Am I hurting myself by exercising?

Rarely does a day go by when I am not asked whether it's safe to exercises despite having arthritis. Like most things in healthcare, it is not such a cut and dry answer, but in most cases, the answer is YES, its not only safe but advisable. Many people and even some health care providers are under the misconception that arthritic changes in your joints are a result of what you do. This is misleading because far more important than what you do is HOW you do the things you do. How you align your body and how you put force through your skeleton has a far greater impact on whether or not you will have pain and whether or not you will be exacerbating your arthritic condition. So how can you tell what is safe and what is harmful? Below are the key things that I consider when one of my patients has pain with an exercise.

Pain is the first and obvious sign that something may be amiss, but not all pain is bad, and not all pain is dangerous. We should approach pain with curiosity rather than fear. Pain is only our body giving us information that something is potentially dangerous. So we must seek to figure out the causes of pain rather than avoid it altogether. If you have pain with an exercise or activity you want to consider pain intensity, pain location, pain duration, pain consistency, and things that make it better or worse.

INTENSITY – No exercise should cause severe pain. Period. If an exercise or activity is bringing tears to your eyes its not right for you at this point in time. If pain in the 2-3/10 range is acceptable at the start of an exercise, but anything far above that is a hard stop. There is never a need to endure severe pain in arthritis management. If you feel that, stop and find an alternative or less intense exercise to try. Always be kind to yourself and try to work with your body and your limitations. I promise you will get much further and be much happier if you do.

LOCATION – A good rule of thumb is that pain or soreness in bony areas or around joints should be considered with caution. It often means there is some stress or irritation of the space where 2 bones meet. Some soreness in meatier areas like the thighs, the but or the calves may just be your muscles working. Muscle soreness is a very common and appropriate response to exercise, especially for those who have not exercised in a while or who have done something more intense than they are accustomed to. This pain can sometimes even last for a few days, but never for a week. So by and large soreness in big meaty areas is okay and in bony joint regions less so.

DURATION – When dealing with arthritis there is often pain and stiffness when you first start moving. That’s why the mornings can be tough or getting up after a long period of sitting. You also know that things loosen up after you move for a little while. The same is true for exercise. You should mot discontinue an exercise because of mild or even moderate discomfort right at the outset of an exercise. Always give yourself a few minutes to settle in and loosen up. Very often patients get on my stationary bicycle and the first few pedals around cause some discomfort in the knees or hips and they think they should discontinue. I encourage them to stick it out for 2 minutes and see how they feel. In most cases, the pain subsides, and they can continue comfortably for much longer and feel better after they are done. Always give yourself at least 2 minutes to see if mild to moderate pain subsides.

CONSISTENCY – If the pain begins to increase throughout an activity or exercise, its time to stop. Toughing it out to hit some time or distance goal isn’t a great idea and will probably just irritate your joints. Remember, we all have good and bad days and sometimes something you were able to do last week might be tough this week (or vice versa). Be kind to yourself knowing that every day is different and be excited to know that tomorrow may very well be a better day. It is so important not to get down on yourself on the bad days. Everyone has them and they are NOT a sign that you are getting worse.

PAINFUL ACTIVITIES – Often there may be one specific activity that flares you up and really frustrates you. For some it is going up stairs, carrying their kids or grandkids. For some people, it is when they hit the 2^nd mile of their walking route. I love it when patients come to me with a consistently painful activity because it lets me know very specifically what we need to focus on. I encourage people to be experimental with HOW they do these things. Try something totally different. Go up the stairs sideways, carry your kid on the other hip, start walking backward for a few feet (if you can do so safely). Breaking our ingrained movement patterns is so important to healing and can be quite liberating (and even fun if you obsess over these things like I do).

So keep moving!!! Our bodies crave activity. There is always something that you can do no matter what condition you are in. Be kind to yourself and be curious about your body’s responses. Understanding is the remedy for fear.