When Is it OK to Work Through Your Pain and When to Stop
Of course you know that exercise is good for you. Yet, many of my patients, perhaps like you, worry that certain activities might cause more pain. After all; your joints ache, and you’re tired from being in chronic pain.
However, your body remembers, even if it has been a while . . . that once you get moving, your joints feel more flexible and your achiness fades away.
Exercise often ends up being exactly what you need to ease your pain.
So, When Your Joints Hurt, Should You Exercise Anyway?
If you have mild to moderate joint pain, then the answer is . . . Yes.
I want you to enjoy all the mental and physical benefits that exercise has to offer . . . Even if you have arthritis.
But, figuring out the particulars of exercising through mild to moderate arthritic joint pain can be tricky. Are you ready to give it a try?
Okay, I’m going to help you determine what to do, how much to do, when to modify things, when to stop, when to take a few days off, what to do if you end up overdoing it, and when you need to see a healthcare professional. And some preventative tips as well.
I know what it’s like to have joint pain
I can relate to how anxiety producing it can be when you are worried that exercising might cause more pain. The rehabilitative exercises I performed immediately after knee surgery were awful, and mildly painful in the ensuing months. In addition to practicing acupuncture, I’m a Certified Chiropractic Sports Physician. And I’m also a certified tennis NUT. So I knew my rehab was crucial to getting back on the court. I had to do those exercises, even though they were uncomfortable. So as I completed my exercise protocol, listened to my body, and got my rehab done without any re-injuries.
Some surgeries are easier to recover from than others . . .
In the 60’s, and probably even today, after a few sore throats and courses of antibiotics, pediatricians were quick to recommend surgery. At least mine was. After I had my tonsils out, at age 6, I got to enjoy plenty of ice cream. (You know that sugar and dairy are not the best nutritional building blocks for tissue repair and healing). And I spent the day after surgery lying in a hospital bed playing games and watching TV. I’m sure I was given some type of drug to ease the pain. Yes, it was 50 years ago, but I don’t remember recovery being too uncomfortable. Fast forward 30 years . . .
It was Christmas Day, twenty years ago. I was skiing in Breckenridge, Colorado. We were about to finish our final run before lunch. Since I had on my Christmas gift, a cute new ski outfit, I wanted to remain dry. Perhaps I was distracted by my growling stomach, but halfway down the mountain, I realized a fall was going to be inevitable. I slowed myself down, hoping I might be able to regain control. But as I was headed face forward towards the ground, the tip of my right ski planted in the snow. My body rotated and I landed on my right shoulder. Rental skis. My binding didn’t release. Snap. Sounded like I had stepped on a twig. I yelled to my companion, “get me a stretcher”. I knew immediately that I had torn the ACL, (anterior cruciate ligament) in my right knee.
If you’re going to tear your ACL, there’s no better place to do it than Summit County, Colorado. Several world-renowned orthopedic surgeons practice there. I loved my surgeon. In fact I chose no sedatives (yes to the epidural, of course). So I was able to watch the procedure on the monitor next to me and join the surgical team in a game of name that tune. Motown, I grew up near Detroit in the 60’s, so of course I won. Surgery was a huge success. But rehab . . . well, I was shocked that it began so soon.
Rehabilitation from my knee surgery REALLY hurt, at times
Within a couple of hours following my reconstructive surgery, I was walking up and down the hall. Yes, that really, really, hurt. It’s an invasive procedure. My own tendon was harvested, woven through holes created in my bones and attached with good sized screws. Eventually the epidural wears off. Then I had to go home and do my exercises all by myself. And my knee was still hurting, for quite some time. So I know what it feels like to worry that any movement at all could cause pain.
You are unique. By paying attention to your body’s signals, you can determine when it’s okay to workout through pain – and when it’s not.
The principles I used in my own knee rehab, are the same ones I share with my patients with arthritic joints who wonder about exercising with pain.
