At Blackberry Clinic we treat a lot of sports injuries using physiotherapy, osteopathy, chiropractic treatments. One question our therapists get asked is ‘Is it ok to exercise if it hurts?’ There is no easy answer to this, but Thanasis, one of our physiotherapy team at Blackberry Clinic Milton Keynes, summarises some research about this below. Remember, it is very important to visit a physio, osteopath or chiropractor if you have a musculoskeletal injury, in order to determine what is causing your pain and whether it is a good idea to exercise or not.
A graduated exercise programme and rehabilitation will be the best answer for a faster return to full activity. Without advice, you may think you are healing, but as soon as you step back out on that field, court, golf course or pitch you may re injure yourself and be worse off than ever. Even one short session of advice and guidance may make all the difference to your return to sport and exercise. Give Blackberry Clinic a call or contact us on the website to book in.
Here is Thanasis’ summary:
Regular exercise and physical activity shown to help improve physical and mental health, including cardiovascular health, stress, mood, sleep, and sexual health. In addition, clinically important reductions in pain are often observed within a few weeks of exercise therapy and as little as 1 session of exercise can lower existing pain levels. This phenomenon is known as exercise-induced hypoalgesia (EIH).
It has been shown that exercise can increase pain thresholds by 15-20% at the exercising body areas, and higher pain threshold can be seen at non-exercising body areas too. It can increase the pain tolerance, and decrease the unpleasantness. Interestingly, painful exercises seem to have larger hypo-algesic effects than non-painful ones!
On the other hand, in individuals with different chronic pain conditions, the response to a single session of exercise is less consistent, as hypoalgesia, reduced hypoalgesia, or even hyperalgesia (ie, increased sensitivity to pain) has been observed.
In high pain-sensitive patients, an increase in temporal summation of pain (increased nerve response) was observed after aerobic exercise, possibly mimicking the pain flare-up after exercise reported in clinical practice by some individuals with widespread chronic pain. Another study showed that exercise above but not below an individual’s pain threshold, increased pain responses to exercise in people with lateral epicondylalgia.
Additionally, the exercise dose–response relationship is different in individuals with chronic pain compared with pain-free individuals.
Nonetheless, as observed in pain-free individuals, negative expectations are associated with the hypo-algesic response after exercise. A randomized controlled trial comparing positive vs negative pre-exercise information, observed a 22% increase in pain thresholds in the positive information group, whereas the negative information group had a 4% decrease (hyperalgesia) in pain threshold at the exercising muscle.
So, before you add “pain” to your exercise routine, and before you cut out exercises and activities due to pain, there are some things to consider;
(1) that exercise is not meant to harm, but a painful exercise might be even more effective,
(2) that exercising non-painful body areas and using low-intensity exercises, such as walking, may be useful as a first step, if in pain.
(3) that beliefs, expectations, and exercise preferences can minimize the risk of a poor outcome when they are taken into consideration.
(4) that the proper exercise program is the one you can tolerate and being enough to achieve your goals.
Please consult your therapist for a safe and effective exercise program of your needs.
Thanks for reading
Thanasis
Physiotherapist Blackberry Clinic Milton Keynes
Reference:
Henrik Bjarke Vaegter and Matthew David Jones. Exercise-induced hypoalgesia after acute and regular exercise: experimental and clinical manifestations and possible mechanisms in individuals with and without pain. Pain Rep. 2020 Sep-Oct; 5(5): e823.
https://www.csp.org.uk/frontline/article/physio-findings-exercise-pain-doesnt-equal-tissue-damage
