Three Techniques That an Exercise Scientist Recommends for Someone Living with Pain

Exercise is one of the best things to do to make the pain better. It isn’t a magic wand that will make you feel better instantly – though sometimes it can – but nine times out of ten, once I’m five or ten minutes into my workout, my pain disappears.

Part of the reason is the physiology of exercise. Our bodies release endorphins and catecholamines, hormones that literally decrease our sense of pain.

More important than any potential immediate benefit, however, is the long-term benefit. Exercise doesn’t just give you a temporary shot of feel-good hormones. As the body adapts to exercise over several months, it fundamentally changes the structures and functions of muscles, joints, and even the nervous system in ways that turn down the dial on pain for the long run. That doesn’t mean you can’t have days when your pain spikes, but the best, most recent research in fibromyalgia specifically shows that exercise is effective at lowering your average pain level1.

Need any more convincing? Learn about other general health and emotional benefits of exercise.

Will exercise make my pain worse?

It's a pretty common concern. Let's say you have chronic low back pain. When your back hurts, even though you may supposedly “know better,” it's very common to worry that doing your normal exercise will exacerbate the pain. Perhaps your past experience has given you reason to believe that pain was associated with a movement and so you worry about moving. Clinically, I’ve seen similar concerns, especially in patients with arthritis. But in all three cases – chronic low back pain, fibromyalgia, and arthritis – research has shown the same thing over and over. Exercise is not going to make the pain worse2.

Knowledge is power

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When we listen to that voice of fear and stop or reduce our level of activity, pain will get worse. Here's how: stopping moving means muscles can get stiff (muscles are meant to move), movement might then become painful, potentially meaning we move less. More pain, less movement. The cycle continues and so inactivity can actually make your pain worse.

A cycle: Pain, rest, muscle gets stiff and atrophy, movement is more painful, move less, lose fitness, get weaker, feel fatigued, movement even more painful.
The cycle of inactivity – resting can lead to further pain

But what about that strange popping noise? Before I get started with some of the exercise suggestions, I want to address a concern I am often asked about: cracking of joints. Whether you’re intentionally popping your knuckles or your neck, or you hear your knee pop when you take a step, sometimes our joints make funny noises; sometimes those noises may also cause you to worry a bit. Based on the best research in basic anatomy as well as physiotherapy, cracking of joints is not a problem unless you feel a sharp pain at the same moment. If you do, and especially if that sharp pain consistently occurs when the joint pops, then you need to schedule an appointment with your doctor or physiotherapist.

Disclaimer: All physical activity poses some risk. While performing the exercise, you may cause discomfort by engaging those muscles. There’s a chance that you could injure yourself through spraining a joint or straining a muscle. Here are three key things you can do to minimise those risks: talk with your doctor, follow conservative, safe progression into your physical activity, listen to your body and how it feels while it is exercising.

You may experience a little discomfort – if I go out right now and jog for even 3 minutes, I will definitely feel some discomfort in my calves and lungs because I don’t run anymore. However, that’s not the same as pain. If you do feel pain – such as your existing symptoms starting to flare or a sharp or strong pain – due to the exercise, stop. 

What kind of exercise?

When you think of exercise, you probably envision people running around the block or sweating it out in a gym for an hour; doing a traditional workout. But here’s one of the most important things I will tell you: you don’t have to do a big workout. It is obviously an option, and maybe in the future you will choose to work up to that, but you don’t have to start there and you don’t even have to end up there unless that suits your lifestyle.

Sit less, move more

The most up to date research on physical activity and health has focused on sitting less. On average, adults in Western societies are sitting for 8 to 12 hours per day3, even those people who are doing their hour-long workout. Sitting so much contributes to many chronic health problems, including fibromyalgia. So our first goal is to sit less.

Now, does this mean you can just stand up or lie down instead of literally sitting? Unfortunately no. We need to be moving. But that movement doesn’t have to be a super intense workout. It can be walking. It can be doing small strength exercises at your work desk. Even if you literally have to stay seated while doing your strength exercises, breaking up the completely sedentary sitting is our first objective.

I want you to pause now and think about moments in your average day where you end up sitting for over an hour at a time. Maybe it’s at work. Maybe it’s in the evening watching your favourite show. Maybe it’s in the morning over your favorite hot beverage and a good book. Do you think you could interrupt that sitting for at least 5 minutes? What about just 1 minute? Or even as little as 30 seconds? If you can, you will literally sit less and move more.

Even as committed as I am to sitting less and moving more, I will not spontaneously hop up every 30-60 minutes to do my little exercises. I have to set a timer, and I highly recommend you do too. When you think you might sit for an hour or more, set a 30 minute timer and move when it goes off.

Below are two simple exercises that are easy to progress.

Sit to stand (the squat!)

Two of the most foundational human movements: standing and sitting. We group these two movements together and call it squatting. It’s key to getting up from chairs, getting on and off the toilet, getting up from bed, in and out of cars – we go from sitting to standing and back again many times a day. The squat exercise is nice because it is efficient – it works all the major muscles of the lower body at the same time. 

The simplest version of squat can be done with stable chair, with the back of the chair against the wall. Stand with your feet about shoulder width apart, toes pointed slightly out and sit down in a controlled movement – don’t just fall with gravity – then stand back up. That's it! If sitting in a standard chair is hard at this point, you can raise the seat up higher, either with a taller chair or stacking books or something else sturdy in the chair seat.

The two most important things in any squat are: straight spine, and heels on the floor. And don't forget to breathe! Breathe in as you sit and breathe out as you stand.

You can then progress this exercise in ways that build strength and challenge balance. For example, you could try to not fully sit on the chair; instead, just tap the front edge with your bottom and immediately stand back up without putting your weight into it. Then you can try without the chair and add weight, from traditional fitness objects such as dumbbells and medicine balls to common objects such as water bottles or canned goods.

The row (the upper body’s turn to move)

The row works the muscles of the upper back and spine, and is key for improving posture and for activities such as moving furniture, carrying boxes, and gardening. It will make you feel more confident and more capable while lifting and holding objects, even something like lifting up and tilting the frying pan to tip out the dinner you cooked.

To get started, you can either stand or sit. There are two components to this exercise: pinch your shoulder blades together, and pull your elbows back behind you as far as you can. You try one or two of those. Now, just so you can feel the difference, pull your elbows back without trying to pinch your shoulder blades together – though your arms move, you should be able to notice that the muscles around the spine don’t feel like they are engaging. Now do it properly again, pinching the shoulder blades together. That’s the basics of the row.

To progress the row, you have to add resistance. We can group these into two ways – weights, or elastic bands (known as Therabands, resistance bands, and power bands). 

So, why not give these simple exercise hacks a go? Sit less, move more with small chunks of movement built into your daily life.

If you want to get started but feel nervous or want some more support to bring exercise into your daily life, MoreGoodDays now have a follow-on program (written and narrated by me, called “Exercise for Pain”). This 4-week program will really unpack some of these exercises (and many others) as well as discuss important behaviour change techniques including motivation, goals and planning. So, please get in touch with us if you might be interested to find out more.

Also, we have some more tips and tricks for bringing more movement into your daily life and, if you want to join in the conversation about evidence based approaches to manage pain and live well with fibromyalgia, join our Facebook Community.