Chiropractors may best be associated with spinal adjustments and the popping sound that many people’s bodies make as their musculoskeletal systems click back into proper alignment. That noise is actually the sound of pockets of gas released by the joints as they fall back into place. But the science of chiropractic dates back to the earliest days of civilization, making appearances in texts discovered from ancient Chinese and Greek civilizations. Today, chiropractic care ranks as the third largest health profession, surpassed only by medicine and dentistry. Here’s how chiropractic works and how it can help you.
With 77,000 chiropractors practicing across the country, this rapidly expanding field offers thousands of patients hope for pain relief. Increasing numbers of everyday people are turning to this time-honored tradition, the same one used by every team in the National Football League to help its players recuperate from whiplash, muscles strains, and neck and low back pain, according to the American Chiropractic Association (ACA).
But, chiropractic care itself has existed since ancient times. Too many ignore these historic, effective traditions as fancy treatments and pharmaceutical interventions captured the public imagination over the past century.
Writings dating from 2700 B.C. and 1500 B.C. were uncovered in Greece and China that reference the use of chiropractic care. Later, Hippocrates, the famous Greek physician whose eponymous Hippocratic Oath all doctors take, famously wrote:
“Get knowledge of the spine, for this is the requisite for many diseases.”
Starting in the late 1800s, chiropractic care emerged in the U.S., pioneered by an Iowa doctor named Daniel David Palmer. Palmer founded the Palmer School of Chiropractic. This school lives on to today, steeping young doctors in the rich traditions of the practice.
During chiropractic school, students undergo four to five years of training. They spend at least 4,200 hours spent in the laboratory, classroom, and medical clinic. Before practicing, chiropractic doctors must pass a national board test along with any tests required on the state level. Each state also has its own licensing requirements. The depth and breadth of training confers chiropractors the ability to act as primary care providers, according to ACA.
Today, the harsh effects of harmful drugs and the reality that wellness comes from a healthy skeleton and lifestyle—not costly and dangerous drugs—is again taking hold. With it, the momentum builds for more natural, holistic, and effective treatments.
Chiropractors focus on the health and proper alignment of the musculoskeletal system. Many muscle and joint pains result when some component in this intricate system of muscles, joints, bones, tendons, and ligaments falls out of place. Whether you’re a sports star or desk jockey, anybody’s musculoskeletal system may experience a disturbance resulting from daily activity.
Chiropractic medicine is based on the idea that a person’s overall health is linked to spinal alignment. The spine is not just a column of bones. It also houses the central nervous system. And, this affects the way a person processes pain.
All body parts are intricately connected. A misalignment in one area can influence misalignments, or even pain, in other, seemingly non-related parts of the body. Through spinal adjustments and manipulations, chiropractors help patients ensure their bodies are in optimal alignment, which encourages the free flow of muscles and bones. Without restriction in the musculoskeletal system, most patients experience a reduction in pain.
The chiropractic approach is medicine-free, minimally invasive, and holistic. The most common techniques used are spinal adjustments or manipulations, but chiropractors treat the whole person. They examine lifestyle choices like diet, stress, sleep, and physical activity levels. These factors influence a person’s experience of pain and the degree of healing that’s possible.
A spinal manipulation may reduce a patient’s pain, but helping that patient possibly lose weight or reduce stress, for example, will support continued health.
Studies show that patients who actively participate in their treatment experience better outcomes and reduced pain. Many patients with low back pain find chiropractic care is an effective way to manage discomfort and find improved quality of life.
Another benefit is that the practice is minimally invasive. Injured workers are 28% less to undergo spinal surgery if they visit a chiropractor before an MD, ACA reports.
With prescription drug abuse skyrocketing and the dangers of opioids increasingly well known, more patients are gravitating toward chiropractors and their minimally invasive, effective methods of treatment.
Back pain is a pervasive and serious issue, affecting up to 80% of people at some time during their lives, according to the ACA. At any given time, about 31 million U.S. adults experience back pain.
While back pain has many lifestyle risk factors, such as poor posture and sedentary living, studies have shown that chronic back pain is related to changes in pain processing, according to research published in The Journal of Pain. The study found that patients receiving spinal manipulation therapy experienced less sensitivity to pain, and researchers said the procedure holds promise as a clinical treatment.
Another study published in The Spine Journal examined the benefits of spinal manipulation in patients with acute back pain and found the chiropractic technique outperformed other treatment methods like medication or exercise.
Back pain is one of the leading causes of disability and costs associated with treating it are estimated at $194 billion annually, according to the American Academy of Orthopaedic Surgeons. Studies show that chiropractors can alleviate some of that cost burden, with patients spending up to 20% less when they visit a chiropractor first instead of an MD, according to ACA.
Chiropractors, instead of prescribing drugs or invasive procedures, seek to understand pain conditions from musculoskeletal origins.
Often times, pain results from tissue injuries that lead to hypermobile or restricted joints. Injuries sometimes develop from accidents, but may also result from daily repetitive stress, such as poor posture.
When tissues become injured, they become inflamed and painful, limiting muscle and joint mobility and often causing seemingly unrelated pain.
Chiropractors are able to uncover the musculoskeletal issues underlying many painful conditions and perform the necessary adjustments. In addition to approaching pain from this alignment perspective, chiropractors also frequently suggest rehabilitation techniques and lifestyle changes such as diet, exercise, and stress management to support a path to healing.
Chiropractors use a whole-body approach with patients. The doctors are trained in specific diagnostic techniques that range from skeletal imaging to observing how patients’ bodies move to identify areas needing adjustment.
During a chiropractor appointment, patients may undergo an examination, receive hands-on treatment to correct misalignments, or receive information about possible lifestyle modifications to help reduce pain.
The short answer is yes, but let’s dive a little deeper.
First, one of the most commonly used methods of treating back and other types of musculoskeletal pain is painkillers. However, even over-the-counter medications like Advil and Tylenol are not without danger when taken over long periods of time.
These medicines are intended for short-term issues, like healing a headache or acute injury. When taken continually, these medications may cause gastrointestinal problems such as ulcers or bleeding. Other risks include high blood pressure, kidney problems, or even heart issues.
