Why Haven’t My Exercises Fixed My Pain?
One of the most common complaints that we hear from new patients in our clinic is that they have been doing exercises to fix their pain, but they didn’t work. A vast number of us use exercises to try and resolve their pain. Some people self-prescribe, while others have the exercises prescribed by a healthcare professional, and many have succeeded. Yet, many of the most vulnerable and sore people still find that it simply does not reduce the pain no matter how many ‘exercises’ they do. Worse still, many people find that the exercises only serve to exacerbate their chronic pain.
We know from mountains of research that rehabilitation exercises are a hugely important part of the solution to chronic pain. Yet, a very significant number of people have no success if they use exercises alone. These facts may highlight why exercises often don’t work for the worst pains when used in isolation.
Whilst exercises are a proven and vitally important component of good rehabilitation; they are not the whole story. Excellent pain management must also include tools and approaches that resolve the pain itself and stretching and mobilising the area. Furthermore, many of the worst cases of back pain, frozen shoulder, neck pain, hip pain etc., have a significant stress-related component. So trying to use exercises that strengthen the tissue whilst ignoring the pain itself and the possibility of issues in the brain’s pain pathway is inevitably going to be quite a hit and miss affair, especially for those with the most pain.
In the same way that using dental floss cannot resolve a root infection in your tooth, exercises often cannot resolve the most chronic back pain, frozen shoulder, hip pain etc. Once you have root canal work done by your dentist, that same dental floss should become extremely helpful in preventing your pain from coming back. After you have had successful pain treatments, you likely find that the exercise that wasn’t resolving your pain now becomes beneficial for preventing recurrence.
The basic concept behind treating pain first and then prescribing exercise later is the same concept that we apply to broken bones. If you break your ankle badly at some point, you will need to do some exercises to strengthen the ankle. But we all know that it wouldn’t be wise to do those rehab exercises until the bone is healed. If you have chronic back pain, neck pain or frozen shoulder, the tissues likely need help healing before you can get the best out of rehabilitation exercise.
The sad thing about all this is that once we are pain-free, our motivation to perform rehabilitation exercises reduces. But for those willing to pursue their exercises in the longer term, it becomes surprisingly easy to stop pain from coming back, even in instances of the most stubborn and recurring pains.
In the same way that using dental floss cannot resolve a root infection in your tooth, exercises often cannot resolve the most chronic back pain, frozen shoulder, hip pain etc. Once you have root canal work done by your dentist, that same dental floss should become extremely helpful in preventing your pain from coming back. After you have had successful pain treatments, you likely find that the exercise that wasn’t resolving your pain now becomes beneficial for preventing recurrence.
The basic concept behind treating pain first and then prescribing exercise later is the same concept that we apply to broken bones. If you break your ankle badly at some point, you will need to do some exercises to strengthen the ankle. But we all know that it wouldn’t be wise to do those rehab exercises until the bone is healed. If you have chronic back pain, neck pain or frozen shoulder, the tissues likely need help healing before you can get the best out of rehabilitation exercise.
The sad thing about all this is that once we are pain-free, our motivation to perform rehabilitation exercises reduces. But for those willing to pursue their exercises in the longer term, it becomes surprisingly easy to stop pain from coming back, even in instances of the most stubborn and recurring pains.
Exercises are essential to the successful long-term management of chronic pain. However, they are not a magic bullet for every single piece of pain on the planet. And when we use them in isolation from all of the other vital components of modern pain management, we ask them to be that magic bullet, which they are not.
Pain is a symptom. Symptoms are the feedback that the body generates when it faces problems with its delicate internal balance (homeostasis). Without symptoms like pain, thirst, nausea and fevers, it would be very difficult for us to maintain a healthy body in the same way that it would be hard to drive a car safely with no dashboard display.
John is one of those rare gentlemen who has continued to play competitive soccer well into his late 50s. He is in really good shape, which you need to be to play football at that age—good shape except for his left leg. His left leg is not in good condition at all. In fact, once you get to know his left leg a bit better, it becomes apparent that it’s miraculous that he’s able to run at all, Let alone the type of running required to play competitive soccer against younger men.
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