Skip to main content

More pain than gain - when you aren't getting the endorphin rush.

I'm always banging on about the benefits of exercise.


It's what I do.

One of the best ones is how it makes you feel good when you've done it. That post exercise endorphin rush where you feel like you're the boss of everything and your body feels like a good place to be.

I've written before about how I use cardio as a way of moderating my fibromyalgia pain.



Exercise and pain relief


There's a proper word for this, it's called post exercise hypoalgesia - which literally means you get a decreased response to pain after exercising. Magic!

We know a bit about how this works. We don't know exactly what the mechanism is, but it's understood that the endocannabinoid system is involved - which is nice.

We also know that cardio exercise is great if you want a whole body pain relief situation, while resistance exercise tends to produce a localised result. This is super useful information for me as a Personal Trainer, because it helps me write really helpful programmes for people with pain issues.

Regular exercise also helps pain management in the long term. People who exercise regularly have better functioning opioid systems - which means their bodies' natural painkillers are more effective.

Essentially, exercise is good stuff if you want pain relief.

But what if exercise causes pain?

Some not-so-lucky people, don't get post exercise hypoalgesia. They get the opposite - post exercise hyperalgesia (such useful nomenclature, they actually have the same acronym...)

Usually these are people with chronic pain conditions, and in the aftermath of exercise they may experience increased sensitivity to pain, a flare up of symptoms, exactly the opposite of what you might have hoped for.

Let me give you an example.

Kim (not her real name), started training with me because she loves to lift and be active. She used to attend a CrossFit facility, but she had hit a problem. Her workouts were triggering migraines.

Nobody likes migraines. And a migraine isn't just the day or 2 of migraine symptoms, it's also the aftermath which could leave her off her game for a few days after. Basically one workout a week was all she could manage, and leaving her, a working mother of young children, unable to function in her daily life. She desperately wanted to exercise, but the consequences were too much.

The good news is, we know some things about exercise and pain flares. We know what makes it worse for most people, and we know what makes it less likely. So it was up to me to build a plan for Kim that allowed her to do the things she loved, without the fallout.

Post exercise pain flares are more likely when exercise is high intensity. They are also more likely if you aren't choosing the exercise for yourself (this also has really interesting implications for people who are active in their jobs). They are more likely if you don't choose the intensity of your training.

So Crossfit, as a workout which is unknown until you turn up at the session, planned for the group,not individual, mixing high intensity lifting and cardio with few rests, where athletes are encouraged to "push the limits", in a fairly competitive environment is the perfect place to brew up a pain flare/migraine.

I spoke to Kim and she told me she would like to continue Olympic lifting, box jumps and such like. So I built her a programme that included those, but also included rest periods between sets. She would work at her own pace and was encouraged to "leave a bit in the tank". 

I separated her cardio and her lifting, so she wouldn't be mixing two demanding training types. We started with a gradual introductory phase, getting her body back into the exercise habit. Then we moved into a progressive strength programme. Her lifting blocks were kept in the hypertrophy/strength zone (6-10 reps) so that she was neither stressing her central nervous system with near-max lifts, nor enduring long sets.

Kim never suffered a migraine after our sessions. She was able to do the fitness activities she loved, without hurting herself.

It's time for the moral of the story


It's really easy to write off the idea of a fitness programme when you have a history of pain and difficulty. Fitness isn't one-size-fits-all, the right activities for you are out there. You might just need some help to find them.

It's also really easy for a coach/trainer to write off  the idea of training someone with chronic health issues. But the purpose of a trainer is to remove/work around barriers to training. Pain is a barrier, not a dead end.