With many medical treatments emphasizing invasive methods, chiropractic care offers a refreshingly non-invasive approach. And even among non-invasive therapies, chiropractic care ranks among the safest there is.
No treatment is 100% safe, and there are risks, however those risks are very small. Some patients experience feelings of soreness or achiness following treatment, but that discomfort usually disappears within 24 hours.
Some claims have linked a specific type of neck manipulation with a stroke known as vertebral artery dissection. However more complete evidence suggests that this stroke may take place spontaneously, and chiropractic care is not a trigger.
Other reports have connected the stroke to normal activities like turning the head while driving or even getting shampooed in a hair salon. These patients have specific symptoms involving neck pain and a headache for which they seek treatment. Only one in 5.85 million patients will experience this type of stroke connected to a high-velocity upper neck manipulation, making this an extremely rare occurrence.
Patient satisfaction for chiropractors is extremely high, with low-back pain patients giving the doctors high marks, above even physical therapists, surgeons, or primary care physicians.
Chiropractors believe in conservative care first. They believe that non-invasive treatments should come before more drastic measures. Further, medications should be used sparingly, and not as the first line of defense. As the American Chiropractic Association (ACA) says:
“For years, many patients would find relief through conservative forms of care such as chiropractic services only after unsuccessfully trying a range of other, more complex, and riskier treatments. Today, that approach has been reversed.”
Chiropractic care promotes non-invasive, drug-free treatments when possible to support patient health.
Over the past few years, increasing awareness about the dangers associated with opioid drugs, which are frequently used to treat back pain, has led to a resurging interest in methods such as chiropractic and associated treatments, including acupuncture.
Opioids are dangerous because they can lead to addiction, and even overdose or death. Meanwhile, these powerful drugs don’t address pain’s root cause. Instead, they leave patients reliant on these pills, which aren’t 100% effective, for the rest of their lives. As these ill effects become better known, alternative therapies such as chiropractic are growing more popular.
Chiropractic doctors focus on the body’s musculoskeletal and nervous systems. These specially trained physicians perform treatments including spinal manipulations, also known as adjustments. These work to increase mobility of a patient’s spinal vertebrae and ensure they’re in the proper alignment.
Exercise is an effective way for pain patients to manage the symptoms of many conditions, including fibromyalgia, back pain, and arthritis. Depending on the condition you have, though, exercise will affect you differently, and you may want to approach activity in a different way. Here’s how to avoid injuries if you’re exercising with chronic pain.
Most pain patients, just as with the general population, will benefit from a mixture of cardiovascular activity, strength, and flexibility training. However, specific exercises can be added to address specific conditions.
For example, pain patients experiencing discomfort in specific areas of the body, the back or shoulder, for example, may need to strengthen correlating muscles and perhaps stretch others. Meanwhile, patients with more widespread pain that’s symptomatic of altered nervous system functioning, like fibromyalgia, may find it helpful to adopt a more generic form of activity, such as bicycling.
The nature of being a pain patient is that pain may make it difficult to exercise. However, not exercising often worsens pain. We’ll talk about the best ways for exercising with chronic pain conditions like arthritis, fibromyalgia, and back pain, as well as how to prevent and treat sports injuries.
Exercising with chronic pain is particularly difficult for people with arthritis. The nature of this condition results in reduced mobility. However, not moving at all may worsen pain and can further diminish mobility, according to the American Academy of Orthopaedic Surgeons (AAOS).
Exercise promotes blood flow to the affected area, which delivers vital nutrients and helps to keep the joint as healthy as possible. Activity also strengthens the muscles surrounding joints. As the muscles strengthen, they support more of the body’s weight, leaving less of it for the bones to support. This re-distribution protects damaged cartilage, which can decrease pain.
For those with advanced arthritis, limited mobility can bring challenges. It’s a good idea to precede exercising with a visit to the doctor or a physical therapist. They can design an appropriate fitness program for you. Good exercises include those that:
Good options might be swimming, yoga, or bicycling. Start slowly and then work your way up as your strength and mobility increase. While some amount of soreness is normal the day after exercising, significant pain is an indication that you’ve gone too far, according to AAOS.
Fibromyalgia results in widespread pain and fatigue, both of which can be impediments to exercising. However, exercise is one of best ways to treat pain for fibromyalgia patients, according to webmd.
If you can’t get out of bed, start there. Fibromyalgia patient and founder of the National Fibromyalgia Association Lynne Matallana was essentially bedridden after her diagnosis. Her doctor suggested exercise, so she began with 30-minute stretching sessions while lying down, followed by a rest period, she tells webmd.
Eventually, the stretching sessions turned into walks to the mailbox, and then she turned to the treadmill. Start with whatever type of physical activity you can do, and then evolve from there. Although exercise is generally fine for fibromyalgia pain patients, it’s still a good idea to check with your doctor before beginning any type of exercise.
Good options include walking, yoga, and strength training. Water activities in particular—especially in heated water—benefit people with fibromyalgia because the warm water relaxes muscles and can ease pain, according to Prevention magazine.
Keep in mind that it could be more effective and healing to exercise in short bursts of activity rather than engage in longer workouts. A 30-minute walk could be broken up in 10-minute increments, spread throughout the day.
Stretching is also beneficial for fibromyalgia pain patients, but try stretching after some light physical activity when the body is warm, recommends Prevention. Stretching cold muscles could lead to injury.
Back pain is increasingly common, affecting up to 50% of working adults, according to the American Chiropractic Association. Back pain frequently develops from sitting too much, poor posture, or injury.
Alleviating back pain requires a mixed approach of strength building, flexibility, and cardiovascular exercises. If you’re overweight, losing those extra pounds through running, biking, or hitting the elliptical will reduce the amount of weight supported by the spine and skeletal system, which could help to alleviate pain. Be sure to talk with your doctor before starting an exercise routine.
Although many people initially think of stretching the back when pain strikes, it’s important to strengthen the low back muscles and those in the abdomen, which help to support the back. Core and abdominal strength-building exercises such as planks, which resemble the top of a pushup, are good to hold for as long as you can, but preferably from one to three minutes.
Another good back strengthener is called a superman, which resembles the yoga pose shalabasana. The goal is to lie on the stomach and, using the back muscles, lift the legs, chest, and arms off the floor with the abdomen remaining on the ground.
