Walking is the best exercise activity to connect healthy mind, body and spirit with environment
The mindset change required to work around your pain is most important in order to meet your fitness goals; especially if your challenge is to manage acute and chronic pain. The mind must learn to embrace and adapt to a specific ill-health pain condition(s) and/or physical-mental limitations in order to increase fitness levels. And it is important to understand your medical condition and limitations before applying exercise. Without this knowledge you may further injure yourself during activity.
The only true way to understand your limitations brought about by pain is to work with your medical providers. By working with medical pain specialists you can then better understand what triggers and aggravates your pain when working through Range-Of-Motion (ROM) activities.  By becoming knowledgeable about your body and ill-health pain condition, you “can†prevent further aggravation or injury and alleviate your pain with customized exercise programming. A fitness goal of yours should be to “find a way†to continue some form of movement activity no matter the mobility status (bed ridden, wheel chair, walker, cane, or other ambulatory challenges, e.g., prosthetics).
Exercise activities are important because body movement provides oxygenated-enriched blood, while strengthening and providing nutrients to muscles, tendons, ligaments and vital organs no matter how “limiting†the movement may seem to the patient.
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Exercise movement activities also activate natural feel good pain reducing endorphins. These hormones are necessary to provide a feeling of overall wellbeing and thwart depression. Physical activity is also a metabolic booster: Weight control, immune deficiency exciter, repairs tissue as a mending facilitator, tones muscle, improves cognitive brain function, realigns and strengthens posture, improves cardiovascular health and promotes good skin, hair, nails etc., with many more benefits too numerous to mention.
It also must be understood that not all preexisting, or recent injuries to the body you experience may ever be 100% pain free. This is because once there is internal-external, or injury breach to the bodies postural integrity, it is most likely this damage will be felt with some frequently after the mend and throughout life. And as you age, and if activity exercise is not continued this pain can become more problematic.
Most first experience acute (infrequent) pain after injury, or surgery, and then with age, these infrequent (acute) trigger pain sights can become a chronic pain condition. If movement is limited for too long because of pain, this can/does become more aggravating if ignored. If you experience unacceptable pain after injury or surgery, ensure you follow up with your medical specialists. Don’t just ignore the pain for years. Learn to properly manage an ill-health and/or alleviate a painful condition by working with the right referred medical resources in a timely manner.
My personal experience when managing pain, whether acute, or chronic; pain is less severe if exercise and activity are applied daily. And when adequate movement is not applied, frequency and intensity of pain episodes at damaged tissue sites tend to increase.
This then translates from the mind to the body an unacceptable pain experience. With unacceptable pain, the mind tells the body to “guard†the pain. Guarding simply means the mind instructs the muscles to tense up and become rigid at the pain sight to prevent full ROM within a body segment to reduce the pain. Another way to explain this is the body becomes less flexible and unwilling to use a full ROM to accomplish work. And this guarded reflex if allowed to continue, “will†create more radiating pain while reducing your ability to accomplish physical activity. Guarding can also damage other tissue in the surrounding trigger pain site; because now other muscle tissue becomes conditioned to guard peripherally around a pain center.
When the mind tells the body to guard a segment of body, it becomes isolated to varying degrees during movement activity. And since body segments within a specific range remain guarded, then the circulatory systems that provide oxygenated enriched blood to areas on the mend are less efficient metabolically and don’t receive healing nutrients to the full extent.
Internal tissue damage requires a constant supply of oxygenated-enriched blood and nutrient lubrication through good circulation to heal optimally. With movement activity, damaged tissues, i.e., nerves, muscle, and joints can be relieved of stiffening, tightening and alleviation of pain.
Keeping pain within a tolerable pain threshold  while exercising requires one to be more in tune with the body’s pain trigger mechanisms. In other words, movement that causes intolerable pain can be modulated to reduce extreme  guarding effect that would severely limit range of motion.  While working with your physician and pain specialists, you must listen and apply their exercise instruction to improve overall muscular endurance, circulation and flexibility when customizing your fit-healthy pain management program.   And to do this will require you tolerate an “acceptable†amount of pain to improve range of motion and mend as best as possible.
No gym membership, no problem. Development in nature can serve all exercise activity needs.
