Feel free to disagree, but I think figuring out how to start moving more or exercising was even harder than actually making the decision that I wanted to move more.
Really, we get these cool exercises at Physical Therapy and then we graduate, still laying on a table doing exercises. I don’t know about you, but my Jane Fonda workout tape died many many moons ago! This wasn’t a real functional way for me to transition back to the gym for HITT classes, Cross Fit or getting back in the pool, even though I had graduated!
I want you to have the tools you need to get back to whatever it is you are missing. So let’s cover the basics, shall we!
Start Moving Again – Refresher about Pain
Repeat after me, all pain is produced by the brain, all the time. No brain, no pain! I wrote a lot more about there here if you want to check this idea out more. The main idea here is pain is not produced by injured tissues. It is a decision the brain makes to alert us to motivate us to action, or pay attention. In persisting pain, the whole nervous system has gotten out of wack. It is now seeing threats everywhere and warning us about, well, everything!
It’s important to remember when pain has lasted past normal healing times. It is a terrible indicator of damage and a much better indicator of sensitivity. This is important to remember when we start moving again. It’s kinda impossible to start moving again without pain or flare-ups from time to time.
Start Moving Again Step 1: CHOOSE SOMETHING YOU ENJOY
It can be anything! Ask yourself: What am I doing less now because of my pain? How can I enjoy my life more with the things I do? What do I miss doing? If my life had what in it, would l feel like I was living more?
The answer to these questions is how to choose a movement or exercise that matters!
Start Moving Again Step 2: FIND YOUR STARTING POINT
Let’s be real, there is always a reason to start “tomorrow” and then “tomorrow never comes.
There’s never a ‘right time’ to start on a challenge like regular daily exercise and activity! There’s often an excuse or reason to put it off. It’s hard to have to DO something yourself. Often, it seems much easier to use a passive approach, waiting for your PT to tell you it’s time. Hoping your friends will take charge. Counting on meds to dull the pain so you can start, then realizing you are too tired or brain fogged to move.
Yeah, I’ve done all those things too. Guess what? They don’t work. Moving beyond pain, means YOU are in charge of yourself. I am all for accountability and sharing goals, but at the end of the day, it’s all about you. Remember all those reasons moving again is helpful in managing pain? Refresh your memory here. Then read on!
Start Moving Again Step 3: SET BOUNDARIES
Where do you start? You start under the threshold of what makes your pain worse. If you can do 10 squats at 50% depth but 11 makes the pain worse, you start at 10. Then increase either depth or reps. The key here is slow and steady! Don’t be greedy and want it all to right itself at once! Understanding graded exposure can help you decide the progression on your own, read here. You can always ask your PT to help you and if you don’t have a PT, book a consult, and we will get you squared away!
Decide how much of a pain increase is ok. Maybe a 2 to 4 is ok with you. Cool, then don’t let your pain rise above a 4. Stop the activity before it’s a 5! ( I tend to suggest a 2 – 2.5 point increase in pain is ok.) Again, that is totally up to you as an individual!
Decide how long it’s ok to take to recover. I tend to suggest 24-48 hours of increase in pain/ discomfort is ok. If this isn’t ok with you that’s ok! YOU ARE IN CHARGE OF YOU! You set the boundaries.
Start Moving Again Step 4: TAKING UP THE CHALLENGE
Depending on your specific pain condition, you may be able to start working on exercise and movement using the advice here or you might need to consult a healthcare professional.
You deserve support, it’s ok to ask family or friends to join you, support you, help you at home or hold you accountable. Asking for what we need helps support us. Inviting others to join us, often makes them feel good. Consider it.
Remember it takes courage to start exercising, it takes effort and commitment. Be kind and gentle to yourself along the way and choose a daily, ‘good for your health’ exercise that you like. Not every workout will be the best one ever. Flares will happen. Progress back into life is never a straight line, and when we remember that, it’s easier to take the turns in stride!
Step 5: SET REALISTIC PROGRESSIONS
Less is more! Remember, it is likely you have been in your current state for a while, so don’t rush things. Don’t be greedy. It might be a helpful idea to make progressions on a weekly basis. Do not exceed your planned progression! No matter how good you feel, no matter how bright the sun is shining. You are doing it this way to have the best amount of success possible!
Bonus tip: figuring out how you can walk in a given time period.
Set your baseline for a walk by taking the 6-minute walk test. Using a regular-paced walk, measure how far you can walk along a flat area in a timed 6-minute’ period. This might be how far you can get down the street or how far you get in a shopping center. Repeat the test a few times (with breaks) to set your baseline. Once you have that distance measured, you can use this to monitor how far you get within the 6 minutes. As you progress, you will cover more distance in the same time.
Fun stuff huh? It’s also Physical Therapist approved.
Step 6: DON’T EXPECT RAINBOWS AND PUPPIES
When you start exercising, depending on what exercise you do, it is very common to experience a temporary increase in pain, body soreness, or stiffness. Muscle soreness usually lasts 24 to 48 hours and is a normal response to unaccustomed exercise or movement. So yes that includes shopping or hanging out with a friend! This reduces as muscles adapt to new exercises and movements. Occasionally you will get a temporary pain flare. Don’t be afraid: this does NOT mean you are doing damage! A pain flare is a common response to starting a new exercise, and it takes a bit of time for your body to adapt. Remember, soreness, increase in pain or discomfort and flares are all normal. They mean you are human!
Step 7: ENJOY THE PROCESS
Think about what this decision means! You are starting. Changes are happening. This process IS moving beyond pain. Starting to move again, this is where living starts. The process NEVER stops. It’s a beautiful thing and you can do it. I know you can!
Want more support? Come join our Facebook group, we would love to get to know you!
More Reading:
https://painhealth.csse.uwa.edu.au/pain-module/movement-with-pain/
https://www.bettermovement.org/blog/2019/the-new-book-is-here-playing-with-movement