Modifications include leaving the legs on the ground and lifting the chest, or leaving the chest on the ground and lifting the legs. You might clasp the hands behind the back and lift you chest and legs, or for a more advanced option, extend your arms in front of you while lifting the legs, chest, and arms off the ground.
Gentle stretches that can be done include the bottom to heels stretch, which resembles child’s pose in yoga, recommends the UK’s National Health Service. Kneeling on all fours with hands under shoulders and knees under hips, slide your bottom back toward the heels until it rests on them, allowing the arms to stretch in front of you.
To work on flexibility, try a bridge. Start out by laying on the back, knees bent and feet on the floor close to the buttocks, recommends the Mayo Clinic. Press the arms into the ground and then lift the hips off the ground by pressing into the feet, gently arching the back. Stay for a few breaths before lowering and repeating.
The goal for back pain patients who exercise is to strengthen and gently lengthen the muscles and connective tissue, so it supports the body.
Playing sports and exercising carries with it innumerable health benefits, but also the risk of sports injuries. Most athletes have sustained an injury at one time or another, with severity ranging from minor sprains to more serious tears or broken bones.
Fortunately, many minor sports injuries do not require professional medical attention and can be cared for at home. The length of recuperation varies depending on the injury and a person’s medical history. For example, a recurring injury may take longer to heal.
With minor injuries, a person may be able to return to normal activity within a few days. If pain persists or worsens, or extreme swelling is present, visit a doctor for professional medical advice.
The best treatment of sports injuries is preventing them in the first place. Damage can result from overuse or an accident, such as landing on a twisted ankle or jerking the knee in an unnatural way.
People of all ages are at risk of injury. For example, a study from the Radiological Society of North America found that young baseball pitchers had a higher risk of an overuse injury that increased the likelihood of further problems, including torn rotator cuffs.
Researchers studied 2,372 pitchers who ranged in ages from 15 to 25. Those most at risk for the shoulder injury threw more than 100 pitches each week. Study author Johannes Roedl says:
“More and more kids are entering sports earlier in life and are overtraining… It is important to limit stress to the growing bones to allow them to develop normally.”
Taking care to ramp up physical activity and abstain from excess is important for preventing overuse injuries. Warm up before each exercise session and take care to cool down afterward, recommends Harvard Health Publications.
Also, take care to ramp up the rigor of an exercise program. If you’re out of shape or haven’t exercised for some time, ease into fitness instead of pushing your body to its maximum limit right away. Even people already in good shape will want to alternate rigorous workouts with more leisurely ones to avoid overtaxing the body.
Using proper form is also essential, particularly when lifting weights or using the body weight to work out, with lunges, for example. Using good equipment is key, with properly fitting and supportive shoes along with any knee or wrist braces as needed.
Overusing muscles is a leading cause of sports injuries. Play it safe and listen to your body.
If you do feel pain, even if it’s just a twinge, recognizing the pain early and easing off the affected muscle or limb can decrease the odds of that area sustaining a full-blown injury.
Sprains: Sprains involve damage to ligaments, which are the tissues that connect bones to each other. Sprains range in severity from first degree, marked by stretched ligaments, to third degree, which involve torn ligaments.
Strains: Strains are similar to sprains, but affect muscles or tendons instead of ligaments. They also range from first to third degree.
Tendonitis: Often caused by overuse, tendonitis is marked by inflammation of a tendon.
Bursitis: A collection of small sacs known as bursa surround joints, muscles, and bones to absorb shock and offer protection. Bursitis is when these sacs become inflamed, usually from repetitive motions.
If the worst happens and you sustain an injury while exercising with chronic pain, remember the acronym RICE—rest, ice, compression, and elevation. This method works for most minor sports injuries and supports the body as it works to repair itself.
Rest is essential for allowing the body to regenerate damaged tissue. With most sports injuries, your mobility will be limited anyway, so listen to your body instead of trying to push yourself.
If your specific injury allows, you may be able to continue exercising. For example, if you’ve injured an arm, you could still go for a hike or run, according to Harvard Health Publications. Above all, however, make sure to avoid engaging in activity that aggravates the injury.
Ice will help to limit swelling and reduce pain. Avoid placing ice directly on the skin. Instead, wrap an ice pack in a towel, applying it to the injured area as soon as possible. For the first day, ice the area for ten to 15 minutes every hour for four hours. For the next two to three days, apply ice four times each day, again for ten to 15 minutes each time.
Try to avoid using heat until the injury begins to heal. Heat could exacerbate swelling and delay the process of healing. Once the injury passes the acute phase, perhaps after the first week, it’s usually fine to use heat, such as taking a bath or applying a heating pad.
Compression refers to elastic bandages wrapped snugly without being too tight. Compression gives the area support and promotes healing.
Elevation helps any fluid that accumulates around the injured area from swelling to drain. You might place an arm or a leg on a pillow, allowing it to rest slightly above the rest of the body.
After the acute phase of the sports injury passes and you feel well enough to return to activity, make sure to do so slowly. You may want to begin with gentle stretching and strengthening exercises. The area will likely have lost some strength while recuperating, so it’s important to work both strength and flexibility. Harvard Health Publications recommends using heat and ice during rehabilitation, as well.
During rehabilitation, use a heating pad to warm the injured area before stretching. Then, apply ice afterward to reduce any swelling.
If pain lingers or worsens, be sure to seek professional medical advice. For severe injuries marked by intense pain, substantial swelling, or discoloration, seek medical advice promptly. Seeking a doctor’s care early on can help to reduce healing time and the risk of long-term damage.
Some people may also find it helpful to visit a physical therapist to plan a rehabilitation program, depending on the type and severity of the injury sustained.
The sciatic nerve is the longest single nerve in the body. It runs from the spinal cord through the buttocks where it branches off to both legs and ends below each knee. When inflammation or irritation of this nerve occurs, it causes a painful condition known as sciatica. Because the sciatic nerve controls feeling in the legs, this kind of pain can create additional, long-term problems. Sciatica pain occurs in up to 10% of the population, most often affecting patients between the ages of 25 and 45. Pilates for sciatica is one therapy many have used to find pain relief. While it won’t work for everyone, some do find benefits from this practice. Here’s how.