- Mild to Moderate Pain. If you have arthritis in a joint, or in several joints, a degree of mild discomfort, or even mild pain, is typical when you start your exercise session. Typically after a few minutes of activity, you’ll begin to feel better. Always begin with slow, gentle movements. Range of motion is great; like big arm circles or a few repetitions of sitting and standing up from a chair. If that feels okay, then it’s fine to progress to a brisk walk or light weight training.
- Moderate to Severe Pain. Exercise is supposed to be create “stresses” on the body. The demands caused by physical activity on the musculoskeletal and cardiovascular systems and the body’s response (adaptation) to such stress, is how those systems become stronger and healthier. So, you may need a day or two of complete rest. You may need some body work before you’ll be ready to exercise. One option if you have moderate pain, is to try some “Restorative” exercise. This type of exercise is, by nature, less stressful, especially to your joints. Many types of exercise can become “Restorative” simply by decreasing the intensity. I was a certified Spinning instructor and I taught a Restorative class once a week. Participants remained seated for the majority of the class. It was 45 minutes instead of one-hour. And I instructed my students to keep their heart rates at a much lower rate. Tai Chi, swimming, certain types of yoga can be Restorative if the intensity is kept low.
- Mild Pain. As mentioned above, mild pain often subsides once you get moving, However, if it doesn’t, it’s probably okay to keep going. As long as you don’t feel worse later. (see below) Decreasing your intensity a bit, then you may be able to continue without pain.
- Moderate Pain. You need to stop. Listen to your body. It is likely telling you that that joint is too inflamed now, and that more stress on that joint could cause damage.
- Severe pain. Stop Immediately. Sharp pain could be a signal of injury.
Mild muscle soreness following a challenging workout is normal. Sometimes even an easy workout can cause muscle soreness. That’s simply because you are using different muscles in new ways, or because you have been inactive for a while. So I recommend to my patients that they take curcumin, 500 mg. b.i.d. and soak in a hot bath with Epsom salts and lavender oil. I also recommend 300 – 500 mg. of Magnesium before bedtime.
Several Days After Exercise
If you experience persistent joint pain (not muscle soreness) for several days, you may need a day or two of rest. Or, try switching to low or no-impact workouts for a while. An activity that puts less stress on your joints, such as water aerobics, swimming, indoor or outdoor cycling is a great choice. If you find yourself popping ibuprofen constantly, (which I RARELY advocate) that’s a clear indicator that your activity has been too hard for your joints.
When and How to Modify Your Workouts
If your upper body is really hurting, you can train your lower body. Sometimes you just need to decrease the intensity of your workouts for a couple of days. I’ve also found that breaking up exercise into shorter segments feels better for some of my patients with arthritis. This is usually the case for people who have had a recent period of inactivity. Try two, or perhaps even three sessions of exercise a day, for 10 minutes each. This may be tolerated better than one 20 – 30 minute session.
When to seek care
You don’t have to wait to enjoy the benefits of body work until your pain is so bad that you have to stop exercising altogether. If you have arthritis, I suggest you take advantage of one, or perhaps a few of the many natural approaches available. Acupuncture, massage, chiropractic, physio-therapies such as ultrasound, low-level lasers and paraffin wax treatments are often extremely beneficial to arthritic joints. These modalities reduce pain by causing the following:
- Increasing ROM and mobility of joints
- Reducing joint swelling
- Increasing blood flow to the joints and surrounding tissues
Acupuncture offers the additional benefits of:
- Activating body’s self-healing mechanisms
- Increasing the body’s production of pain-reducing chemicals such as endorphins
- Aiding in reducing not only local, but systemic inflammation
Body work can help you feel good now. But even if you’re not currently experiencing achy, stiff joints, these natural approaches can keep your body “tuned-up”, potentially preventing further degeneration or damage.
If you’d like to find out if Acupuncture can help your aching joints, we’d love to speak with you. We help people, just like you, everyday.
Sometimes your body feels okay, but you STILL don’t feel like exercising
Even “the pros” have days like that. So you’re not alone. There are several tennis pros who see me regularly for acupuncture. They share their physical and mental challenges with me. So I can assure you, we all struggle with motivation at times. I’ll be sharing tips on how to motivate yourself when you just don’t FEEL LIKE exercising in an upcoming post.