“Am I safe to exercise?”
“Am I safe to exercise?” This is a common question for people who have had an injury, surgery or for people who are experiencing persistent pain. If you’re unsure of this, then your first intention should be to get assessed by a qualified doctor or physiotherapist. They can help rule out any injuries or conditions that might require you to avoid exercise, or to identify what types of exercise might be more appropriate with consideration to your condition.
Once you have some clarity regarding if you are safe to move, it’s important to ask yourself a range of questions to help get you started:
1. What would I be doing right now if I didn’t have my pain?
2. What would I like to achieve by exercising?
3. How much exercise should I do?
4. How can I plan to do more exercise?
5. What about the pain?
What would I be doing right now if I didn’t have my pain?
Think back to when you didn’t have your pain and try to identify the activities that you enjoyed doing, that made you feel good, and maybe gave you some purpose and fulfilment. It might be something as simple as mowing your lawn, weeding the garden, walking your dog, or it could be something more challenging like hiking on your weekends, playing sport, or lifting weights in the gym.
The key here is to find something that you actually enjoy doing and start with that. Don’t pick a type of exercise just because you think or have been told it’s “good for you”. For conditions such as chronic low back pain, there isn’t any research or evidence to show that one specific type of exercise is more superior than another for recovery. So, if you don’t enjoy the activity, then you’re unlikely to consistently do it and persist with it.
2. What would I like to achieve by exercising?
This is where you can set some goals for yourself. Are you exercising because you want to feel healthier, stronger or lose some weight – great, then write down a goal that is specific to this.
If you enjoy the social aspect of exercise, then maybe your goal will be based on walking with your partner or a friend or joining a group exercise class.
Try to be realistic with your goals and consider the amount of time it might take to achieve it. You can certainly set yourself a great big audacious goal, but try to set a few smaller goals to help get you there. An example might look like this:
Big Audacious Goal:
In 4 months, I want to walk 3km at the beach without stopping
Baby Goals to get you there:
I’m going to start by walking with my dog 2 days per week for 4 weeks
Then I’m going to start walking 3 days per week
I’ll Increase the distance of my walk every week
3. How much exercise should I do?
It’s always best to start with an amount of the exercise that you feel confident that you can do without aggravating your pain too much. Usually, I would recommend being slightly conservative. If we use the goals example set out in the previous paragraph, you might start with walking for 10 minutes at an easy pace, twice per week. If this caused a significant pain increase that you couldn’t tolerate, then you would reduce the duration or pace of the walk until you felt more comfortable.
4. How can I plan to do more exercise?
This will depend on a few things, including how much of the activity you normally do, what your end goal is, and how you are tolerating it thus far. Yet again, using the example from earlier, you might increase the duration of your walk by two minutes per week, depending on how you feel. If you have only experienced minor increase in your pain or no increase at all, then it is definitely safe to ramp up your exercise program.
It is important to know that our bodies need time to recover from activity, and we also need time to adapt to the new exercise. Muscles, bones, tendons all need time to increase in their capacity, so make sure you increase what you are doing slowly, until you feel more confident that you are managing well. For someone dealing with persistent pain, your sensitized nervous system also needs time to adjust. In essence, you are teaching your brain and nervous system that this new activity is safe. If you overwhelm the nervous system by flaring your pain heavily each time, you might be sending it the opposite message, and therefore sensitizing yourself further.
5. What about the pain?
Experiencing some pain with activity isn’t always an indication that you are injuring yourself. Pain and tissue injury are quite separate from one another. In other words, you can experience strong and distressing pain in the absence of any significant injury, or any injury at all. You can also be completely pain-free or only experiencing mild pain when you are in fact injured or injuring yourself.
We can apply this idea with the following process:
Does this activity cause me pain or increase my pain? Yes/No
Is the severity of the pain during or after exercise high, distressing, or making me want to stop? Yes/No
Does the Increased pain persist for more than 24hrs after exercise? Yes/No
If you answered “yes” to either of the second or third question, then it means you may need to reduce the volume or intensity of the exercise. If you answered “no” to the second two questions, then you are likely exercising at an ideal level and could make an incremental increase in the volume or intensity of the exercise.
Conclusion
Once you are confident in the exercise or activity you selected, you can then begin to add some complexity to your exercise. Using our previous example, this might include walking on different surfaces like sand, including some inclines or increasing your speed in order to feel more challenged. If you happen to achieve your goal, don’t stop! Make some new goals and crack on. If you aren’t enjoying the exercise or activity you chose, change it.
In summary:
Choose an exercise or activity you enjoy, and are likely to stick with
Set some goals – what would you like to achieve by doing this activity? Make sure to be realistic and give yourself a timeline to achieve your goal/s
Start with an amount of the activity or exercise that you think will be achievable
Increase slowly, giving your musculoskeletal and nervous systems time to change
It’s safe to feel some pain, but it shouldn’t be too distressing, and it shouldn’t last longer than a day
If you’d like more information on the above topics, would like to find out if you’re safe to exercise, or would like some help making a plan for exercising more, feel free to contact my clinic to make an appointment or book online.