Sciatica is any type of pain that stems from the irritation or inflammation of the sciatic nerve. This can be caused by repetitive movements, poor posture, or lifestyle factors.
A slipped or herniated disc can also put pressure on the sciatic nerve. Chronic lower back pain is linked to this kind of pain. A pinched nerve will also create pain radiating down the leg like sciatica.
A number of different physiological events can trigger sciatica. A fall or injury that affects the spine and presses on the nerve can be one possible cause. However, most of the time a specific injury isn’t involved. In these cases, the irritation or pinching of the nerve due to the body’s natural aging effects lead to sciatica.
Pain will also usually increase when patients are sitting for a long period of time. However, it is important to note that increased pain over time may indicate a problem with the nerve itself.
If you are experiencing these symptoms, it may be helpful to seek the advice of a doctor or pain specialist who can suggest a variety of treatments to stop or alleviate the pain. Your individual treatment will depend on the severity of your pain and the specific cause. One noninvasive option is pilates for sciatica pain.
Pilates offers similar flexibility and stress-reducing benefits as yoga. However, because the exercises are done at a relatively quick pace, with a greater emphasis on strength, Pilates offers superior fat-burning and muscle-building capabilities. For tension and pain related to sciatica, these exercises can provide pain relief.
You’ll perform most Pilates exercises seated or reclining, instead of standing. These exercises frequently focus on the core, chiseling your physique as you move through the practice. As an example, a typical Pilates workout might include exercises such as laying on your back while lifting your legs straight into the air for a low-impact abdominal workout. Another exercise involves moving into tabletop position, with hands and feet on the floor, before lifting alternate legs straight for more core work.
While pilates for sciatica can help you find pain relief, always talk to your doctor before trying any new routines. Certain exercises may actually exacerbate or increase your pain. Therefore, it’s important to work closely with your doctor. Also, find a trusted Pilates teacher and talk to them about your condition. They can suggest exercise modifications during the workout as needed. This interview with Brent Anderson, phd, discusses some of the common poses to avoid if you suffer from sciatica pain.
Joe Pilates designed the Pilates system. He originally taught self-defense to detectives at England’s Scotland Yard in the years leading up to World War I. During the war, Pilates, a German, was taken as an enemy alien by the English. While held in camp, he taught other internees the exercise system.
Pilates’ students were sometimes patients lying sick in hospital beds. Pilates would rig equipment to hospital beds, allowing the patients to exercise despite their immobility. This influence can be seen in the Pilates reformer machine, which resembles a hospital bed. Resistance bands and other equipment secured to the frame increase the potential for building muscle and strength.
When Pilates moved to the U.S. in 1926, he took his exercise system with him, although it didn’t gain widespread popularity until the media began covering it in the late 1980s.
Today, 8.5 million people practice Pilates, and the industry grew more than 5% from 2008 to 2013, according to market research firm IBIS World.
Pilates’ premise involves building strength from the inside out, with strong abdominal and back muscles leading to overall physical strength. That’s why it can be so effective for a condition like sciatica. Pilates for sciatica helps build up the deep muscles that can help provide support to the sciatic nerve.
Nearly all Pilates movements focus on building the core—the muscles throughout the abdomen, those supporting the spine, and others involved with supporting the center of the body. Classes are either mat-based or conducted on special pieces of equipment. They also frequently involve the use of resistance bands, marking another departure from yoga.
Although many Pilates exercises can be challenging, modifications are available to suit people at all levels of fitness. As workouts progress and strength builds, you naturally progress to stronger movements with fewer modifications. Having a strong core makes your entire body feel strong.
The goal with sciatica treatment is to decrease pain and increase mobility. There are multiple ways to achieve this objective beyond Pilates for sciatica. Talk to your pain doctor about your best options. Some are more invasive or may require treatment with drugs to reduce the inflammation and irritation of the sciatic nerve. Some patients find relief with better nutrition. Therapeutic massage can also help manage your pain.
Acupuncture is a technique developed over centuries of Chinese medicine. Trained acupuncturists insert small needles in the skin at various trigger points. These trigger points access the body’s natural energy flow, also called chi. Acupuncture is also often coupled with relaxation and meditation techniques that incorporate the mind, body, and spirit. Individuals with symptoms of sciatica have experienced relief with acupuncture treatments. Acupuncture is non-invasive, with minimal risks for patients.
A trained physical therapist can help patients dealing with the effects of sciatica with exercises design to relieve the pain. A therapist will help you work through exercises that strengthen the muscles of the lower back, help you stretch the area, and alleviate some of the pressure on the sciatic nerve. Typically physical therapy has a component of at-home exercises as well to keep up the level of recovery. Your length of treatment will often depend on the cause of your sciatica pain and how well you keep up with the exercises between physical therapy visits.
Another alternative treatment for sciatica pain may be yoga. It’s similar to Pilates for sciatica, but is a deeply meditative practice. It practice involves a series of specific stretching exercises designed not only to increase your body’s flexibility but also calm your energy and promote relaxation. The physical exercise coupled with the mindfulness of yoga can help many patients better handle the effects of conditions such as sciatica. However, if yoga causes more pain than it alleviates you may want to speak with your doctor about different treatment options.
For more disruptive sciatica pain, some patients consider an epidural steroid injection. This treatment is designed to inject medication into the affected area of the body to reduce inflammation and help restore the body’s natural balance. However, most experts currently believe this is just a short-term fix and that patients will need to seek longer-term treatments along with comprehensive lifestyle changes to find the most relief from sciatica pain.
A chiropractor manipulates the human body to realign the musculoskeletal system. They can provide relief from a variety of conditions. Chiropractic care helps the body through its own natural healing process and does not involve any drugs. The manipulation of the spine can free its movements and relieve pressure on the sciatic nerve alleviating the painful effects of the condition.
Sciatica is often made worse by remaining stationary. Most specialists encourage you to move to alleviate the pain and strengthen the muscles around the area. In the case of a herniated or slipped disc, you may need additional specialized treatments that will address those specific conditions. These treatments help relieve pressure on the sciatic nerve to reduce pain.
