Monday, June 8, 2015

"But Exercise Makes Me Feel Worse"

"Exercise improves your pain threshold,” says Trent Nessler, PT, DPT, MPT, a vice president with Champion Sports Medicine in Birmingham, Ala. “With chronic pain, your pain threshold drops -- in other words, it takes less pain to make you feel more uncomfortable. With cardiovascular, strengthening, and flexibility exercise, you can improve that pain threshold.”

“Exercise improves your pain threshold”  

Lets think about that for a minute. 

Ok minutes up!
Who wouldnt want to feel just a bit better if they could just from getting a little exercise? 

The first thing you think is "when I exercise I feel worse". 
The next thing you think is "I am so sick of people telling me to exercise!"
(Its ok, I dont get offended)
But you have to realize the only reason people say it all the time is because generally its true. NOT always, but generally.  (I'm not talking about those who think exercise and a good nights sleep will cure you!) Just as changing your diet "generally" helps. I always point out that I am never ever a one size fits all person. I don't like blanket statements because I am smart, experienced and open enough to know that not everything works the same for everyone. 
There is such a thing as exercise intolerance

Impaired oxidative phosphorylation not only causes muscle fatigue but also muscle cramping with or without tenderness, or a feeling of extreme heaviness in the muscles. These symptoms are especially severe in those muscle groups being used, and patients often complain of discomfort in the legs or even muscle spasms.The discomfort may be felt immediately following the activity or later on, waking up the patient from sleep. Following more prolonged or intensive activity, the pain or heaviness can persist into the next day(s) despite rest. A subset of patients has pain associated with elevations of CK and intensive exercise can lead to frank myoglobinuria; there may also be associated lactic acidemia (DiMauro, 1999).


With that said of course if you are going to hurt more you are not going to want to do it. And it takes a special determination to do it anyway knowing what lies ahead. One of the most common statements you hear from a Fibromyalgia/ME/CFS patient is  "I'll pay for it later"
Its part of our permanent vocabulary. But lets put this in perspective.


You drink foul tasting cough medicine because you know it will help your coughing. 
You take antibiotics when you dont like prescriptions because it will help your infection.
You spend $500 dollars on a brake job because you know it will save your life. 
You do so many things as a parent that "hurt", because you are trying to shape, protect and teach your child.
Something we are very guilty of is doing too much because we dont like to say "no" to others. We KNOW its going to hurt, but we do it anyway. We just decide to "pay for it later".

Well, a permanent part of my vocabulary is "you are in pain anyway". You are in pain anyway so why no make it count for something. Why not endure just a little more pain now, to prevent even greater pain down the road? I don't say that off the cuff, I don't think "if I can do it you can do it" and  I don't think its easy. 
BUT..aside from the abundance of articles, studies and "opinions", you do experience this yourself that....
The less you move, the more it hurts. The more it hurts the less you move.
 So it becomes a self fulfilling prophecy. It hurts so bad you stop for a while and when you try again you want to die because it nearly kills you. And that's real pain, not an excuse to avoid exercise. 
The first "exercise' you should do is with your fingers! Do some research. Look on the internet, ask questions in support groups, read blogs and see what types of exercises and modalities seems to have the best results.  Make a list and then rate them in order of effectiveness. 
#1 Would be the most common, popular or least painful to incorporate. #2 Would be the next most common answer. 
Example:
1. stretching
2. walking
3.yoga 
(certain types, not the twist in a pretzel type!) 
etc....
Then, call the doctor and make an appointment to discuss the best way to go about getting some exercise. Bring your list and your research. DON'T FEEL FOOLISH. Most times coming armed with information will make them take serious, and provide specific answers. Don't let them tell you "go get a trainer", or "just start walking". That's not a plan. 
A plan is a detailed proposal for doing or achieving something, OR an intention or decision about what one is going to do. You need to decide what to try first, at what intensity level and how often. It might be to even get a referral to a physical therapist or exercise physiologist to get the proper advice and program.

