Exercise is an effective way for pain patients to manage the symptoms of many conditions, including fibromyalgia, back pain, and arthritis. Depending on the condition you have, though, exercise will affect you differently, and you may want to approach activity in a different way. Here’s how to avoid injuries if you’re exercising with chronic pain.
What’s so important about exercise?
Most pain patients, just as with the general population, will benefit from a mixture of cardiovascular activity, strength, and flexibility training. However, specific exercises can be added to address specific conditions.
For example, pain patients experiencing discomfort in specific areas of the body, the back or shoulder, for example, may need to strengthen correlating muscles and perhaps stretch others. Meanwhile, patients with more widespread pain that’s symptomatic of altered nervous system functioning, like fibromyalgia, may find it helpful to adopt a more generic form of activity, such as bicycling.
The nature of being a pain patient is that pain may make it difficult to exercise. However, not exercising often worsens pain. We’ll talk about the best ways for exercising with chronic pain conditions like arthritis, fibromyalgia, and back pain, as well as how to prevent and treat sports injuries.
Exercising safely with arthritis
Exercising with chronic pain is particularly difficult for people with arthritis. The nature of this condition results in reduced mobility. However, not moving at all may worsen pain and can further diminish mobility, according to the American Academy of Orthopaedic Surgeons (AAOS).
Exercise promotes blood flow to the affected area, which delivers vital nutrients and helps to keep the joint as healthy as possible. Activity also strengthens the muscles surrounding joints. As the muscles strengthen, they support more of the body’s weight, leaving less of it for the bones to support. This re-distribution protects damaged cartilage, which can decrease pain.
For those with advanced arthritis, limited mobility can bring challenges. It’s a good idea to precede exercising with a visit to the doctor or a physical therapist. They can design an appropriate fitness program for you. Good exercises include those that:
- Require the entire range of motion
- Support flexibility and reduce stiffness
- Build strength
Good options might be swimming, yoga, or bicycling. Start slowly and then work your way up as your strength and mobility increase. While some amount of soreness is normal the day after exercising, significant pain is an indication that you’ve gone too far, according to AAOS.
Best exercises for fibromyalgia
Fibromyalgia results in widespread pain and fatigue, both of which can be impediments to exercising. However, exercise is one of best ways to treat pain for fibromyalgia patients, according to WebMD.
If you can’t get out of bed, start there. Fibromyalgia patient and founder of the National Fibromyalgia Association Lynne Matallana was essentially bedridden after her diagnosis. Her doctor suggested exercise, so she began with 30-minute stretching sessions while lying down, followed by a rest period, she tells WebMD.
Eventually, the stretching sessions turned into walks to the mailbox, and then she turned to the treadmill. Start with whatever type of physical activity you can do, and then evolve from there. Although exercise is generally fine for fibromyalgia pain patients, it’s still a good idea to check with your doctor before beginning any type of exercise.
Good options include walking, yoga, and strength training. Water activities in particular—especially in heated water—benefit people with fibromyalgia because the warm water relaxes muscles and can ease pain, according to Prevention magazine.
Keep in mind that it could be more effective and healing to exercise in short bursts of activity rather than engage in longer workouts. A 30-minute walk could be broken up in 10-minute increments, spread throughout the day.
Stretching is also beneficial for fibromyalgia pain patients, but try stretching after some light physical activity when the body is warm, recommends Prevention. Stretching cold muscles could lead to injury.
Exercising with back pain
Back pain is increasingly common, affecting up to 50% of working adults, according to the American Chiropractic Association. Back pain frequently develops from sitting too much, poor posture, or injury.
Alleviating back pain requires a mixed approach of strength building, flexibility, and cardiovascular exercises. If you’re overweight, losing those extra pounds through running, biking, or hitting the elliptical will reduce the amount of weight supported by the spine and skeletal system, which could help to alleviate pain. Be sure to talk with your doctor before starting an exercise routine.
Although many people initially think of stretching the back when pain strikes, it’s important to strengthen the low back muscles and those in the abdomen, which help to support the back. Core and abdominal strength-building exercises such as planks, which resemble the top of a pushup, are good to hold for as long as you can, but preferably from one to three minutes.
Another good back strengthener is called a superman, which resembles the yoga pose shalabasana. The goal is to lie on the stomach and, using the back muscles, lift the legs, chest, and arms off the floor with the abdomen remaining on the ground.
Modifications include leaving the legs on the ground and lifting the chest, or leaving the chest on the ground and lifting the legs. You might clasp the hands behind the back and lift you chest and legs, or for a more advanced option, extend your arms in front of you while lifting the legs, chest, and arms off the ground.
Back stretches to improve flexibility
Gentle stretches that can be done include the bottom to heels stretch, which resembles child’s pose in yoga, recommends the UK’s National Health Service. Kneeling on all fours with hands under shoulders and knees under hips, slide your bottom back toward the heels until it rests on them, allowing the arms to stretch in front of you.
To work on flexibility, try a bridge. Start out by laying on the back, knees bent and feet on the floor close to the buttocks, recommends the Mayo Clinic. Press the arms into the ground and then lift the hips off the ground by pressing into the feet, gently arching the back. Stay for a few breaths before lowering and repeating.