Because of the intense pain caused by sciatica, your doctor will likely create a comprehensive treatment plan that uses medical interventions alongside lifestyle changes or exercise regimens, like Pilates for sciatica. Especially at the onset of the pain, seek treatments that are less invasive. This may prove to have better long-term effects than drugs or surgical interventions.
Shoulder pain at night is a very common issue among chronicpain sufferers. The shoulder is one of the most vulnerable joints as it has such a wide range of motion, which opens it up to various injuries and problems. So, why are you experiencing shoulder pain at night and what can you do to find relief? We discuss five treatment options ranging from shoulder stretches to chiropractic to interventional procedures.
On top of the pain, most people with shoulder pain at night sleep poorly, which a completely different set of problems has associated with it. These can include:
Although many shoulder disorders can cause pain, the most common cause of shoulder pain at night comes from rotator cuff tendinitis. It usually is caused by irritation of the shoulder tendons leading to inflammation and pain. This condition can be caused by many things, including:
During the day, the shoulder is being actively used while you are in a vertical position. The tendons engage and are pulled downward by gravity, which allows space to be made in the muscle groups in the shoulder. This additional space allows for an increase in blood flow and oxygen that alleviates the stiffness and pain that would be present otherwise.
When you lay down to rest or sleep at night, you are generally in a horizontal position. This removes the effect of gravity and allows the shoulder muscles to relax. The lack of movement and the relaxation of the muscles allows the fluids in your joints to settle and decreases the flow of blood, allowing the joint to become inflamed. People also tend to lie on their shoulder while sleeping, which can compress the joint even further, and thereby worsening the inflammation.
The first course of action to relieve shoulder pain at night is to find a good sleeping position for you. Tossing and turning at night is normal for most people, but can agitate your shoulder if you land on it wrong. Sleeping on the opposite shoulder can help avoid this pain, but try not to sleep on your back.
If the pain persists, you can always trying wrapping your arm or wearing a sling to assist in preventing movement during sleep. Sleeping with a pillow under your knees can help alleviate any associated back pain.
Along with fixing your position while sleeping, always make sure to try to stick to a sleeping schedule. Good sleep hygiene can make all the difference in your sleeping patterns. Having a consistent bedtime ritual that helps wind you down at the end of the day can do wonders in terms of reducing stress and tension, and improving sleep length and quality.
Try something relaxing before bed like a shower and make sure you fall asleep in a dark room with no electronics. Medication can also help you sleep, but be cautious of how often you use them. Constantly requiring sleep aids can be a major sign of a problem and the more you use over-the-counter drugs, the more you will need to be effective. In addition, if you’re using other medications, they may react poorly with the sleep aids.
Exercising a few hours before bed can also be useful as it will increase blood flow throughout the whole body. This can alleviate pain, but also relax you enough to ease sleeping troubles. Try something low impact like a brisk walk or a bike ride, and then allow your body to cool down again before going to bed.
Further, certain shoulder stretches can help you reduce the tension and stress that has built up during the day. Not only are shoulder stretches an easy option, but they take only a few minutes at night. Stretching has huge health benefits like increasing flexibility, range of motion, and blood flow. Another big plus is that they are simple to do in your own home and require no special equipment. Before you go to bed, try these seven shoulder stretches to alleviate some tension and reduce your stress.
If you start to feel pain at any time during a stretch, stop immediately. Stretching should be done to the point of mild strain. If you experience pain, you are going too hard and could injure yourself. This is especially true if the pain is sharp or sudden. It is a good idea for chronic pain sufferers to consult a pain doctor before starting too strenuous of a stretching routine as overexertion could exacerbate certain conditions.
For best results, always warm your muscles up a little before stretching. For the following stretches, it is best to do each for approximately 30 seconds to one minute for maximum effect. Also, make sure you are steadily breathing in and out in a controlled manner.
This is a quick stretch that is great if you spend way too much time staring at a computer monitor. Slowly extend your neck outward, making sure your keep your chin parallel with the floor. Then, pull it back in to a neutral position that is straight with your spine, slightly tucking the chin in. Repeat.
Sit in a cross-legged position on the ground. Extend your arms in front of you and place your left elbow in the crook of the right arm. Now, bend your elbows back so your hands are touching. Hook one hand over the other so that your palms are facing each other.
For this stretch, you should keep your palms together, elbows lifted in a 90 degree angle, and your hands in front of your face. Try to keep your shoulders relaxed and down. You should feel a powerful stretch in your shoulder blades as well as the lower part of your neck. After this, change arms by placing your right elbow in the crook of your left arm and repeating.
Take your right arm and reach over your shoulder aiming to lay your palm in-between your shoulder blades. Then take your left arm and reach up your back (not over the shoulder) also placing the hand between the shoulder blades. Try to interlock your hands and pull slightly.
If you are having trouble interlocking your hands, you can modify this stretch. Keep a towel or something similar in your top hand, and then grasp it with your bottom hand instead of clasping the hands together. Gently pull with each arm to feel your shoulders start to open up.
While standing tall, reach out and place both of your hands on a wall. Walk your feet back until the arms are straight, but don’t let your arms reach too far above your head. Make sure you keep the shoulder blades open and relaxed downwards during the whole stretch. Also, avoid pushing against the wall and don’t allow your shoulders to press up and into your neck.
Start by spreading your feet, so they are shoulder-width apart. Raise your arms above your head as far as possible and bring your palms together. Now, simply twist your waist by bringing one shoulder forward and simultaneously pulling the opposite shoulder back. Hold this stretch and then switch sides.
This stretch begins by lying face down on your stomach. First, place your right hand palm down on the floor like you are starting a pushup. Next, lift your chest slightly and slide your left arm under your chest. Finally, square your chest with the floor and lower on top of your arm. Hold this position and then switch your arms.
If you want a deeper stretch in this position, you can move on to the full dragonfly. This is accomplished by lying on your stomach face-down. Crisscross both arms near the collar bones and straighten your arms out as far as possible. Then, allow your body to drape onto your arms.
