Typically the clients that I work with have been in pain for a long time. Pain that has continued past 6 months is considered to be chronic. Most of the people that I see have had pain for years...
As the cycle of pain continues past the normal tissue healing process, pathways to the brain can become affected, this is called central sensitization. A “wind up” of sorts occurs in the nervous system so that your threshold for pain actually lowers. What this means is that, what used to be a mild stimulus sensed in the body, is now more reactive and can set off a “flare”, i.e. a loud noise becomes louder, light becomes brighter.
As the cycle of pain continues past the normal tissue healing process, pathways to the brain can become affected, this is called central sensitization. A “wind up” of sorts occurs in the nervous system so that your threshold for pain actually lowers. What this means is that, what used to be a mild stimulus sensed in the body, is now more reactive and can set off a “flare”, i.e. a loud noise becomes louder, light becomes brighter.
Studies have shown that exercise can be an effective way to manage chronic pain levels. So, how does someone with chronic pain initiate a program so that it doesn’t set off a “flare” or increase current pain levels?
The goal of a movement or exercise program is to open the “therapeutic window” just wide enough to improve daily function without increasing pain.
The first step is to become aware of performing exercise and movements with good alignment. The better the body is aligned, the less damaging forces are acting on your joints, and your muscles can be more efficient. To learn more about what good alignment is, attend my free intro to alignment session, and then sign up for Restorative Exercise™ classes. The exercise classes are designed to move through a variety of stretches and motor skills to get your body back into alignment and functioning more optimally.
The second step is to tune into, and understand your tension patterns. For many people with pain, holding the muscles in a braced and tightened position is very common because it is a way to protect the area. However, over time, the muscles habitually will go into that pattern of tension and you may not even be aware of it anymore. It is important to tune back in and allow the muscles to relax. When muscles are in a constant state of contraction, blood flow is not able to circulate properly to bring in oxygen and remove wastes to the area for tissue healing and regeneration. Learning to become aware of specific muscle groups and to consciously relax them is an essential process to begin to reprogram the nervous system and heal.
The goal of a movement or exercise program is to open the “therapeutic window” just wide enough to improve daily function without increasing pain.
The first step is to become aware of performing exercise and movements with good alignment. The better the body is aligned, the less damaging forces are acting on your joints, and your muscles can be more efficient. To learn more about what good alignment is, attend my free intro to alignment session, and then sign up for Restorative Exercise™ classes. The exercise classes are designed to move through a variety of stretches and motor skills to get your body back into alignment and functioning more optimally.
The second step is to tune into, and understand your tension patterns. For many people with pain, holding the muscles in a braced and tightened position is very common because it is a way to protect the area. However, over time, the muscles habitually will go into that pattern of tension and you may not even be aware of it anymore. It is important to tune back in and allow the muscles to relax. When muscles are in a constant state of contraction, blood flow is not able to circulate properly to bring in oxygen and remove wastes to the area for tissue healing and regeneration. Learning to become aware of specific muscle groups and to consciously relax them is an essential process to begin to reprogram the nervous system and heal.
Focused breathing can be an effective tool for relaxing muscles. People with chronic pain typically take short, shallow breaths that result in the upper chest and shoulders expanding on the in breath. The goal is to allow the belly to be soft, as you expand the ribcage so the lungs can fill more completely on inhalation. Filling the lungs means more oxygen to your system.
Practice focused breathing and relaxation daily. Start with short sessions, and then progress to 15-30 minutes.
The third step is flexibility. Begin to stretch the muscles that have been held in a contracted state. As the muscles begin to lengthen, the grip and compression held in the joints that they cross, will begin to loosen up. The joints will have more range of motion as the muscles let go. As you stretch, begin to feel for the very first resistance to the motion. In the beginning, it is important to stay below a pain threshold or intense sensation of the muscle being stretched. Make sure that you have good alignment when performing the stretch and stay relaxed. Less is more when you first start out. If you notice that your pain has increased after the stretch session, modify for the next session: 1) you may need to perform every other day rather than daily 2) hold the stretch for less time 3) back off of the intensity of the stretch and make sure you are performing the stretch correctly.
Practice focused breathing and relaxation daily. Start with short sessions, and then progress to 15-30 minutes.
The third step is flexibility. Begin to stretch the muscles that have been held in a contracted state. As the muscles begin to lengthen, the grip and compression held in the joints that they cross, will begin to loosen up. The joints will have more range of motion as the muscles let go. As you stretch, begin to feel for the very first resistance to the motion. In the beginning, it is important to stay below a pain threshold or intense sensation of the muscle being stretched. Make sure that you have good alignment when performing the stretch and stay relaxed. Less is more when you first start out. If you notice that your pain has increased after the stretch session, modify for the next session: 1) you may need to perform every other day rather than daily 2) hold the stretch for less time 3) back off of the intensity of the stretch and make sure you are performing the stretch correctly.
The fourth step is to begin a walking program for endurance and aerobic conditioning. Begin with short bouts of walking, maybe 5 minutes 2-3 times a day. Increase the duration of walk by 5 minutes every 1-2 wks until you are able to walk 20-30 minutes.
Chronic pain conditions require tailored exercise and movement modification. For those of you with chronic pain, utilizing the guidelines presented in this post, may open the “therapeutic window” to enhance function and quality of life.
Chronic pain conditions require tailored exercise and movement modification. For those of you with chronic pain, utilizing the guidelines presented in this post, may open the “therapeutic window” to enhance function and quality of life.
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT. Helpful tips and other self care strategies can be found at www.alignintegrationandmovement.com.
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