Get Moving & Grooving. The How & Why of Movement with Pain

Pain is all about protection, right? But pain isn’t the only way that our body protects itself. You can also experience lots of other changes that impact the way you move. Things such as tensing up, moving slower and limping all work together to protect you!

This makes sense in acute pain (such as when you limp to protect a sprained ankle), however, this is less helpful when pain becomes persistent. This is after tissues have healed, central sensitization has developed and your body systems have become over-protective. This kind of pain is a bit like the ultimate nanny state…’uh-uh don't do that’, ‘be careful’ and ‘better safe than sorry’, and can make getting into new movements feel scary and unsafe. However, we do know that not only is movement safe for most people experiencing chronic pain, but it also has many benefits!

In this article, we're here to give a plug to our friend “movement” as a great pain management approach! Even when you’re experiencing pain, the many benefits of moving outweigh the costs – especially if you choose the type of movement wisely! So, are you ready to get moving?

The mindset of movement

Let's call it out up front, we need to get your mindset right before you start moving.

All your experiences throughout your life blend into an exotic cocktail of beliefs about movement. And we know that beliefs can impact your pain. You might have a belief that movement is unsafe, that you are allergic to it, or that your body is not “made” for moving. That’s completely understandable, these beliefs have come from somewhere. Maybe you had bad experiences in high school (urgh, the teenage angst, the uniforms, the picking of teams – shudder!). Maybe you were told unhelpful things by people you trusted that made you believe you were unable to move “like other people” because of your pain/condition. Or maybe there were times you tried a new movement and had a pain flare.

All of these past experiences can affect your opinion of movement. So, before we even dive in, it might be worth checking out some helpful blogs like our beginner's guide to chronic pain and our top 9 healing obstacles.

It’s also important to remember that we know what movement is generally safe for people with chronic pain. In a review of studies investigating physical activity in people living with pain (which included ~37,000 people living with pain!) movement-based interventions were found to have few adverse events and, even better, engaging in regular movement may result in reduced pain intensity and improved physical function, and consequently quality of life. However, if you’re still worried that movement may be unsafe for you, please have a chat with your trusted health professional or consider a referral into our MoreGoodDays® program which has modules on this very topic!

If you’re anything like me, there is probably one more big stumbling block holding you back from committing to regular movement. Confidence.

I’m not sure what I’m doing! What if this movement is unsafe, or makes my pain worse? Sound familiar? Well, allow me to knock this on its head before we go any further. Pain self-efficacy (confidence that you are able to do the things you want to do) has been shown to be a major contributor to reductions in pain. Even better, we know that improved confidence is associated with less pain and disability.

We want to arm you with all the knowledge you need to confidently start your movement journey! Remember, anyone who starts something new, like walking, running or even stretching, whether they live with pain or not, they are likely to pull up a bit sore afterwards. Why? It's the DOMS! This is delayed onset muscle soreness (DOMS) and it’s the sore, aching, painful feeling you feel in muscles after unfamiliar and unaccustomed intense exercise. We all get that, but it doesn't last and will fade once your body adapts to the new level of movement.

How you can start exercising with chronic pain

Understanding why movement is helpful can help start you heading in the right direction. Our bodies were made to move. Our tissues love movement, and even need it to stay healthy. And it’s not just your muscles. Bones, discs, and joint cartilage all get stronger with movement. If these tissues don't get to move because of excessive rest and inactivity they get deconditioned (weaker), and can even become stiff and painful. Beyond our muscles and joints, exercise is also good for our overall health and wellness (more on that below!).

Every week it is recommended adults undertake 150-300 minutes of moderate-intensity activity and two days of muscle strengthening activity. This amounts to around 20 minutes a day (or 30 minutes over 5 days – good to factor in rest days!!). Yet, research shows most of us don’t even come close to this! In Australia, less than half of adults reach these movement targets.

For some extra convincing power, here are all the reasons why moving is good for you, especially if you are living with chronic pain:

• Improves mood (produces feel good hormones – endorphins) and we know living with pain can be linked to low mood so this can create a great counterbalancing effect.
• Increases energy levels – I know it seems a bit counterintuitive, but the more you move the more energy you have.
• Promotes better sleep.
• Decreases the number of tender points on our bodies – great news for those with fibromyalgia!
• Improves strength – think of the things you could achieve with a bit more of the oomph! factor.
• Nerves and discs get nutrients to improve their health and strength.
• Joints get lubricated and glide easier – ‘motion is lotion’.
• Helps maintain a healthy weight which can reduce pain.
• Reduces risk factors for other health conditions such as high blood pressure or cholesterol.
• Reduces flare-ups – well, you had me at hello!