Stand your feet hip-width apart. Turn your right foot forward. Turn the left foot so it is perpendicular with the right and raise both arms to shoulder level straight out from the body. Stretch your right arm up and forward, pulling your body up slightly. Then slowly lower the chest forward over the right leg until it is parallel with the ground. Place your hand on your thigh or calf, while avoiding placing it on the knee directly. Try to keep as little weight in your hand as possible, focusing on keeping yourself upright with your core instead. Extend the left arm completely upward towards the ceiling, if it feels comfortable. Finally, turn your head upwards towards the ceiling or down towards the ground for an additional neck stretch.
Since shoulder pain at night is often related to neck pain, trying the following yoga poses for neck pain could also help relieve your pain. This video also demonstrates the triangle shoulder stretch.
If these natural treatments don’t work to relieve your shoulder pain at night, it may be time to talk to a pain doctor. They can help diagnose the exact cause of your shoulder pain. If your pain isn’t due to an acute injury or fracture, they may suggest interventional treatments for chronic pain.
These shoulder pain at night treatments include:
Physical therapy to increase flexibility and reduce pressure on your joint
Chiropractic care to increase mobility and loosen tension
A regimen of non-steroidal anti-inflammatory medications
Joint injections that can relieve nerve irritation
Surgery, but only for the most severe cases of shoulder pain at night
If more conservative treatments like chiropractic care or physical therapy haven’t worked, a joint injection provides a minimally-invasive treatment that doesn’t require surgery. You can learn more about this approach in the following video (while not a shoulder injection, it does showcase a knee joint injection using a similar approach).
When it comes to the topic of Fibromyalgia and exercise, there is an abundance of research showing exercise to be extremely beneficial when it comes to managing pain. However, for many with Fibromyalgia, exercise may seem completely counterproductive. After all, you really don’t need to look very far to find people who have tried to exercise but have then experienced one of the biggest pain flare-ups of their life, as a direct result of exercising.
So, why is exercise held in such high esteem, especially when there are so many people who seem to have such negative reactions to it?
Why can some people with Fibromyalgia seem to get away with exercising, yet others end up in bed for a week with a fibromyalgia flare-up?
If you are one of the many sufferers of Fibromyalgia from around the world, you’ve probably asked yourself the question “should I exercise when I have Fibromyalgia?” The available research and guidelines do say yes to this question, but is it really that simple?
In this article, let’s dive into the top of exercising with Fibromyalgia, and take a look at how people often get it wrong, and what you need to actually be focusing on when exercising with Fibromyalgia.
There is no doubt that you will have been told by friends and family that exercising can help with your Fibromyalgia. Whilst most of the time this is meant as an honest way of trying to help, nonetheless, it can often be very unsolicited advice that leaves you feeling down, as you have likely already tried exercise, all to no avail. There are reasons why people with fibromyalgia struggle with exercise, this is despite it being one of the most effective treatments for chronic pain.
But first, before we look at why people struggle with exercise, what does the research actually say about exercising with Fibromyalgia?
Research does support the idea that aerobic and strength training helps not only improve physical fitness and function, but also reduces the symptoms of fibromyalgia, whilst also improving quality of life. There are also numerous other reasons to exercise when you have fibromyalgia, such as the fact that it has largely beneficial effects on symptoms of depression, which if you are in constant pain, you will very likely have. Another study found that for those with Fibromyalgia who did take part in exercise, it significantly improved pain catastrophizing, sleep, and even anxiety.
However, not all exercise is created equal. The studies above were performed using low to moderate intensity. But, it’s important to remember, that exercise is a human construct. It’s unlikely our ancestors put aside an hour a day to exercise when their entire lives were focused on hunting and movement. Simply reframing exercise as movement, can completely change the narrative around fibromyalgia and exercise, and in some instances, actually make it enjoyable. Exercising doesn’t mean you have to go to the gym and hit the treadmill, it simply means moving.
Many people with Fibromyalgia have found this to be true when engaging in movements such as Tai Chi, a low-intensity form of self-defence. In fact, one study found that yang-style Tai Chi was one of the most effective forms of exercise when it came to Fibromyalgia, producing results fairly quickly, with very limited pushback or side effects.
Whist all of these things sound and look great on paper, it still doesn’t change the fact that there are millions of people with fibromyalgia, who end up with a flare-up from trying these exercises.
Think of it like this. We called it fibro “box”. Everyone on the planet, Fibro or not, has an exposure limit for stress. This is where the brain and body essentially put you into protection mode to keep you safe from actual or perceived, danger or damage. With Fibromyalgia, we became more sensitised to stressors: physical stressors like exercise or lack of good quality sleep, psychological stressors such as dealing with a death in the family, or social stressors such as a 40-hour work week or a global pandemic!
For those with Fibromyalgia, our exposure limit to these stressors is greatly reduced, which means that it does not take a high degree of these stressors to put us into a flare up. The important thing to keep in mind here is that when the brain senses danger, it has a brilliant little protection method to ensure that you immediately start limiting that stressor: we call this pain.
June has Fibromyalgia and currently works 39 hours per week. June starts to struggle with the work week, and often finds by the time Thursday rolls around, she is in so much pain that she is literally limping into the next work week. June has tried for 6 months now to just push through and keep working, however, one day, by the time Thursday comes, she has a huge flare-up of pain and has to call in sick on Friday. This is June going over her exposure to stress limit.
After a week, June’s pain is back down to her normal baseline and she goes back to work, unfortunately, she gets hit with another huge flare–up. June recovers and has a back-to-work meeting with her boss, where it is agreed that she can drop her hours down to 20hrs per week.
June goes back to work at reduced hours and everything is much better. After 2 weeks, June is really starting to enjoy work as it’s not so physically and mentally demanding anymore. However, as brains often do, June’s exposure limit drop and one day June goes into work and is hit with another huge pain flare-up. June rests for a week and then goes back to work, but 20hrs per week feels just like 39.
After another back-to-work meeting with her boss, June agrees to only do 10hrs per week and off she goes back to work, all whilst staying under her exposure limit.
For a little, while everything seems fine, that is until she has another huge pain flare-up. Over time as the exposure line drops more and more, June can deal with less and less stress, until eventually, she goes into the Flare-up Box.
In the box, yes she is in pain and she is still tired, but as long as she doesn’t try to push herself out of it, she will avoid any major flare-ups. This is where most people with Fibromyalgia eventually end up, conditioned and forced into the box.