Comments

  1. Very Good information, the information which you have provided is very good and necessary for everyone. Always keep sharing this kind of information. Thank you. Shoulder Massager

    ReplyDelete
  2. This information is very interesting. I liked your blog because the content was really impressive.Thank you for giving so much information. personal injury treatment Phoenix az

    ReplyDelete

Post a Comment

Popular posts from this blog

Managing Fibromyalgia flares

I've written before about living with EDS and Fibromyalgia ,  much of my personal fitness and health practices are geared around managing those conditions and keeping me as well as I can be. When managing a chronic health condition, particularly one that involves fatigue and potential flare ups, pacing, good nutrition, good sleep and generally taking care of yourself is always the first priority. Ideally we want to have as few flares as possible. But sometimes they still happen, and when they do, it's good to have a strategy in place. And I'm going to be talking in fairly general terms, because while EDS and Fibro are my personal experience, there is so little understanding of the mechanisms behind these conditions, that most strategies are going to be applicable to a number of conditions where crashes of exhaustion and pain are a feature. So what is a flare? A flare is a period where someone with chronic illness suffers increased symptoms for a short while. The

My top apps for supporting a healthy lifestyle.

The hardest part of making healthy choices and lifestyle changes is making it a habit. It's easy to make a decision to "eat better", "exercise more" or whatever your current plan is. It's a lot harder to stick to it on the rough days, for long enough that it becomes a habit and part of your life that you can't imagine being without. I love a bit of tech. I am a super geeky science nerd and finding ways to use technology to support my health and fitness makes me very happy. So with this in mind I thought I'd give a quick run down of my favourite smartphone apps for developing and maintaining healthy habits. Habitica I'm starting with this one because it's mad and I love it. Habitica is basically a to-do list app, but it's specially for the gamers among us. If you are familiar with Dungeons and Dragons, and all the games that grew out of that system and fantasy world, you will recognise Habitica. The app allows you to create 3 t

4 reasons why you should eat

I feel ridiculous writing this post. It should be excruciatingly obvious. But it's not. Everywhere I look I am seeing messages about not-eating. "don't eat these things" "don't eat very much" "don't eat at this time" And frankly, it's not very healthy. Physically or mentally. So what I'm going to talk about today is why it is important to focus on eating, rather than not-eating, when working towards your health-improving goals. And yes, even, no, especially, when one of those goals is fat loss. Fuel for your activities So food is fuel for your body. It provides the energy you need to function. Your body uses carbohydrates and fat as fuel. It can use protein, but only when under quite a lot of pressure. Your brain can only fuel itself on glucose (carbohydrate) and you can only metabolise fat in the presence of carbohydrate ("fat burns in a carbohydrate flame"). When your body runs low

Becoming a powerlifter - the aftermath.

The main event! It's been a couple of weeks now! So a bit of a delayed update because I have been up to all sorts of things. The news on powerlifting is that I did get to my meet! I made weight (hoorah!) by cutting a couple of kilos, then I did the competition, and because I knew that I would likely not be able to update my blog straight away, I made a little video to summarise how the competition went. [TLDW, I totalled 230kg, which is less than my gym PR, but I'm pretty happy considering. There were hiccups...] Here's a couple of quick videos (kindly recorded by Ryan from Kernow Gym ). My second squat, with extra angry lockout, and my third deadlift. The one that didn't get away. This is my second squat @ 72.5 after my first @ 70 was disqualified. I was pretty annoyed at that, which probably accounts for the fast lockout 😂😂 A post shared by Claire Salem (@firelotusfitness) on Oct 16, 2017 at 11:04am PDT I like deadlifts, de

Protein. Are you eating enough? Are you eating too much? Do you need a supplement?

Let's tackle a meaty topic. Meaty. Protein. Get it? Everyone seems to be going on about protein. Everyone in the gym is chugging shakes. People on the internet are claiming its the secret to weight loss and everything else. Other people on the internet are saying the first people's kidneys are going to fail. Someone else says there's really no need to worry as we don't actually need much protein after all. Some people have numbers, but those numbers are all different. Everyone is confused. Who is correct? Well, everyone is a little. Save that they are all only telling a very small part of a bigger story. So shall we break it down? WITH SCIENCE! The RDA OK, so a figure you will often see bounced around is 0.8g of protein per 1kg of bodyweight. This is the Recommended Daily Allowance. This figure is based on the idea of a "normal" person who is not particularly active, or growing and consuming an adequate amount of calories per