Fit Not Fad: Chronic Pain
Join Bianca as she discusses chronic pain, its causes, and how exercise helps in episode ten of the Fit Not Fad podcast.
Bianca Grover: Hi and welcome to episode 10 of the Fit Not Fad podcast! I know it has been a while, but I promise I have been busy doing lots of exciting things and working with my amazing clients.
That being said, this episode is going to conclude season 1 of the podcast, so I decided to finish with a highly misunderstood fitness concept, chronic pain. We will talk about exercising with pain and answer the questions: “What is chronic pain,” and, “Should I exercise with it?”
First I would like to tell you a little bit about why I picked this subject. For a healthy person without any special considerations, this might not be applicable, yet. However, according to the CDC in 2018, 50 million Americans lived with chronic pain. I can only imagine the numbers went up given the world’s most recent circumstances: a pandemic.
A lot of gyms closed temporarily during the pandemic which took away access to fitness centers for a lot of people. This likely has had a negative impact on many people who live with chronic pain and special considerations. It may not make a lot of sense how, yet, but let me explain.
What is Chronic Pain?
Pain is our body’s way to signal that something is wrong. But it’s not always that simple. Yes, pain is a signal we need to take seriously but it doesn’t always indicate injury. This is because we experience different kinds of pain for different reasons. Let’s go over a few types.
There is acute pain that comes in response to an injury and goes away when the trigger is resolved. Acute pain is sharp, sudden and lasts less than 6 months. Sources of acute pain can include a cut, a bruise, burn, broken bone or a pulled muscle.
Then we have chronic pain, which lasts longer than 6 months and continues even after the injury or illness seems to have been resolved. Chronic pain can be on and off or ongoing; you feel achy and it persists. Luckily, chronic pain - depending on what is causing it - can be relieved through stretches and exercises. We can further categorize chronic pain into subsets.
Neuropathic pain is one of the subsets of chronic pain. Neuropathic pain is pain caused by damage to the nerves or other parts of the nervous system. This kind of pain can be described as shooting, stabbing or burning pain.
The other subset, radicular pain, is a very specific kind of pain that many people try to self-diagnose. Radicular pain occurs when a spinal nerve gets compressed or inflamed. The pain can be described as radiating from the back and hip into the leg by the way of spinal nerves. People also experience tingling, numbness and muscle weakness which all makes sense with nerve inflammation. This kind of pain is also known as radiculopathy, also known as sciatica. This pain needs to be diagnosed by a professional, not by WebMD. There are other things that can trick you into thinking you have radiculopathy, but again, this is a very specific type of pain.
As mentioned earlier, more than 20% of the United States population lives with some sort of chronic pain. The results of chronic pain can be life-changing, for the worse. Compensation, reduced functionality, poor sleep quality, weight gain, loss of muscle mass, irAscibility and even depression can be the result of living with chronic pain. Here is how this happens.
Causes of Chronic Pain
There are some predisposing factors that can lead to dysfunction, such as repetitive motion patterns, awkward postures, work environment, poor exercise technique, imbalanced training programs, poor body mechanics, trauma and pathologies. These are all some of the unfortunate series of events that ultimately lead to dysfunction and chronic pain.
When one or more of the factors mentioned earlier are present, they lead to altered muscular physiology, which in turn compromises the stability and mobility relationships in the body. Your body then needs to adjust and compensate, following the path of least resistance. This encourages dysfunctional movement patterns which inevitably leads to the breakdown of the weakest link, also known as injury.
Let’s take for example rotator cuff injuries. The shoulder joint is very complex, thus it involves a good amount of structures working tirelessly to keep the joint moving smoothly and safely. We have prime movers, which in this case are the muscles that move your arm. These include, but are not limited to, your deltoids, pectorals and lats. These are strong muscles. Then we have the prime stabilizer muscles, also known as your rotator cuff muscles. There are four of these: suprasinatus, infraspinatus, teres minor and subscapularis. Yes, the labrum provides stability in the shoulder as well, but this is a story about teamwork. The rotator cuff muscles are crucial for the health of the joint.
Unfortunately, people tend to overtrain the prime movers and overlook the prime stabilizers until they create an imbalance in the joint. They then end up getting injured and find themselves in Physical Therapy. You see, when the prime stabilizers are overlooked and undertrained, they struggle to do their job. This results in muscle tears, impingement and other unpleasant situations. Why would anyone do that, you may wonder? For aesthetic reasons, and likely a fair amount of ignorance. Based on the structure affected, ROM and severity of the injury, certain exercises, stretches and other methods of rehabilitation can be prescribed. Is it starting to make a little sense?
So many people are stuck in this vicious cycle of pain without knowing it. And if you’re someone living with chronic pain, I am sure you’ve tried physical therapy, water therapy, cryotherapy, all sorts of massages, pain killers, antioxidants, ice and heat and other methods. I’m gonna go on a limb here and say...therapy probably helped the most but once you stopped, the pain returned. Enter regular and hyper-focused exercise!
How Exercise Helps With Chronic Pain
For reasons covered earlier, regular physical activity helps with pain management. Simple as that. I speak from experience and from my client’s experience. Strengthening overlooked muscle groups is always a good step. Improving mobility and range of motion is necessary as well. When pain persists for weeks and months, you might think that the best solution is to simply take a break and some pain meds, but it couldn’t be further from the truth. More often than not, inactivity only makes things worse. Arthritis is a perfect example of this. Walking and stretching should be done at least. Working towards pain tolerance is also a good step.
Sometimes you might even have to look at how you complete some activities of daily living like picking something up from the ground, how you stand up from a chair, your sitting posture, your sleeping posture and so on.
It’s important to look at each person individually since there are no cookie-cutter recipes for success with chronic pain. In some cases it may take 2 exercises done religiously every day, and in other cases, it may take that and then some. This is why it’s important to find someone experienced who can help you find the best solution for your pain specifically. Make sure they have the credentials and knowledge necessary to help, or you may find yourself in a worse condition.
It may seem counterintuitive to work out more when you have chronic pain, but believe me when I say exercise is medicine. My hope for you today is that you learned something new and that you are willing to give this a try, despite your pain. If you know someone other than yourself living with chronic pain who struggles to make sense of it, share this episode with them or have them reach out to me.
And just like that, season one is in the books! As I look towards season two, please feel free to share any questions or topics you would like me to address. If I don’t have the answer, I have industry-best resources to help me find it.
As always, thank you for listening and stay fit!
