News from the Center for Physical Excellence

Even very small changes in muscle size can make a big difference in strength. This is especially true in people who already have lost a lot of muscle. Increased strength improves your ability to do things such as getting up from a chair or climbing stairs.

Your muscles are active even when you are sleeping. Their cells are still doing routine activities they need to do to stay alive. This work is called metabolism, and it uses up calories. That can help keep your weight in check, even when you are asleep!

To do most of the following strength exercises, you need to lift or push weights. You will need to keep gradually increasing the amount of weight you use. You can use hand/ankle weights sold in sporting goods stores. You can also use things such as empty milk jugs filled with sand or water, or socks filled with beans and tied shut at the ends.

Download the Exercises Here.

The most common reason people seek medical care is related to pain. Acute pain, defined as pain that came about quickly and has lasted less than 3 months, serves as a red flag to a person, indicating that something is wrong. Unfortunately chronic pain, defined as pain that has lasted greater than 3 months, does not necessarily serve the same useful function . Chronic pain can change every aspect of a person's life including emotion, relationships, wellbeing, job, and money. This article will talk about chronic joint or muscular pain and give guidance for improvement by encouraging the person be active in managing the problem.

A person's attitudes, beliefs, and coping have a huge impact on whether they are likely to improve quality of life by activity. Each person is individual in many ways, and their conditions are unique, so each problem requires a little trial and error as far as activity goes. Therefore, it is necessary that a person in chronic pain be patient, have a positive attitude, assume there is a natural and active way they can reduce their pain, and be productive in the way they deal with the pain.

There are general recommendations that may help a person with chronic pain. One is for people to be mobile in a dynamic fashion versus being in sustained postures over long periods of time. Avoiding immobility and repetitive tasks may be best. Finding new interests alternative to the ones that may increase pain would likely help. There are all kinds of physical activities that can be modified or different types of physical activity that would be tolerated much better and still be fulfilling to a person. For example, a person with knee pain who previously loved to run could try hiking, biking, or swimming. Modifications in things a person likes to do could make all the difference. How about just walking fast? People with chronic pain may restrict their leisure time because they cannot participate at the level they would like. It is important to prioritize and make time for alternative or modified activities.

Problems such as deconditioning, difficulty walking, history of falling, slow recovery from an illness, mental declines, poor nutrition, and incorrect use of medication can be made worse if a person has chronic pain. Pain is associated with depression, reduced tendency to socialize, and sleep loss. So, all efforts must be made to reduce the experience of pain to reduce its impact on the above issues.

An interesting aspect of pain in relation to strength and posture is that the painful joints often shut off or allow weakness in specific muscle groups of the body. If the back muscles that allow you to sit up straight become weak and over stretched over a period of time, then you are probably more likely to develop pain and arthritis. This weakness can be reversed, at least in part to improve posture and arm reaching overhead, by exercise and activity. Strengthening of your legs even with the presence of osteoarthritis in the hips or knees often reduces pain and improves walking and standing tolerance. Improved muscular strength by performing the proper exercises over a period of time would undoubtedly reduce joint stresses. Ways must be found to maintain strength of these joints without increasing pain significantly. Otherwise the muscle will continue to get smaller and weaker.

In some cases, chronic pain will remain to some extent despite varying levels of improvement in different people. Therefore, these people must learn to adjust. This means changing aspects about how they live, what they would like to do, and expectations about the future. As said before, ways must be found to alter the activity so it can be tolerated. For example, if the person has knee arthritis, loves to do gardening, but can't kneel due to pain. Maybe they could try knee pads, or lying on a side in order to do this. Or someone who loves to hike but can't due to increased knee pain and weakness. Maybe a trial with walking sticks would help or trying a different trail that isn't as long or challenging. A person may need to accept that there are things they just can't do anymore. A trial of avoiding these things temporarily or permanently in order to reduce pain, and improve quality of life wou ld be worthwhile. This would allow the opportunity to recognize the variety of activities there are and substitute.
One of the most wonderful concepts for pain and activity is using the strategies of pacing and goal setting. Setting reasonable goals that are important to the person in steps would be a good way to do it. Looking at pacing oneself for the long term benefit vs. short term is also best. If your long term goal is to be able to walk throughout the day doing your normal activities with a reasonable amount of pain, you should pace yourself to attain that goal and not expect to achieve it right away.

A person must try to avoid losing endurance or general conditioning of the body because they are in pain. They are likely to get along better and enjoy life more if endurance is addressed. There are many ways to improve general conditioning or endurance. Commonly, a person with chronic pain will have it mostly in one segment of the body, often a knee, hip, low back, neck, or shou lder. If this is the case, they could do endurance training on the other body segment in order to maintain general fitness. For example, if a person has severe R knee pain and arthritis, they could do an upper body circuit training ro utine at a gym, or exercise on an arm bike.
Other simple ways to reduce joint related chronic pain is to use an assistive device if needed, such as a cane or walker. These can help quite a bit with stability to avoid falls, reduce joint stresses and pain, and improve the amount of mobility. One common mistake among people who use a cane is holding it in their dominant hand or on the same side of the problem. If you have a cane you shou ld always use it on the opposite side of the painful area despite which arm you are dominant with. Another way that may be beneficial to reduce chronic pain is to ensure you get adequate amounts of sleep. This means staying away from your bed in general except to sleep.

Thank you for reading this article. You are always welcome to seek help from a physical therapist at the Center for Physical Excellence.

Reference: Strong, J., Unruh, A., Wright, A., & Baxter, G. (2002). Pain A Textbook/or Therapists. Churchill Livingstone.