Exercise and pain

What has exercise ever done for us? (or why should I exercise?)

Do you want to know the secret to having less pain and being more mobile?  For most people the answer is simple, do more exercise!!  Our bodies are built to move, so many of the body’s vital processes are supported by movement.

Did you know that breathing deeper helps your heart?  When you breathe in you increase the air pressure in your chest, as the heart sits beside the left lung this squeezes the heart and causes it to empty it’s chambers of blood, as you breathe out the pressure drops and the heart expands helping it’s chambers fill up again.  This ‘priming’ effect helps the heart supply the body with oxygen and nutrients more efficiently.

Our bodies are also very efficient in terms of producing what they need and getting rid of what they don’t, if you don’t exercise you don’t stimulate the body to maintain or increase the production of bone, muscle fibres and connective tissue.  If you don’t use a muscle then there is a decrease in the input from the nervous system leading to a loss of strength, then a loss of muscle size (1).  Similarly, if you don’t place stress by movement through bone then the body has no reason to maintain a high level of bone density keeping the bone strong, as we age this becomes more important as a loss of bone density can result in osteoporosis (1).

Put simply, people who don’t exercise have many more problems to contend with (obesity, diabetes), especially when it comes to pain.  People who sit all day at work have been shown to be more prone to low back pain (3) and neck/shoulder pain (4).  Our experience as osteopaths is that people who are very inactive and are struggling with pain can be harder to get results with than those who are active, this is reflected in research (5).  This is possibly due to the person being in pain due to weakness in certain muscles causing postural problems, a lack of stability or not enough movement (1).  People who are active seem to improve faster and resolve their problem more satisfactorily.   The evidence seems to support this as manual therapy combined with exercise is recommended as best practice for neck pain (6), whereas controlled exercise is recommended for low back pain (7).

How much exercise would I have to do to get some benefit?

The NHS guidelines (8) for adults aged 19-64 to stay healthy are;

• At least 150 minutes of moderate aerobic activity such as cycling or fast walking every week (20mins/day), and  strength exercises on two or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms).’

Or

• 75 minutes of vigorous aerobic activity, such as running or a game of singles tennis every week, and strength exercises on two or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms.’

This may not be achievable for everyone from the off but the main thing is to get started and work your way up to the recommendations. To help you can use starter programmes like Couch to 5Km

Exercises if you already have pain

At Align Body Clinic we put a strong emphasis on prescriptive exercise, meaning that the exercises we give you are very specific to your symptoms.   There is no magic routine or ‘weird old trick’ as the cause of the same type of pain may be completely different in two different people.  To take an example, low back may be caused by not enough movement, or a lack of stability in the hips and pelvis.  Both can cause chronic low back pain (1).  If on assessment it is found that a person has a lack of movement in the area then as well as treatment we may wish to give them carefully chosen stretches to improve the movement.  However if the problem is one of too much movement or a lack of stability, stretching will not help and may even be harmful, with this type of problem it would be best to prescribe strengthening and stability exercises (9).

To get the best results anyone suffering from pain should get assessed by a medical expert such as an osteopath, have some hands on treatment, and then have an individualised exercise programme written and taught to them.

We also advise our patients on the type of exercise suitable for their age group, injury history and physical health.  We hope to help our patients find the type of exercise that will result in a long behaviour change that will benefit them for a lifetime, not just in January!

Do you want to know what is causing your pain and if we can help?  Why not take advantage of our new patient assessment introductory offer to get you started towards a tailor made recovery plan for only £19.

Are you in a lot of pain and want to get better as soon as possible?  If so then why not book in for a new patient consultation, with treatment on the day, for £72.

We are also there to help you from home. Take a look at our suite of exercise resources and advice sheets which you can easily download and use from home.

References

1 – Magee D, Zachazewski J, Quillen W, (2007).  Scientific Foundations and Principles of Practice in Musculoskeletal Rehabilitation.  Elselvier, Philadelphia.

3 – Gupta, N., Stordal Christiansen, C., Hallman, D.M., Korshoj, M., Gomes Carneiro, I. & Holtermann, A. (2015). Is objectively measured sitting time associated with low back pain? A cross-sectional investigation in the NOMAD study. PLoS One, 10, doi: 10.1371/journal.pone.0121159.

4 – Hallman, D.M., Gupta, N., Mathiassen, S.E. & Holtermann, A. (2015). Association between objectively measured sitting time and neck-shoulder pain among blue-collar workers. Int Arch Occup Environ Health, 88, 1031-1042.

5 -Malmivaara, A., Hakkinen, U., Aro, T., Heinrichs, M., Koskenniemi, L.,Kuosma, E., et al. (1995). The treatment of acute low back pain—Bed rest,exercises, or ordinary activity? New England Journal of Medicine, 332 (6),351–355.

6 – Miller et al (2010).  Manual therapy and exercise for neck pain: a systematic review, Man Ther,  Aug;15(4):334-54.

7 – NICE (2009).  Low back pain in adults, early management.  Available at, https://www.nice.org.uk/guidance/cg88/ifp/chapter/Treatments-for-low-back-pain#combined-therapy.

8 – NHS Choices (2015).  Exercise Guidelines For Adults.  Available at, http://www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-adults.aspx.

9 – Vleeming A, (ed), (2007).  Movement, Stability & Lumbo-pelvic Pain: Integration of Research and Therapy.  Elselvier, Edinborough.