Exercising can be a painful experience.
For those living with the pain of arthritis or another condition, just the thought of moving can make it more painful.
“It can become a Catch-22 situation,” Dr. Victor M. Romano, an Oak Park, Illinois, orthopedic surgeon and sports medicine specialist, writes in the blog Wealth of Health. “We don’t want to exercise because we have pain, and yet exercise will usually help you reduce the pain over the long run.”
Not only is exercise an essential part of treating chronic pain, the lack of it can make the pain worse. Stretching, cardio and weightlifting are the three main types of exercise people with chronic pain need in every workout, said Romano, author of “Finding the Source: Maximizing Your Results — With and Without Orthopedic Surgery."
Before suggesting a fitness regimen, doctors and fitness specialists ask those dealing with chronic pain to rate pain experienced for 12 hours out of a 24-hour day on a scale of 1 to 10. This establishes the baseline level, from which pain should not increase more than two points during exercise. More than that means the person should stop or modify the exercise.
Erica Hein, fitness services supervisor for Community Hospital Fitness Pointe in Munster, said people should check with a doctor and physical therapist before starting an exercise program to make sure it will help address their medical conditions.
“People with peripheral artery disease traditionally have leg pain, and what is appropriate is a walking program, stimulating more blood flow to the legs to help new arteries form and minimize the pain,” she said.
“For arthritis, quite often we steer them to water exercise, where the pool is 93 degrees (Fahrenheit). A lap pool is cooler, but for low-intensity exercise, you don’t want to be in cooler water. They do range-of-motion exercises, stretching and flexibility, and water walking,” she said.
The warm water pool also is good for those with chronic back pain. Patients put on flotation devices and simulate walking in the deep end to eliminate the jarring impact on the joints from walking on a treadmill or pavement. Neuropathy patients have pain in their feet, making bicycling a good option for them, Hein said.
“General exercise has so many health benefits that people should find a way to do it,” said Rick Barker, supervisor of physical therapy at Fitness Pointe. “Almost always the goal should be to exercise around the injury in a safe way. In more chronic conditions, the key is in the pace and dose. You can’t do too much too fast.
“Either people are so afraid that they don’t try anything, or they do too much. You want to stay easy and slow and make small advances as you go. Move forward at a careful pace and be consistent. If you do too much, it can make it worse. Fitness specialists can help a person make the small changes they need.”
Barker said conditions such as fibromyalgia or myofascial pain disorder, which cause chronic muscle pain, can benefit from light aerobic exercise such as walking on pavement or in the pool and biking. For arthritic pain, he said low-impact, moderate-intensity walking or biking 30 minutes a day for five days a week along with strength work two or three days a week are best.
“Start with a weight that feels easy and do three sets of eight to 12 reps,” he said. “Everybody gets sore, but that’s normal. As it gets easier, increase the weight 2 or 3 percent. Everybody has a different starting point, but start light with slow increases. And be consistent.”
Noting that chronic pain has doubled in the last 15 years, affecting 100 million people in the U.S., Amber Hanas, a clinical specialist at Fitness Pointe, points out the reluctance of sufferers: “A lot of the problems are that they fear to move. They have a problem with depression and anxiety, and there is a correlation. When you are not exercising, you are not living life the way you should, and you are more likely to be depressed."
“The biggest thing is cardio,” she said. “Slowly work your way up to four times a week for 10 to 20 minutes to get the heart rate up to about 100 beats a minute. If you feel you are pushing yourself too hard, let up. Work at a rate you can still talk.
“Sitting is more detrimental to your health than moving."
Jesse McCabe, a personal trainer at Franciscan Health Fitness Centers in Schererville, said flexibility is key to moving without pain.
“You should pick mobility exercises that allow you to move through a range of motions you are looking to improve, whether it is walking or doing stairs,” he said. “Stairs create knee pain, and you could work on leg exercises like the leg press or squat. You don’t want to do exercise that is causing more pain.”
McCabe also said rest and hydration are equally important. The Centers for Disease Control and Prevention offers information on proper hydration at CDC.gov.