It doesn't matter your pain levels, your diagnosis/condition, your range of movement, there is always some movement that is right for you. Finding the right movement for you will give you more confidence and freedom – all leading to feeling more in control of your life. Sounds good?  So, hopefully we have convinced you that movement helps (the WHY) – so let's turn our attention towards developing a plan to get you moving and grooving (the HOW).  

Tips & tricks for exercising with a chronic illness

Talk to your doctor

This is always a good place to start. Get some advice and help to build a plan of attack. Other health professionals, like exercise physiologists or physical therapists can also give you some pointers on how to best get started on your movement journey.

Remember how pain is only one of many protective outputs? Pain can also change the way that you move (like bracing your core to protect your back, not raising your arm to protect an old shoulder injury or limping to protect a sore knee). Even the way you walk might have changed to accommodate or avoid bringing on more pain! Health professionals can help you recognize and understand these movement changes. If you want to work with a physical therapist who understands chronic pain and pacing, then consider the MoreGoodDays® program.

Goals

Starting a new movement program can be tricky without a plan, so before you start, think about what you want to achieve. Grab a pen and paper and write down your goals – some short term and some long term.

Once you have your goals written down, you can then work out how to make them happen! It’s best to add some details – scheduling when you will do it, how, what you'll need etc. Writing this information down will help make sure it happens.

Be SMART (specific, measurable, achievable, realistic/relevant with a timeframe). You can even share it with a friend, family member or your physical therapist for some extra accountability!

Try this:

I will [activity] for [time/duration] [schedule and factor in a few rest days] for [time frame] because [reason] and [for bonus points – some longer term add on/increase/pacing up effect].

For example: I will go for a walk for 15 minutes every second day for the next 3 months because this will help boost my energy levels, and I will increase by 5 minutes each month.

For example: I will participate in a 30-minute online yoga class every Tuesday for the next 3 months because this will help increase my flexibility and after that I will add another class on a Friday until the end of the year.

Start small

If you have been inactive for a while, start small and remember that each step is getting you closer to your goal.

Here, you might consider finding a baseline amount of movement (the minimum amount before you experience pain). So, for example, you may try walking a small distance then stop and assess pain levels. Try again the next day. After a few days you will have developed an idea of what is the small starting point from which to begin building up. And hey, if it's to your letterbox then, start there. No points for trying a 5km run straight away and overdoing it. By starting small and building up you will slowly and safely get to your 5km (or other goal) – it might take a while, but you will get there.

Have fun exploring

‍There are so many types of movement! As mentioned, no matter what is going on for you, there is a movement type that will work for you. It just takes a bit of experimenting, patience, and creativity (and even a bit of fun) to find what works best for you! You may strike out the first round or two, but don’t give up, keep exploring until you find the right fit.

The Frankie effect

‍(Sinatra, that is!) Once you find the right movement for you it’s important to stop the comparisons. I’ll do it my way!

You really do need to ditch the comparison – to others (and their glamorous Instagram workout shots), but also to yourself. Don't think about what you “used to” be able to achieve, just focus on right here, right now. This is easier said than done! Especially if your old exercise highlights reel is full of impressive feats, awards, achievements etc.

Just ask, what can I do today!? High intensity or low, indoors or outdoors, alone or in a group – you will find something that works for you. There is no right way, just your way.

Make it easy

‍Movement should be a habit, so it’s best to look at how we can form new habits.

In the best selling book, Atomic Habits by James Clear, one trick is to make it easy. So, leave your shoes/clothes out so you can see them and get it done. Think about making movement convenient – can you do something at home? Everyone thinks that you have to go to the gym for exercise, but getting to and from the gym can be difficult (plus memberships can be expensive!). Instead, think of ways you can move at home. Equipment like yoga mats, blocks, and hand weights are easy to access and make moving easy. And, you don't need to get all fancy, a tin of beans work perfectly fine as hand weights!

A great place to look that’s NOT a gym can be your local community center. They often host regular classes in lighter movement styles like yoga or Pilates, which can be great if you want some instruction or community connection. And don't forget there are SO many movement options available online – try YouTube! Some of the other tips below will help make it easy. Remember, there is a “too hard basket” for a reason, it's our human nature to want to ditch the hard stuff when it becomes too much of a battle.

Do stuff you enjoy

Did you know that many types of movement are equally effective in reducing pain? The most important factor is that you stick with it. That means that you can focus on what you enjoy doing most!

