FAQ: What Should I DO For Knee (Back, Shoulder, Neck, etc.) Pain?

The International Association for the Study of Pain (IASP) defines pain as an “unpleasant sensory and emotional experience associated with actual or potential tissue damage.” It is more than data received from the body.   The reason we perceive physical pain is not always simply due to tissue damage. Pain is complex.  One thing is for sure, everybody hurts…sometimes.  And it seems more of us are in pain more frequently.  

• The 2012 National Health Interview Survey (NHIS) found that an estimated 25.3 million adults (11.2 percent) experience chronic pain.  Chronic pain is defined by pain every day for the preceding 3 months.
• 25% of adults experience knee pain and it appears to be increasing in prevalence.
• About 80 percent of adults experience low back pain at some point in their lives.
• The overall prevalence of nonspecific neck-shoulder-arm pain appears to be increasing in the general population. 

When we are in pain, we don’t want to move.   The more it hurts, the less you move.  The less you move, the more things hurt. It's a vicious loop. Maintaining regular movement is absolutely critical to a healthy, functional body and a fulfilling life.   Not only that but studies suggest that exercise can provide pain relief equal to medication in some cases. 

Your body was meant to move but how do you do that when you are experiencing musculoskeletal pain?  Of course, it's imperative to be checked out by a medical professional; pain can be a sign of underlying pathology.   Second opinions are also a great idea.  You want to be cleared for exercise so that you do not exacerbate any injuries or medical conditions.   If your doctor or physical therapist tells you that you can proceed, you should! 

I am asked about pain in some form every few weeks. A certified personal trainer (CPT) cannot diagnose or treat medical conditions.  But a CPT can help you get moving if you are ready, able, willing (and cleared!)   Here are a few important things to keep in mind.

Never work into pain.  If a movement hurts (which is different than muscle fatigue) then you should not do it. Sometimes we get into the no pain, no gain mindset. However, we definitely don’t want to reinforce the idea that exercise equals pain.  Have you ever hurt yourself doing something and then when you think about it you can feel that twinge…?  Or you go to do something similar and it hurts?  Your nervous system remembers!

A second reason to not work through it is that even if you don’t intend to do so, you will compensate for pain.  You will inadvertently alter movement patterns which can cause additional problems in the future and in other areas of the body. 

Rather than work through it, find ways to work around it! 

Like your car, alignment is important.  Get it checked.  A qualified personal trainer can look at your posture and alignment and some movement patterns to see where changes may be needed.  While a certified personal trainer cannot diagnose or treat diseases or injuries,  she can increase awareness of posture and form and include exercises to strengthen weak areas.  Areas above and below where your issue resides can play a role in your pain.  For example, a foot or ankle alignment or mobility issue may be felt in the knee or hip.  Weak hip muscles can affect the knee.  Depending on assessment results, your personal trainer may refer you to a physical therapist.

If a specific exercise is causing pain: Remove that exercise or modify the movement.  You can reduce the range of motion or the position of your body while maintaining proper alignment.   Adding support to reduce the load may help.  If you can’t make a specific exercise work, find other exercises to work the desired muscles.  This is where hiring a fitness professional can matter.  She can program exercises around your pain and help you make adjustments as necessary. 

For example, if you experience occasional knee pain with exercise and wanted to to work your lower body, exercises we could potentially include are:
-Glute bridges & hip thrusts
-Wall sit
-Clam shells and banded abductions
-Goblet squat to bench to reduce range of motion
-Variations of the deadlift 
-Low step ups
We would play with appropriate progression/regression to find what works best for your body right now.

When it comes to cardio, which is an important part of a well-rounded fitness program, you can find ways to get your heart rate up that don’t exacerbate your pain.  High impact activities such as running or plyometrics aren't your only option.  Start with walking.  See how that feels.  Play around with intervals where you increase your speed in short bursts. 

Body weight exercises  and calisthenics can easily be modified.  You can do these at a moderate-intensity steady state or at higher intensity intervals.  Exercises such as low impact jacks, marches, and kickboxing moves are effective.  Dance-based workouts (yes, I'm talking about Jazzercise) can be done low impact or lower intensity.   Strength training exercises done at higher reps in a circuit format will increase your heart rate and improve cardiovascular fitness. Swimming and biking are other options that often work well for those who have joint pain.

Consistency matters more than intensity when it comes to general health and well-being.  It’s not worth it to go hard and then hurt for days on end, putting you out of commission for not only exercise but  all of life’s activities.  It’s better to go slow and steady at first.

Finally, practice positive thinking and gratitude.  Pay attention to what you are telling yourself as you are figuring out works best.  Be kind to yourself when your plans have to change due to pain. Focus on what you CAN do rather than what you cannot currently do. If you fall into the trap of thinking you can’t do anything, it will become a self-fulfilling prophecy.  It can be difficult to maintain positivity when you are hurting or when you aren’t able to do the things you want to do.  Find a coach or group that will offer encouragement. Decide that you are capable of exploring various areas in relation to your goals for self-improvement, health, and wellness. 

You might not be able to take on the activities you'd like right now.  However, it is highly likely that you can do something! 
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Are you interested in exploring movement and exercise with guidance? Contact me to set up an initial consultation.  This is a free, no obligation conversation and a step towards creating a healthier, stronger, happier you.