Editor’s Note: In “Hey, Health Coach,” Sarah Hays Coomer answers reader questions about the intersection of health and overall well-being. Have a question? Send her a message (and don’t forget to use a sleuthy pseudonym!).
Hey, Health Coach,
My husband and I both have chronic joint problems: carpal tunnel for me and old shoulder and knee injuries for him. These problems, in and of themselves, don’t keep us from basic activities of living, but, over time, they discourage leisure activities (like throwing a ball with kids) or weight training that is appropriate for our age and would keep us strong and balanced. How can we manage chronic issues while keeping exercise interesting? Thank you!
– Achy Breaky Body
Dear Achy Breaky Body,
In 2021, researchers from Brigham and Women’s Hospital compiled comprehensive data from the Centers for Disease Control and Prevention (CDC) showing that approximately 50 million U.S. adults—one in five—experience chronic pain[1].
Clearly, it’s not uncommon for nagging pain to get in the way of good fun. Fortunately, it sounds like you and your husband are going about your lives without too much disruption, but the pain is bothersome enough to keep you from playful activities you’d like to do and challenging ones that could increase your strength and endurance.
Chronic pain is pain that’s ongoing, usually lasting longer than six months, according to the Cleveland Clinic. This type of pain can persist even after the injury or illness that caused it in the first place heals or goes away. The body’s pain signals can remain active in the nervous system for weeks, months or even years.
In other words, even if you heal an injury, your nervous system can keep harping on it for quite some time, which can make important interventions like physical therapy and strength training seem fruitless. Annoying, right? Persistent discomfort can also increase your odds of avoiding activities that cause you pain.
This situation, as my mother might say, is a slippery slope.
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Avoidance and Chronic Pain
It sounds like you want to keep moving, but it hurts. Understandably, you avoid the triggers and, over time, those activities feel increasingly difficult. That perception is real. Activities we avoid do get harder over time.
According to a study in Pain, avoiding musculoskeletal discomfort results in “poor behavioral performance, hypervigilance to internal and external illness information, muscular reactivity and physical disuse in terms of deconditioning and guarded movement… Pain-related fear and avoidance appear to be an essential feature of the development of a chronic problem for a substantial number of patients with musculoskeletal pain[2].”
For example, imagine the difference in your body if you walk a mile every day for the rest of your life or avoid walking entirely because something hurts. Over months and years, you’d see a big difference in your strength, endurance and gait.
Muscles get weaker and joints stiffen when we don’t use them. The same holds true for functional and playful activities as well.
Use It or Lose It
In renowned investor Warren Buffet’s biography, he tells a fable to a group of students. He conjures a genie who appears to him at age 16, offering him any car of his dreams but warning that there’s a catch: This car is the only one he will ever own for the rest of his life. In that context, Buffet notes the importance of regular service along the way—oil changes, fixing dents and patching scratches to prevent rust—to make sure the car runs smoothly over the course of decades.
“That’s exactly the position you are in concerning your mind and body,” he writes. “You only get one mind and one body. And it’s got to last a lifetime… It’s what you do right now, today, that determines how your mind and body will operate 10, 20 and 30 years from now[3].”
This wisdom is as true for 70-year-olds as it is for 16-year-olds.
As human beings, every small adaptation we make impacts our energy and mobility in the long run, and it works in both directions. If we make concessions for pain and slip into avoidance, we concede to limited mobility indefinitely. On the other hand, if we inch forward, moving through the pain under proper care from physical therapists and doctors, we stand a good chance of reducing, if not eliminating, it over time.
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Keep It Interesting
You said you hope to “keep things interesting.” I’d love to know more about what that means for you. I imagine the freedom to move however you please is a good place to start, so I’ll offer a few questions to get you thinking:
- What are you capable of doing right now that’s important for you to continue?
- What would you like to do that feels hard or painful lately?
- What kind of support can you get (or what safe, functional exercises can you do on your own) to regain access to those desired activities?
Exercise Is Medicine
Exercise is a form of regulated stress. When you put appropriate stress on your body, it gets stronger and more stable.
“Changes in the relative level of physical stress cause a predictable adaptive response in all biological tissue,” explains researchers cited in Physical Therapy. “Exercise interventions that modify physical stress have been shown to decrease impairments, functional limitations, disability and pain in a variety of patient populations[4].”
Note the word “all.” Proper stress creates “a predictive adaptive response in all biological tissue.”
Admittedly, I’m a nerd for anatomy and physiology, but I don’t think I’m alone in feeling hope when I read that, given the right kind of support, human bodies are predictably capable of adapting and healing. In the case of chronic pain, that support often comes in the form of strengthening and stretching through the pain in controlled ways.
Repetitive Acts of Healing
In my second book Physical Disobedience, I wrote, “Physical disobedience is about defying not only external forces but our own physical and emotional pain by meeting them with repetitive acts of healing.”
So my question for you, Achy Breaky Body, is how can you meet your aches and pains with acts of healing that feel fun and interesting? Sometimes healing is not particularly pleasant. Physical therapy can be both slow and painful, but while doing that work, if you’re able to get curious about how your body functions, you can adapt steadily and increase your strength while playing with the kids or toying around with new ways to exercise.
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I can’t promise the pain will go away entirely, but it might. Even if it doesn’t, you’ll likely be able to reduce it and have tools in place to help when it flares up. Look directly into the pain to figure out what kinds of exercise feel like reinforcements. Take it slow and, whenever possible, consult professionals to make sure you’re navigating it safely.
“Hey, Health Coach” is for informational purposes only and should not substitute for professional psychological or medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions about your personal situation, health or medical condition.
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