Now, keep in mind, that this is not just exclusive to work, it also applies to exercise and just general mobility. Pain is a conditioning tool that absolutely works, and your brain wants nothing more than for you to be safe. So, if you’re doing exercise that your brain deems as dangerous or you are pushing past your exposure line, then you are going to slam down into that box.
The Box is a concept we came up with when we noticed a repeated cycle in many of our Fibro clients. We actually recorded a Podcast episode going into this concept in a little more depth.
The takeaway here, for those trying to exercise who have Fibromyalgia, is that exercise is a physical stressor. The amount of stress that you as an individual are able to handle at the moment, is unique to you, driven by an incredible amount of variables. Variables we will discuss in this article.
There are two reasons why exercising with fibromyalgia is so hard and difficult: Sensitisation and exposure limits. However, before we get into that, we need to look at what Fibromyalgia pain actually is. There are three main recognized definitions of pain:
Neuropathic pain: This is where there is damage to the actual nervous system. Some examples of this are nerve damage after surgery, viral infections, cancer, vascular malformations, alcoholism, neurological conditions such as multiple sclerosis and metabolic conditions such as diabetes.
Nociceptive pain: This is pain that arises as a direct result of nociception. Within your body, there are no such things as pain receptors. In fact, this outdated idea was first coined back in 1664, and keep in mind, that we were still burning people at the stake back then because we thought they were witches. Luckily, science has progressed a lot since then. We now know that what we once thought were pain receptors, are actually nociceptors.
A nociceptor is a special kind of nerve that detects anything that may be potentially dangerous, So, extremes really, of temperature, chemicals, stretch, pressure, and vibration. The job of nociceptive nerves is to report to the brain about potential danger. That’s it, they don’t tell your brain that you are in pain, they just tell your brain that something may be wrong. Once your brain has this information, it’s up to your brain to decide if producing pain is warranted or not.
Nociception and pain are two completely separate entities and they are not mutually exclusive. You can have nociception and pain, you can have nociception and no pain, and you can have pain without nociception. But when pain is created as a result of nociception, we call this nociceptive pain. An example of nociceptive pain would be stubbing your toe on a coffee table, or any injury really.
Nociplastic pain: The pain that those with Fibromyalgia experience, in general, and not just from exercises, is what we call “Nociplastic pain“. This is where there is a change in how nociception works. When pain is created, despite no clear evidence of actual or threatened tissue damage causing the activation of nociceptors or evidence for any disease, we call this nociplastic pain. Think of it as a faulty check engine light on your car, that keeps going off even though your engine is fine. This nociplastic pain is when your alarm system for danger and threat keeps going off when it shouldn’t.
So, we mentioned earlier that a reduced stressor exposure limit, is going to cause problems with how people exercise when they have fibromyalgia. But, there is also another issue that can arise to cause even more problems: sensitisation.
As we mentioned above, those with Fibromyalgia suffer from abnormalities in the way that the brain deals with pain. Supraspinal processes have a top-down enhancing effect on nociceptive processing in the brain and spinal cord. This effectively means that those with fibromyalgia may be far more sensitive to noxious stimuli compared to the general population. Brains are predictive at the end of the day, and research shows us that when a brain is unsure of the exact movement that causes pain, it will just guess. Meaning that movements that should not be inherently painful can soon become that way. Combine that with a nervous system that reports danger or a threat to tissues, when there isn’t any, and a drop in tolerance to stress, and exercising with Fibromyalgia can seem an almost impossible task.
To answer this question, we need to really understand its intent. Because as it stands, an exercise that one person can do with fibromyalgia, is often an exercise that another cant tolerate. If you are looking for a quick fix exercise to dramatically bring down your pain or push you into a full recovery/remission, then I’m sorry to say, that is not how it works. Whilst there may indeed be some form of exercise that most people with Fibromyalgia can tolerate, there are going to be people who feel worse for it.
There are many suggested forms of exercise for Fibro, which all have their own individual benefits.
As we mentioned before though, not everyone is going to have success with these forms of exercise. But, they do seem to be the most tolerated forms of exercise for those with Fibromyalgia.
Here at The Chronicillness.co, we don’t even approach the topic of exercise, until we have a good understanding of what issues our clients are facing. And when you work like this, it makes things so much easier. After all, would you rather exercise when your danger alarm system is heightened or turned down: it’s always going to be latter. We initially saw Kit online. She was practically immobile when we first met her. The slightest use of her body swung her into a flare-up for days. But, focusing on the underlying issues as to why she had Nociplastic pain in the first place, it allowed us to calm those nerves down and increase her stressor exposure limit enough to be able to start exercising and reaping the benefits. These days you can catch her at her Zumba class and hiking the hillside.
But, you’re not here to listen to us talk about our clients, you are here to learn about fibromyalgia and exercise. So let’s take a closer look at these most tolerated exercises.
We mentioned earlier that Tai Chi was one of the most effective and safest forms of exercise for Fibromyalgia. So, let’s take a closer look at why this potentially is.
Remember when we mentioned earlier that we don’t even start thinking about exercise before we find out the reasons why someone has Nociplastic pain. Well, Tai Chi is a great form of exercise because it allows people to jump straight in, without worrying all too much about the reasons why they are in pain, but still reap benefits from exercise. There have been some brilliant studies done on Tai Chi as an exercise for fibromyalgia and the benefits may surprise you.
Tai Chi is a very graceful form of exercise, it’s slow, elegant, and as far as your brain is concerned it’s a pretty low stressor. This is great for anyone with Fibromyalgia who wants to exercise, as it allows them to take part in exercise without pushing above their stressor exposure limit and causing a huge flare up. The current body of evidence shows Tai Chi to help with increased well-being and improved sleep. Something to also note is that there were no studies that found tai chi worsened a condition.
So, Tai Chi as an exercise for Fibromyalgia looks like a good way to start increasing your stressor tolerance level. If it can help to increase your well-being and improve your sleep, your pain levels will come down, which means your tolerance level to stress will go up.