By working closely with your primary care physician(s): Advocate and self-refer to a pain management specialist through your primary physician (i.e., immunologist, rheumatologist, generalist-holistic pain specialist, physical therapy, physiatrist, sports medicine, certified pain management fitness trainers, orthopedic specialists, etc.). You can activate many needed referred services to help you better manage your chronic condition. In this way, you begin to build a customized activity exercise program that will help to alleviate your pain and increase your overall fitness levels (Cardiovascular endurance, flexibility, strength, muscular endurance, improved posture, reduced body fat, encompassing being mending, neural conductivity repair etc.).
You also may be taking a cocktail of pharmaceuticals, causing you to lose productivity and gain weight only to find out years later, your pain disease has progressed to the point you need surgery!  Again, my point is to learn as much as possible about your medical ondition “while in the early stages of development†and advocate through primary physicians and self refer to the medical specialists you need. Don’t just accept years of pharmaceuticals to bandage your underlying pain problems and medical condition(s).
If your pain management program is just about pill management, this will likely create many other secondary health risks that will complicate your pain story and make it more difficult to focus on exercise activity to alleviate your pain. Why is this? Because your body & mind can’t feel the natural healing effects (biofeedback mechanisms are broke due to the numbing effect of opiates) from exercise. Especially if overusing medications that also have mind altering effects. Note: I’m not saying to stop taking your prescribed medications. I’m saying you may need help in “balancing†your prescription use with exercise activity.
Fortunately, I now live a lifestyle with managed pain tolerance. Although I must admit, to get to this point was not easy.   I understand, my pain will always be with me and I do have to manage it daily. Nobody else can mentally, physically or spiritually do this for me. It would be easy to become depressed about daily pain, but pain and depression once managed can be very tolerable. And the only way to do this is through pain management and customized exercise activity approved by medical doctors.
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It is also understood one can have pain in a specific, or multiple areas throughout the body. It is my experience after going through many medical consultations and conversations with other pain patients and clients as a fitness consultant; most are not educated on how to work around pain and prioritize activity risk and benefit. I believe this has mostly to do when a physiatrist, sports medicine, exercise physiology or physical therapist is not involved in a pain patient’s therapy.
The next thing you should think about when identifying your fitness goals while working around pain, what do you enjoy doing? Do you enjoy exercising in a gym, walking, biking, swimming, gardening, shopping, arts and crafts, reading, computer work, etc? Why do I ask? Because a patient activity of interest, it is hard to know what the right motivational activities are to therapeutically modify and prescribe for the chronic pain patient.
When I list activities, it also should be understood that mental exercises that appear to be more sedentary then physically active do not “activate optimally†your body’s metabolism. But any activity can improve an overall ill-health condition whereby depression, anxiety and stress is minimized, hence an overall health benefit is gained. For example, if bed ridden, a mental activity stimulus can transfer a portion of that benefit to the physical body. This is due to the psycho-somatic Neurochemical transmitter connection (mind-body).
Once you identify your physical and mental limitations to include fitness goals that may interest you, pay close attention to the prescribed pharmaceutical(s) you ingest. When you pursue fitness activity, as mentioned previously; medications can reduce pain sensation (numbing effect) with a false sense of security while increasing physical effort. Also, there are many medications used that regulate blood pressure, balance hormones, control cholesterol, regulate body weight, alleviate depression, the list goes on.
I do not claim to be an expert in pharmaceuticals or their prescribed use. However, it is well known your health risk(s) will increase when pursuing an exercise program while on certain medications.  Therefore you need to consult with your medical provider.  Ask about prescribed drug use and if those risks increase during exercise.
For those that are using more pharmaceuticals and moving less, you must find some way to become less dependent on pain killers if using them. If not, fitness levels and overall health issues tend to get worse through time. I’m not advocating you quit using your medications! I’m advocating increasing your daily activity levels while balancing pain medications to reduce your overall pain experience. I know through fitness activity you’ll become less dependent on the opiates. Of course, you need to work through this process with your pain management specialist to help you reach this balance.
I believe if patients are armed with safe exercise fitness activity, pain management information and treatment options, they enjoy a better quality of life, especially if they suffer with chronic pain and disease.
By reading MirrorAthlete Articles you can learn how to customize a fitness-pain management program that works well for you (subscribe to our free monthly eNewsletter and be sure to stay up-to-date on all hard to find fitness secrets information).
Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET.  2011 Copyright, All rights reserved, MirrorAthlete Publishing @: http://www.mirrorathlete.org, Sign up for your Free eNewsletter.
