I humbly start this post today admitting to you that I have committed all these exercise mistakes trying to get back to moving with chronic pain, and probably more of them.
Let me know if you relate.
I would wake one day and be so flipping tired of all the things I couldn’t do. All the life I had given up to tend and nurse and protect my body so the pain would stop. I did EVERYTHING my medical team told me. I followed all the rules, and still, the pain persisted.
Then, on those days, the ones where I was totally fed up, thought to myself, there HAS to be a different way to exercise with this pain. I would throw caution to the wind. Grab a swimsuit, toss meds town my gullet, and head to the pool. I would ease myself in and push off the wall and start swimming. OHHHHHHHHH the joy, the elation the.. .uh oh the wall was coming.
Exercise mistake #1
PANIC!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Was I going to put my pelvis out of place, flare-up my hip bursitis, get my psoas too tight, cause further damage to the discs in my back… I would swim for a while and the panic and small voice would grow louder. My pain would increase, I would try to be positive and eventually, I would exit the pool in tears feeling like I had gone against the rules, caused more damage to myself, and been irresponsible.
Take a moment and re-read that ok.
I thought it was irresponsible to be exercising in a way that gives me control, feels good and I love to the depth of my soul. ( Not to mention it’s what we tell everyone to do when they hurt or have pain… oh take a swim, it’s good for you!) For me, it had been forbidden and was dangerous. – guys – this hurts to write. The insanity of it all. The shame I felt, the guilt I felt. All so very very real and painful.
I am sure you know how this story ends – huge flare-up, me barely being able to drive home, swearing I won’t do it again, but knowing in the back of my head I can’t stay out of the water. So I will, and I am convinced it will hurt.
I did this for 18 years….. Over again. Gardening, playing with my kids, huge trips, medicating, ignore, paying the emotional and physical price and my depression and sorrow grew every time.
Where I got it right…
Then, one day, I started doing it differently.
I decided 5 minutes of swimming without pain was better than an hour of swimming and 6 months before I tried it again.
Started to accidentally apply the principles of pacing and graded exposure in my life. Focused on doing activities I loved and moving towards the movement I wanted, not PT exercises.
I want you to have the freedom to start moving again. Without making the mistakes I made getting back to exercising.
Exercise Mistake #2
We forget to pace.
This causes so much drama! We end up undervaluing the amount of movement we are already doing in getting ready, driving, cooking, keeping up with the house ect. Then we add in a new routine and forget to account for the load we already have. We start our new exercise routine like we are in shape and don’t need to step up to the challenge. In other words, we sign up for a 10K without having prepared, trained, or considered our needs. To start a new routine, when we are balancing pain, we need to realize the whole exercise routine is a load on our whole system and plan accordingly.
Exercise Mistake #3
Getting Stuck in Movement Prison
If you have been told there is only one way to squat, that you must roll over in bed a certain way. In order to move correctly you have to suck your belly button to your spine. Maybe you have been told you should never lift with a rounded back or can’t lift anything more than 25 lbs if you want to avoid back pain. Shoulders back, head up, chest up, sit bones on the chair…. these are all examples of types of movement prison and are absolutely exercise mistakes.
These “helpful hints about movement tend to have the opposite effect. Instead of helping us more, they actually make us move less, for fear of doing something wrong. Variability is what we want in movement. We want to be able to move in lots of ways. All the ways. If you are too focused on making mistakes while exercising, you are going to miss the joy and most likely tense up. Which is going to make it harder to move.
Relax. This is one exercise mistake you don’t need to make. Relax, remember you and your brain are very smart, and you can figure out ways to move. Just because it hurts doesn’t make it wrong, it makes it painful, in that moment. Get playful – see how you can move!
Exercise Mistake #4
Focusing on “turning on” specific muscles.
Oh, guys… the pain with this one. This exercise mistake makes me cringe. I hate to admit that there was a time when I use to walk down my street tapping my right butt cheek. You see, I had been told it was ‘dumb” “dead” “had forgotten how to turn on” and so I needed to tap it to get it to respond correctly. The point of getting it to “turn on” was to end my decades of pain. I hate to think what my neighbors thought about the crazy lady obsessed with, what had to look, like smacking my own ass!
This exercise mistake makes me shake my head. There is so much information on why instructions like this and the idea of “thinking about contracting and turning on” certain muscle before we move is the opposite of helpful!
Think about it, do you think about contracting your pronator teres before you turn your key in a lock? Bet you don’t – cause that would be weird!
Why focusing on this exercise mistake is really a bummer
In 2010 Gabriele Wulf et al. wrote a review of the key factors that influence the learning of movement skills
Here are the main takeaways…
1. Makes it harder to learn
Asking someone to “contract your psoas” results in poorer learning than the cue, ‘lift your knee towards the ceiling’ We want the body to move naturally. Focusing on the muscles doing the work is not natural, so it requires attention away from the body and movement and pulls it elsewhere. This is distracting to the nervous system and it is not at its peak performance – which means it’s harder for us!
2. It reduces endurance
Focusing attention on something external – for example, music, or the results of your movement, increases endurance, compared with focusing on the sensations of moving, which reduces endurance. For example, instead of focusing on contracting a particular muscle, paying attention to the temperature of the barbell, the weight stack of the bar, or the feel of the water or wind against your skin will increase the number of quality reps you can achieve.
5. It gets in the way of getting better
Since the early 2000s, evidence has been building that what is called the biomedical model – the idea that the human body functions as a car or machine – is not our best model for injury and rehabilitation. (You know I believe this!) The biomedical model assumes that pain is an indicator of tissue damage or dysfunction. If we take this view, pain is something to be fixed through specificity. The exact right exercises in the exact right way.
However, as you already know, this approach hasn’t solved the problem of pain.
“Since 2003 the best practice, as defined by 15 national clinical guidelines from around the world, including the current Australian clinical guidelines has been to use what is called the biopsychosocial model. The biopsychosocial model of injury and rehabilitation views pain as a complex multifactorial phenomenon, arising from an interactive combination of biological (e.g. tissue status), psychological (thoughts, emotions, beliefs) and social (social support, meaning, engagement) influences.
The current scientific understanding of pain acknowledges that there is almost never a single, linear cause and that most musculoskeletal pain is not related to tissue damage. For example, around 90-95% of all back pain is unrelated to any identifiable tissue damage.
The current best practice for treating musculoskeletal pain, according to a 2010 review of 15 national clinical guidelines across the world, is (after screening for serious medical causes like fracture and cancer) to provide reassurance and advice to stay active. ” Quoted from here.
Sound familiar? I bet it does. So, let’s stop making those mistakes and simply start with moving in ways we are not afraid of and bring us joy, shall we?
Which one of these exercise mistakes are you making? Join the Facebook group and share with us. We can help you change it!
Further Reading:
https://breathe.edu.au/time-let-go-obsession-anatomy/
https://www.bettermovement.org/
https://breathe.edu.au/time-let-go-obsession-anatomy/