For example, If you decide to walk you shouldn't just walk 2 miles after having done little to no exercise. You could cause a flare and/other reactions. Graduated walking is best.  Decide with the doctor based on your condition how much and how far. Starting with only 10 minutes (any pace) 3 times week for 3 weeks. Then try to increase it to 15 minutes or just try walking a little faster.Then 4 times a week for 3 weeks (or simply increase to 15 minutes still 3 times a week), and so on. If it does not agree with you you will know right away. Maybe you have to cut back to 2 days, walk slower, or move on to the next thing on your list.  

If you chose yoga, start with only one class in a week. Wait and see how your body responds for the next few days. (Try looking on Meetup , facebook,  or local papers, gyms and studios for a free class in your area before you commit to the cost of a full session in case its not for you. A lot of studios also offer a drop in rate to you can try just one class) Its also not a bad idea to talk to the instructor ahead of time via phone or email and make them aware of your medical issues and what your goal is. They will be able to give extra instructions for your benefit, provide blocks or straps for you to modify some of the common moves so they do not cause you great discomfort and make sure you are in the right class, or tell you which one to try.  In my experience, Hatha, Svaroopa and Restorative are the top most effective types for Fibromyalgia and whole body pain related issues. Especially for beginners. 

The key is to find something that works for you. Don't judge  yourself or compare yourself to the others, especially "healthy" people around you. Each person has their own challenges, progresses at their own level and are motivated by different reasons. I beg of you to keep trying. Just keep trying and don't get discouraged by setbacks. 
I actually took that word out of my Rolodex because it has too much of a negative connotation. It's not a setback, its simply a communication from your body. Just as a dog has to bark or a baby has to cry to communicate, your body has no voice. It has to tell you when you have pushed it too hard somehow doesn't it? Its just a message to "slow down', pace yourself and in some cases when you seem to get no feedback, its actually saying "hey that wasn't so bad! you can probably do that again!"
    • tention or decision about what one is going to do.


Matthew Jones, researcher at the University of New South Wales who led this study   said “the results remind us that the longer we stick with an exercise program, the less physically discomfiting it will feel, even if we increase our efforts ... The brain begins to accept that we are tougher than it had thought, and it allows us to continue longer, although the pain itself has not lessened.” (A less technical article that translates the study can be found here.)

*This is not to say you will be healed, that you won't or don't need additional therapies or medications. Exercise it is just an additional tool for your arsenal to help combat pain. Always consult your doctor before starting any exercise program. 
A Beginners Guide to 8 Major Types of Yoga
Yoga Diciplines- Different types of Yoga
Relieving Pain Through Exercise-Not Medicaion





29 comments:

  1. Thanks for all the great ideas! I was sitting at my computer today and could not for the life of me think of something to write about. This was really helpful. Thanks again!
    Aire Bra | Sandhi Sudha

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  2. Exercise improves your endurance. These three are basics yet most effective to build up your body. Thank you for sharing all this.

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  3. Hey excellent information!! thank you for providing such a great post as it was helpful to me and I will surely recommend it to all my friends. Keep updating with more such posts

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  4. Valuable Post.
    It is helpful to fibromyalgia patient.
    Thanks for sharing !
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  8. I absolutely hate my disease and everyday used to be a battle to get out of bed.I've tried everything and it all came down to diet and yoga. The yoga to increase my pain threshold and to stretch out those joints and tendons. The diet I found in the form of a book at this website: http://bit.ly/2esk8Ka . The only way to start beating fibro is with knowledge. Hope this was helpful

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  9. Detestable condition! Maybe some people do better with exercise and diet. It would be nice to know what really causes fibromyalgia, and what to do for it. There are so many conditions that cause widespread pain! They can't all have no cause.

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    Replies
    1. I agree, but even when one study, doctor, or lab test says they know, that is in dispute by many other studies, doctors, and lab results....its a no win as far Im concerned.

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  16. thanks for the information
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