Is exercising a pain?

11 November 2005

Dear Chris,

How does one know which comes first - the chicken or the egg? If you've got a painful elbow, or a creaky shoulder, how does one decide whether or not it NEEDS exercise to resolve it, or whether exercise will exacerbate it?

Vicky

Dear Vicky,

Many people wonder if exercise will help or hinder their ailment, especially if they are new to an exercise program. When people feel aches and pains in their joints, especially if they have been there for quite some time, they want to be sure that exercise won't compound the problem.

Exercise, if done correctly, will not hurt you. In fact, exercise can strengthen the muscles which surround the joint and promote flexibility in the joint itself, thus protecting it from injury. Exercise can, however, put undue stress on joints if done incorrectly, especially if those joints are already hurting from wear and tear, trauma, or arthritis. Exercise may need to be modified for your particular condition because, at all times, it must be done safely.

If you have an ache or a pain that just won't go away, it may be something serious and you should talk to your doctor. You also may choose to go for physiotherapy, chiropractic, or other treatment. When you see your doctor, be sure to tell him or her that you are interested in pursuing exercise. Otherwise your doctor may think you are only interested in taking medication and not discuss other options with you. If you and your doctor agree that some medication is warranted, exercise can still go a long way to not only alleviate symptoms but correct underlying problems. It may possibly mean that you are able to take fewer medications because you will have less pain. As always, proceed slowly but keep an open mind to the possibilities exercise can bring to painful joints.

Many people have a hard time distinguishing an exercise "pain" from other aches and pains. To protect a joint, the muscles surrounding it need to be strong. The process of making a muscle stronger will in itself cause some soreness. That soreness means that you are working the muscle hard, often causing little micro-tears in the muscle, which will cause it to repair itself and get stronger in the process. That type of soreness should not last long, however. If the soreness lasts more that a couple of days, is throbbing, or a shearing pain, then you have probably overworked the muscle and may have sprained or put repetitive strain on the joint.

If you experience pain while you exercise, you should be able to tell if the pain is acute (sudden onset) or chronic (long-term) by asking yourself the following questions?

• Did the pain come on all of the sudden or was there a slow and gradual onset of signs and symptoms?
• Was it the result of a single event or gradual continued abuse?
• Was it a moderate or sharp pain, or did it start out a mild discomfort which developed into long-term pain, perhaps because you didn't get it treated right away?
• Did I sprain a muscle or ligament or have a I had a pain in a joint for quite some time?

If you have suffered an acute pain, back off from doing that particular exercise and help yourself to some RICE.

That's right, RICE, which stands for Rest, Ice, Compression, and Elevation. Rest will allow the damaged tissue to heal and keep you from further aggravating it. How long and to what degree of rest you require will depend on the injury itself. Ice is used to reduce inflammation, which usually occurs after an acute episode as your body's way to tell you to stop what you are doing. However, after you have stopped the activity, the inflammation remains and can be the cause of further and longer lasting pain. Ice is best used within the first day or so of an injury and must be applied frequently and consistently for best results. Compression of the injured area with an elastic bandage or other type of tension will also reduce swelling. Finally, you need to elevate the area above the heart (hopefully with ice and compression) to help fluid move away from the injury and thus alleviating some of the pain caused from the inflammation.

Chronic injuries are usually harder to look after. They often started out as something acute long ago and we often forget what caused the problem in the first place. These are the types of conditions that can be made worse by exercise if a person has forgotten about them and then done something to aggravate the condition.

Often a chronic condition is the result of muscle imbalance that has gradually developed over time. Improper posture and movement can often be the cause. If someone is exercising with poor technique, they could be placing more stress on an already strained joint, muscle, or ligament. Other times a person over-exercises and does not give themselves time for rest and repair. Regardless of the cause, chronic injuries should be examined by a health care professional to see if they can be improved by properly performed exercise and possibly other therapy.

Once your program is over and you see improvement in your condition, you will want to make a lifestyle of exercise, where I would suggest you initially work with a personal trainer and let him/her know what aches and pains you've been treated for. That way he/she can prescribe an exercise program that takes these areas into consideration to ensure that your former aches and pains don't come back. A good trainer will communicate with your health care practitioner about your program to ensure that the exercises he or she does with you are cleared by the practitioner.

To your health

Chris

Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.

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