, which can then calm down our nervous system. This can be done as a warm-up before your workout or first thing when you get out of bed in the morning. Closing your eyes can be a great way to increase your concentration on this exercise, especially if you are new to performing body scans.

Crocodile breaths

Deep breaths that are done by using the diaphragm can be a great way to calm the nervous system. Try imagining that there is a deflated balloon deep in your belly, right above your pelvis. Take an inhale and fill the balloon (we want to go deeper than just filling the lungs in our chest). You can place also place a hand on your low belly for some great feedback. As you exhale, feel your hand on your belly gently fall in towards your spine. Repeat for 15 cycles, or more if desired.

Keep your body temperature comfortable

Sometimes aerobic activity that can heat your body causes an increase in neuropathic pain. Try and avoid hot or warm environments. Alternatively, keeping your limbs from getting too chilled may help some individuals. I always recommend to clients to bring layers to their workouts so that they can adjust as needed.

There are other pain-related diseases or injuries that we know enough about to make safe exercise recommendations with respect to pain levels.

How Can you keep moving while staying safe?

These guidelines and recommendations are for the purpose of encouraging someone to move in a safe and supported way while simultaneously improving the body’s strength and endurance. We explore these recommendations below:

Arthritis pain

To help decrease pain during your workout, it is important to focus on an extensive warm-up for your joints. This may be on a recumbent bike, a Theratrainer or even a Nustep machine.

Adding extra insulation layers around the arthritic joints is also a great way to increase warmth. Many of my clients who have arthritis in their knees and ankles like to wear thicker socks or fleece-lined pants on top of their workout gear. This can help resolve some of the pain for a more enjoyable exercise session.

Musculoskeletal injuries

If your injury is something that you are choosing to work through, then I suggest the first thing to do is figure out where your pain-free range of motion is. If your shoulder is hurting, how far up can you extend your hand overhead before that pain kicks in? How far can you reach that hand to the side without discomfort? Get help with assessing your range of motion with one of our team members.

Stay within the established pain-free range for the time being until your injury has been treated or addressed. Keep in mind, this does not mean that we should work through ALL musculoskeletal injuries…

When in doubt, refer out

Physiotherapists are experts at assessing an injury and finding the diagnoses. They can then help support your recovery by using manual manipulation techniques and setting up a proper treatment program. Most physiotherapists will see patients without a referral, however, sometimes a referral through your doctor can help with costs.

pain can be good for us

Yes, I realize this headline might put a cringy look on your face. But hear me out! Pain is our body’s ability to send us information. It is an indicator. If we don’t have pain as an indicator, that can be really dangerous. This is the main reason why it is so hard to determine when to push through the pain.

Pinpointing what kind of pain you have and being cognizant of it can be what helps us successfully manage it in a way that brings us progress in our exercise routines and goals. Take Janice for example, who lives with a neuromuscular disease;

“…For over thirty years, I’ve experienced high levels of pain after many of my own efforts to train at the gym and didn’t understand how to achieve results. I used to get quite discouraged and I became somewhat fearful of new physical challenges, but Megan keeps teaching me how to make progress.

“Now, at age 56, instead of frequent acute injuries that have limited my function and independence, I am enjoying more freedom and ease of movement. I used to have weeks when sore shoulders would keep me from lying on my side in bed, and now I can open doors more easily.

“I am curious and hopeful about what I can achieve in the future now that I know how to do a good warm-up and can improve my strength even though my degenerative and painful neuromuscular disease still has no cure. My chiropractor has seen a huge shift in my back’s muscle tone and I don’t need as many appointments….”

Pain is an important indicator that our body gives us. But sometimes (especially with neurological pain), the pain is nothing but a distraction that can stop us from making traction in our exercise routines.

So regardless of what your chronic pain is stemmed from, just know that there are ways to approach exercise that will allow you to move your body in a safe and supported way, even if this looks different for everyone.

Your Coach,
Megan Williamson