Low intensity/impact activities like walking, swimming or yoga are effective so think outside the square…What about cycling, dancing, martial arts, tennis, golf? For years, people told me swimming was the best thing for backs. Yes, yes, it’s a non load-bearing, gentle movement for the whole body. But I hated it. My preferred stroke is backstroke and in a public pool this is troublesome as I can’t see where I am going and well, lets just say, I’ve had a few ‘incidents’ where I have accidentally collided with other swimmers. But once we got our own pool, it became easier, fun, simple and now, a daily habit.

So choose something that is right for you! Dancing in the kitchen – that's movement. Belly dancing is movement! Gardening is movement! It’s all about varied postures and positions, it’s about using lots of different joints and muscles. But, if it’s not something that you enjoy, then you’re much less likely to stick with it whereas If it's fun, there will be greater chances of commitment and success in the long term.

Grab a friend

Picture this, you’ve committed to going for an early morning walk. Your alarm goes off, but you're tired and so toasty warm in your comfy bed. What will you do? Hit snooze and pretend you’ll do it tomorrow (and let the same pattern repeat every morning)...

But what if instead, you had arranged to meet a friend? It’s much harder to fall back asleep when you know your friend is outside waiting for you! Getting a friend to join you helps to stay accountable and motivated. Plus, let's face it, doing something with a friend is so much more fun! There are also plenty of ways you can find a new friend to move with – check out Meetup for ways to connect with others with similar interests.

Befriending your body

We are all unique and sometimes an important step in starting to explore new movements is understanding your own body. Sometimes living with pain has meant changes to your body shape, posture or ability. Bringing a little self-compassion to the new you might help make getting moving easier.

It’s also important to know what your body feels like, and when to push it (or just as importantly – when to ease off!). One helpful place to start can be a guided body scan – just feeling what sensations are present in the body when you are still. In the book, Living Well with Pain and Illness, Vidyamala Burch proposes an exploration of the soft edge (the point at which you first feel a sensation) and the hard edge (the last point of movement before strain occurs).

Gentle mindful movement (like stretching or hatha based yoga) can be another good way of exploring sensations in your body. Read more information on some ways to befriend your body and use meditation to reduce pain.

Rewards

Without choosing chocolate (well, at least not everyday), how can you reward yourself after a movement session? I often plan to have a coffee after my morning swim! Consider some things you enjoy doing the most and schedule them after your planned physical activity so it gives you something to look forward to.

Tell yourself the right things

A few affirmations never hurt! Figure out the helpful things you will say to yourself before, during and after your workout. This can be pretty good if you link it back to a “why”. For example, ‘I’m going for a walk to strengthen my body so I can play with my kids’ or, ‘I’m playing tennis today to be social’, or ‘I’m swimming to grease my joints for increased function.’

There are plenty of motivational posters for sale out there, why not adopt one of those lines to help get you through when you feel tired and like giving up? ‘You're almost there’, ‘Don't give up’ and don't forget Dora in Finding Nemo ‘Just keep swimming!”. As hockey Hall of Famer Wayne Gretzky said, "You miss 100% of the shots you don't take."

The basics

Don't forget incidental movement too. Not all movement has to be structured – there are plenty of ways to stay active and burn calories around the house or while you’re at work. At home you can walk around the house, do household chores, standing instead of sitting, gardening, washing the car. At work you can take the steps instead of the lift, try a walking meeting, or do squats in the tearoom waiting for the kettle to boil….all opportunities to bring in some extra movement.

Don’t think the gym is the only place for a workout! Again, mindset matters.

In one study, a group of hotel cleaners were told that their jobs consisted of high levels of exercise, and that they were meeting all physical activity guidelines. One month later, researchers followed up with them and found that this group had improved health markers, even though their activity levels were the same. This shows that just changing your mindset can improve your health.

Starting more incidental movement can also lead to a positive feedback loop. Once you start, you’ll feel better and more confident. This can then lead to even more movement – and so the loop begins!

Don’t put all your movement eggs in one basket

(And definitely don’t move whilst holding all those eggs unless you’re joining an egg and spoon race – great fun!).

Varying your types of movement allows all different muscles to move and stretch and get stronger. So choose a few different types of movement in your overall program so that your whole body gets involved. Mixing things up can also keep movement fun and interesting (making it easier to stick with it). Functional movements are a great addition as these target critical areas of the body that you need for undertaking the daily tasks – think squats, lunges, pushups, bridges. All of these movements also come with loads of variations – so you can increase or decrease the challenge (think starting out with a wall push-up or a mini squat).  

So, let's get physical! (Sing it with me!)

Start small, bump it up slowly over time and work towards making regular movement a part of your daily routine. So, do you feel a bit more prepared, ready to get planning and get active? Don't be shy, share with us your plan, reach out for some extra help or hop over to the 'Living well with fibromyalgia' Facebook community.