Forget rest: Movement is the way to heal and thrive post-injury, post-surgery and during chronic pain. As someone who lives with chronic pain, I know this first-hand.
I developed neck and upper back pain after being hit by a car while cycling in Toronto in 2001. For almost three years I wrestled with my pain, finally going on disability when it got completely out of control. My approach back then was to limit activities: I thought that taking it easy for a month or two would heal my pain. That backfired ‒ in fact, the less I did, the more it increased my pain level and decreased my functionality. At my lowest point, I could barely write a grocery list, let alone a magazine article.
Things began to turn around in 2005, when I was diagnosed with fibromyalgia, a disorder characterized by widespread musculoskeletal pain, as well as fatigue. With the right medications my pain was manageable enough that I could think about reintroducing movement and exercise. Through trial and error, I found exercises (rehabilitative Pilates, Conscious Movement and Foundation Training) that strengthened my body, corrected my posture and reduced my tightness and pain. Now, in my mid-50s, I’m more fit than ever: Stretching, strengthening and moving my body are often the highlight of my day.
A prescription for movement
I’m not the only one who’s updated her thinking around treating pain. After decades of telling patients with injuries or pain to take it easy, medical professionals are prescribing exercise instead.
In a recent article for The University of British Columbia’s Faculty of Medicine, Dr. Jennifer Robinson outlines why she changed her sports medicine practice to adopt movement instead of RICE ‒ rest, ice, compress, elevate ‒ as the gold standard for treating physical injury: “Excluding fractures, cord or catastrophic injuries, I get patients moving post-injury and doing range of motion exercises as soon as possible.”
She cites research that shows inactivity shuts down the muscle, restricting blood flow to the injured area and leading to tissue atrophy. By contrast, movement improves blood flow, which drives oxygen to heal the injured area and removes metabolic waste, while also stimulating the healing of tissues.
The evidence that movement and exercise can reduce chronic lower back pain, the most common cause of pain as we age, is particularly strong. For instance, core stabilization programs reduce back pain by 39 to 76.8 percent, while muscular strength programs decrease it by more than 60 percent, according to “A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain,” published in 2016 in the journal Healthcare.
“Our bodies evolved to need these external stimuli ‒ we need these forces acting on our body to maintain strong bones, strong muscles, strong ligaments,” says Dr. Doug Gross, co-author of “Prevention and Treatment of Low Back Pain,” a 2018 study published in The Lancet.
Gross, who is a professor of rehabilitation medicine and director of the Rehabilitation Research Centre at the University of Alberta, says exercise has a host of health benefits for an aging body on the mend ‒ it’s good for your lungs, heart, digestive system and brain functioning, and it’s an effective treatment for depression and anxiety.
Go for Goldilocks
Movement is the best thing you can do to heal trauma, says Gross: “Stay as active as you can within the limitations of your condition.”
Aim for “the Goldilocks zone ‒ not too much, not too little ‒ right in the middle there’s a therapeutic zone where it is the most effective,” he says, adding that too much activity can result in overuse syndrome (injury caused by repetitive trauma or improper technique), while too little can lead to detrimental physiological changes in muscles, ligaments and tendons that end up prolonging healing. (This is something I can attest to: When I started working with a rehabilitative Pilates teacher, we had to start at ground zero because my muscles were so atrophied.)
For those of us over 45, Dr. Julia Alleyne, a sport and exercise medicine expert with Women’s College Hospital in Toronto, recommends enhancing the rehab regime with balancing exercises, which improve coordination and reflexes while decreasing fall risk.
TIP: Although no one activity “does it all,” working out on an elliptical machine strengthens your arms and legs, and also improves cardio and balance.
When it comes to chronic pain, “small, frequent doses of activity throughout the day help retrain the brain to normalize symptoms so that the body doesn’t interpret movement as painful,” says Alleyne, who reassures patients that the pain associated with low-intensity exercise is not harmful.
TIP: For movement and healing, Alleyne recommends a walking pole, which can “help people do higher-quality activity,” as it supports the legs and activates the upper extremity and core muscles.
“The human body is meant to move,” says Frank Bach, who teaches Conscious Movement in Toronto and Cobourg, ON.
For 10 years, I attended Bach’s one-of-a-kind classes, which incorporate elements of meditation, Pilates, yoga, Tai Chi, Qigong, energy work and dance. Like me, most of the participants are middle-aged or older adults healing from pain, injury or hip/knee replacement surgeries. Others come simply to gain insight into how to move their bodies as they age.
About every 10 years we should “reset and recalculate” how we do our activities, says Bach. “If we’re 60, we’re not going to be moving like we’re 18. … We have to find the smart way, not just the old habitual way.”
Conscious Movement is about “getting people back into their body,” which can be challenging if they feel physical discomfort, says Bach, who begins each class by focusing on breath awareness, as well as grounding and centring techniques. It’s important for people to be “fully there” when they exercise, he says. “People often get injured because they are not listening to their body.”
I’ve learned a lot about listening to my body to promote healing and manage pain. I’m much more present when I exercise; I focus on correct form, and I spend time strengthening my core. I’m not totally pain free, but I can move, work, play and even do challenging exercises that would make many people quiver.
Over-the-counter orthopedic braces for knees, elbows, wrists, ankles and backs provide support for healing. Made of everything from rigid plastic and metal to tightly knit fabrics, braces can help immobilize joints so that ligaments, muscles and tendons can heal with the right amount of blood flow and range of motion, both post-injury or post-surgery.
Because the goal is to support alignment, reduce swelling and promote the healing of connective tissues, finding the right brace is essential, according to Kerri Trudeau, a Wellwise by Shoppers Drug Mart customer service representative, who has been fitting supports and braces for nearly a decade. Here are five things to consider:
Should you consult a doctor? Not everyone needs to talk to their doctor before buying a brace, especially if they have a past recurring injury. If uncertain, however, it’s always advisable to consult your physician. “Plus, if you have a prescription, sometimes your private insurance will cover it,” notes Trudeau.
Your activity level: If you’re active, you’ll want to maintain a certain range of motion and make sure the brace can keep up with you. It should be as comfortable when you’re standing still as when you’re active.
Is it the right brace for your injury? Braces and supports often list on the box every injury or condition that particular item is good for. Or better yet, says Trudeau, come in and talk to a consultant: “That’s what we’re trained for.”
Size matters: Ensuring that your brace fits properly is paramount if it’s going to help — rather than hurt — your healing process.
Getting it off and on: “This is something people don’t often think about,” she explains. “But if you have issues bending at the waist or trouble getting down to your foot, it’s going to affect how you get a brace on.” Fortunately, there are many different styles and types of braces designed to accommodate your every need.