The goal for back pain patients who exercise is to strengthen and gently lengthen the muscles and connective tissue, so it supports the body.
How to prevent injuries
Playing sports and exercising carries with it innumerable health benefits, but also the risk of sports injuries. Most athletes have sustained an injury at one time or another, with severity ranging from minor sprains to more serious tears or broken bones.
Fortunately, many minor sports injuries do not require professional medical attention and can be cared for at home. The length of recuperation varies depending on the injury and a person’s medical history. For example, a recurring injury may take longer to heal.
With minor injuries, a person may be able to return to normal activity within a few days. If pain persists or worsens, or extreme swelling is present, visit a doctor for professional medical advice.
Prevention is the best treatment
The best treatment of sports injuries is preventing them in the first place. Damage can result from overuse or an accident, such as landing on a twisted ankle or jerking the knee in an unnatural way.
People of all ages are at risk of injury. For example, a study from the Radiological Society of North America found that young baseball pitchers had a higher risk of an overuse injury that increased the likelihood of further problems, including torn rotator cuffs.
Researchers studied 2,372 pitchers who ranged in ages from 15 to 25. Those most at risk for the shoulder injury threw more than 100 pitches each week. Study author Johannes Roedl says:
“More and more kids are entering sports earlier in life and are overtraining… It is important to limit stress to the growing bones to allow them to develop normally.”
Warm up, especially if you’re exercising with chronic pain
Taking care to ramp up physical activity and abstain from excess is important for preventing overuse injuries. Warm up before each exercise session and take care to cool down afterward, recommends Harvard Health Publications.
Also, take care to ramp up the rigor of an exercise program. If you’re out of shape or haven’t exercised for some time, ease into fitness instead of pushing your body to its maximum limit right away. Even people already in good shape will want to alternate rigorous workouts with more leisurely ones to avoid overtaxing the body.
Using proper form is also essential, particularly when lifting weights or using the body weight to work out, with lunges, for example. Using good equipment is key, with properly fitting and supportive shoes along with any knee or wrist braces as needed.
Overusing muscles is a leading cause of sports injuries. Play it safe and listen to your body.
If you do feel pain, even if it’s just a twinge, recognizing the pain early and easing off the affected muscle or limb can decrease the odds of that area sustaining a full-blown injury.
Common types of sports injuries
The most common types of sports injuries include:
- Sprains: Sprains involve damage to ligaments, which are the tissues that connect bones to each other. Sprains range in severity from first degree, marked by stretched ligaments, to third degree, which involve torn ligaments.
- Strains: Strains are similar to sprains, but affect muscles or tendons instead of ligaments. They also range from first to third degree.
- Tendonitis: Often caused by overuse, tendonitis is marked by inflammation of a tendon.
- Bursitis: A collection of small sacs known as bursa surround joints, muscles, and bones to absorb shock and offer protection. Bursitis is when these sacs become inflamed, usually from repetitive motions.
Treating sports injuries
If the worst happens and you sustain an injury while exercising with chronic pain, remember the acronym RICE—rest, ice, compression, and elevation. This method works for most minor sports injuries and supports the body as it works to repair itself.
Rest is essential for allowing the body to regenerate damaged tissue. With most sports injuries, your mobility will be limited anyway, so listen to your body instead of trying to push yourself.
If your specific injury allows, you may be able to continue exercising. For example, if you’ve injured an arm, you could still go for a hike or run, according to Harvard Health Publications. Above all, however, make sure to avoid engaging in activity that aggravates the injury.
Ice will help to limit swelling and reduce pain. Avoid placing ice directly on the skin. Instead, wrap an ice pack in a towel, applying it to the injured area as soon as possible. For the first day, ice the area for ten to 15 minutes every hour for four hours. For the next two to three days, apply ice four times each day, again for ten to 15 minutes each time.
Try to avoid using heat until the injury begins to heal. Heat could exacerbate swelling and delay the process of healing. Once the injury passes the acute phase, perhaps after the first week, it’s usually fine to use heat, such as taking a bath or applying a heating pad.
Compression refers to elastic bandages wrapped snugly without being too tight. Compression gives the area support and promotes healing.
Elevation helps any fluid that accumulates around the injured area from swelling to drain. You might place an arm or a leg on a pillow, allowing it to rest slightly above the rest of the body.
Be cautious after an injury
After the acute phase of the sports injury passes and you feel well enough to return to activity, make sure to do so slowly. You may want to begin with gentle stretching and strengthening exercises. The area will likely have lost some strength while recuperating, so it’s important to work both strength and flexibility. Harvard Health Publications recommends using heat and ice during rehabilitation, as well.
During rehabilitation, use a heating pad to warm the injured area before stretching. Then, apply ice afterward to reduce any swelling.
If pain lingers or worsens, be sure to seek professional medical advice. For severe injuries marked by intense pain, substantial swelling, or discoloration, seek medical advice promptly. Seeking a doctor’s care early on can help to reduce healing time and the risk of long-term damage.
Some people may also find it helpful to visit a physical therapist to plan a rehabilitation program, depending on the type and severity of the injury sustained.
What tips do you have for recuperating from sports injuries or exercising with chronic pain? If you need help managing your chronic pain, contact one of our doctors today!
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