Exercises For Pain Management - How Long Should You Keep Them Up ?

Exercise for pain management

The health industry stats for long term compliance with rehabilitation exercise programs make for depressing but perhaps unsurprising reading.

Less than 1% of people are still doing their prescribed exercises for chronic complaints after a year, some because they are slack but many because they simply didn’t realise that it was needed.

If I reflect on my conversations with people over the decades in this industry I can scarcely remember an occasion that someone told me they kept up their ankle sprain rehab for more than a month or 2; much less keeping up long term with some prescribed exercises.


Reason 1 – Injured areas were usually already weak before they got injured.

The vast majority of injuries happen in body parts that were already struggling a bit with repetitive strain, under-use or postural weakening. What this means is that for many of us by the time we are doing rehabilitation for an injury we are actually dealing with a body part that has struggled sometimes for decades.

Reason 2  Injured and painful areas nearly always have muscle wasting after the fact.

In the aftermath of a significant sprain or fracture there is rapid muscle wasting. If you have ever seen how skinny a forearm can be when it comes out of a plaster cast then you have glimpsed this phenomena. This kind of muscle wasting might have easily rehabilitated itself in hunter gatherers .. in the bodies of office workers it takes specific attention!

Reason 3 Muscles are what hold our joints together.

There are 2 things to remember about muscles. The first is that they are a basically what hold our joints together over the course of our lifetime. The second is that they don’t just ‘be strong’, they adhere to the use it or lose it principle.

Perhaps this is all we would ever need to know about the importance of long term strength exercises for our old war wounds ???

Reason 4  If you are never done with looking after your teeth why would you ever be done with looking after your old pains and injuries .

The reason you keep caring for your teeth is because you know that they are subjected to life long  ‘dietary stress’. All of our joints are subjected to life long ‘mechanical stress’ that comes not only from things like running on concrete but just ‘life’s general; so why wouldn’t we do them the same favour we do our teeth. This principles doubles in importance when we are dealing with an old injury or old pain area.


Not long ago at my office in Wellington I met a very unfortunate chap who had recently aquired around half a kilo of screws and bolts for the purpose of putting his leg bones back together after a massive fall. We met 10 months after his operation and he had long since stopped doing his exercises. He still had so much muscle wasting around his knee and hip that you can see it from the other side of the room; but had stopped his exercises thinking he was done with them after a few months.

If this man really knew what this could mean long term he would most likely be doing them for an hour per day. Stopping his exercises left the door wide open not only for more pain but for premature arthritic change in the joints. With respect I felt that his hospital  physiotherapist could perhaps have made more effort to help him understand this.

Maybe you have had ankle sprains or shin splints, if you have had episodes of lower back pain and seen chiropractors for adjustments, if you have had knee pain or injuries, if you have had plantar fasciitis or heel pain, maybe you have had shoulder pain or shoulder surgery? Do any of the above apply to you?  Did you work long and hard at the strength in that area way beyond the mere resolution of pain ? If not then you probably to some degree are in the same trap as my friend with the smashed leg. Chances are you still have some stubborn muscle wasting in that area; and if that part of you sometimes feels achy, sore, stiff or not quite right then its probably quite a bad.

At our clinic in Wellington we offer treatment for everything from plantar fasciitis and heel pain to neck pain and migraines. We always aim for more than ‘the mere resolution of pain’.

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