The most common prescription discussed in my practice is for physical therapy and exercise. It is not that I am an exercise nut, but a lot of pain comes from the lack of movement, strength and general conditioning. Restoring motion is necessary to function more properly, and the closer one gets to a level that mimics an uninjured body, the more normal the body will feel. The baseline state of the body is an incredibly balanced machine. If the normal balance and motion is impaired, then the rest of the body strains to compensate. The easiest state for the body is when everything moves in the way it was meant in its original design.
Restoring and maintaining function as close to normal levels is the goal of most of medicine. Today, many people look for the shortcut to get to a normal level. A quick fix just sounds good, whether it is a pill or a surgery. Unfortunately, the simple solution is often not an answer but just a cover-up. Usually, it takes a lot of work to correct a problem, and often only a partial solution is found. Not all damage to the body can be corrected. Changes in the body related to aging, for example, may be permanent.
Exercise May Be Best
The best solutions for the body are often the simplest. The more we change, the more we have to compensate. If it is not broken, do not fix it. An over riding principle is to keep it simple. All this points to working with our bodies and teaching them once again to function normally.
The reason why I harp on activity is because it is the one thing that has been proven scientifically, in study after study that will work. It is one of the cheapest investments overall and when you actually do the right stuff to help the body heal and restore function, it works. When you skip parts, it’s frustrating and only gives partial results. Exercise may not be the only part of the solution, but it is one of the most important aspects.
Exercise for the body requires at least three components of activities to be successful. The first aspect is stretching and maintaining range of motion of the body. If the body does not move in its full capacity, muscles that do not normally do an action must step in and help compensate. These muscles that are helpers to restore balance in the body often need training and everything tends to tighten. Learning to actively stretch muscles and ligaments in an area keeps things moving correctly, and if they are not to tight, they do not hurt. Movement done correctly may hurt, but should not be causing damage to the structure, and as normal motion returns, pain lessens. Ongoing exercise programs with stretching may include activities like yoga or the martial arts.
Strength Training Also Key
Once motion is obtained, one must also have strength in the muscles. Most people think of body builders when they discuss strength. More realistic is having the muscles in the injured area perform with their normal power and what is expected in the un-injured state. There are many muscles in the body, and often we need to learn special activities to build up strength in them. Core body strengthening of the muscles in the abdomen, trunk, hips, pelvis and spine are necessary for low back injuries. This requires a number of very different exercises to engage the appropriate muscles to be effective. This type of exercise needs to be taught to people usually by a physical therapist to learn correct techniques. Once learned, they often do not require any amount of special equipment, but they do require diligence. Pilates is an excellent type of exercise to work on core strengthening. Most physicians are also recommending a general strengthening program for the whole body and large muscle groups as this has been shown to reduce the effects of aging, from joint deterioration to improved cardiac and pulmonary health.
The last component of exercise is general aerobic conditioning. This helps maintain cardiovascular health, but also allows the body to improve its overall endurance. Having the ability to perform an activity for a prolonged period of time is the goal of general aerobic conditioning. It gives the body the ability to stand or walk for a long distance, or just allows the body to make it through the day doing the necessary activities. Aerobic conditioning starts with things as simple as walking and then moves to fast walking, and then to more strenuous pursuits like swimming, biking, or running. More intense activity improves the cardiovascular system, improves the body’s immunity, and increases endorphins – the body’s own painkillers. Performing aerobic exercise at least three times a week for 30 minutes is the general medical recommendation.
Exercise that includes all three components; stretching, strengthening and aerobic conditioning does actually work. Chronic pain is usually more of a learned signal in the body that is indicating one is performing motions in the past that caused harm. Exercise when done correctly, returns the body to a more normal pattern of behavior, and reduces stresses on previously damaged components. Pain may not disappear, but it will usually be much diminished as function and overall ability improves. One needs to concentrate on all the things that one can do and not dwell on the one’s past glories. We can always move forward, but we cannot erase our past.