One of the main forms of exercise most guidelines advocate is strength training and with very good reason. Strength training has unrivalled benefits for both chronic pain and the general population. Strength training is not just about working out your tissue, it’s also about working your nervous system. Whilst you may not see muscle growth initially, this is because neural adaptation is taking place, wherein your brain is getting better at recruiting muscle fibres.it already has. Making you feel stronger, which honestly, is a huge benefit in itself.
When you feel stronger, you hold yourself differently, you interact with people differently, and you gain a new sense of ownership over your body. When it comes to fibromyalgia, this is important, as it can often feel like you don’t own it. We get better at the things we do, and the better you get at producing feel-good chemicals from exercise, the easier it is to produce them in general.
As a general rule, we use the following when introducing strength training to a Fibro client:
Do they understand it?
Do they enjoy it?
Is it not overly complicated?
Is it needed?
Is the client’s nervous system able to deal with the stress?
If the answer is yes, strength training is in. Bear in mind that it is important to lay the groundwork in the form of education and changing the narrative around pain before jumping in at the deep end and picking up a weight.
When we begin a strength training journey there are some common themes which always occur.
Number one is the person gets a sense of achievement. Having not done much for a long time, the sense of pleasure from completing a new movement task can be like a drug. With very good reason, the brain is like a pharmacy and in its cabinet are some of the most potent drugs known to man. The use of movement, strength training or otherwise, helps this mushy pharmacist release those “feel good” chemicals (namely Dopamine and Endorphins) These chemicals give us the feeling of having achieved something and craving it again.
This is why it is so important to address any factors pertinent to YOUR pain before beginning as this process can be just as easily a negative one.
Number 2 is the person will start to notice changes in their body. Weight loss, changing shape, muscles popping up and even muscle soreness will all occur pretty early into the process. Muscle soreness is a weird one. It can be scary to think the pain is being made worse by exercise, but on the other hand, it is an excellent way to prove that although the soreness comes, it goes just as quick. And this can be where the magic truly happens. When you have tangible, physical proof that the body can repair and recover, the associated sensitivity from chronic pain starts to dial down over time and you become much more resilient. Both physically and mentally. After all, a good way to show your brain that your body isn’t damaged is to show it what it can do. Remember earlier when we said that if a brain doesn’t know what movement causes pain, it will just guess? Well actually moving is a good way to for your brain to figure this out.
Number 3 is catching momentum. Once you have experienced a change in your symptoms for the better, the nervous system craves movement. You’ll be itching to move more and actually look forward to exercising. At this stage, the movement has become a tonic and is much more energy-producing than fear-inducing or painful. Again, it all comes down to the narrative and having someone guide you through the process to help address the underlying issue as to why you have Nociplastic pain in the first place.
A Spanish study, of 33 women with fibromyalgia, demonstrated that: “a warm water pool-based exercise program for 12 weeks (2 times/week) led to a positive immediate decrease in the level of pain in female patients with fibromyalgia.” The women involved in the study also reported feeling less depressed and more sociable, as a side benefit of their swimming programme.
Swimming gives someone with Fibromyalgia a chance to exercise without having too much load on their tissues, meaning the alarm system is going to be a lot more forgiving than it normally would be. However, there is one issue with swimming as an exercise for fibro: It’s just not transferable to everyday life. Once you are out of the pool and subject to the same load and gravity that is normally enacted upon you, are you going to be able to deal with that stressor? Unfortunately, there isn’t any research on this so it stays as food for thought.
The name Osteoarthritis is somewhat of a misnomer, as “Osteo” means bone,”‘Arth” means joint, and “Itis” means inflammation. And when we realise that Osteoarthritis is a degenerative condition, not an inflammatory one, we can start to see why there is likely so much misinformation around fibromyalgia and osteoarthritis, especially considering it’s not even named correctly!
There is a lot of misinformation around Osteoarthritis, even more around Fibromyalgia, and an absolute abundance around exercise. So, let’s take a look at some studies and start to break down those damaging narratives that you have likely been told or have read.
One study focusing on professional football players found that 92% of football players had at least 1 spinal degenerative condition, but in some cases, more than 6 were found. The interesting thing was that none of them reported any pain. This is a nice study that helps us look at the complexities of pain, as when it comes to chronic pain it isn’t always about the tissue.
There is a ridiculous amount of evidence that shows us that pain is not tightly linked to tissue damage. And when it comes to Osteoarthritis, there should also be evidence of people with severe degeneration shown on a scan, but who feel fine, and vice versa. This study of 113 people found exactly that, a huge disconnect between degeneration and pain. In which they found that the people with less degeneration had more pain, and those with more degeneration had less pain!
As we mentioned earlier, those with Fibromyalgia suffer from abnormalities in the way that the brain deals with pain. Supraspinal processes have a top-down enhancing effect on nociceptive processing in the brain and spinal cord. Studies have begun to suggest that such influences occur in conditions such as fibromyalgia. This means that those who do have Fibromyalgia may be far more sensitive to noxious stimuli compared to the general population. Factoring in changes at the joint, those with Fibromyalgia may be more prone to reacting to these changes byways of producing pain.
There have been a few studies that have looked into how Fibromyalgia may affect Osteoarthritis. One such study published in the European Journal of Neuroscience, measured brainwaves in response to short painful laser pulses on the skin of patients suffering from osteoarthritic and fibromyalgia pain, as well as test subjects who had no underlying pain. Scientists discovered that the insula cortex part of the brain increased its activity when expecting a painful pulse, as it predicts the extent and intensity of the patients’ own chronic pain.
It is important to keep in mind, that increased activity in this brain area has been linked to a number of phenomena, including body perception and emotional processing, which might explain the greater pain perception in some patients.
In essence, there are a lot of factors that come with fibromyalgia that can make osteoarthritis worse, when compared to individuals without it. One such factor is sleep disturbances. It is well documented that with sleep disturbances and lack of sleep, comes an increase in pain. For those with Fibromyalgia, getting a good, restful night’s sleep can be somewhat of a challenge due to pain. Meaning that it has the potential to create a breeding ground for worsening the symptoms of not just fibromyalgia pain, but also the pain of Osteoarthritis.
The take away though, is that changes and sensitisations seem to be the pain driving forces of osteoarthritis. While you may worry that exercising with osteoarthritis (OA) could harm your joints and cause more pain, research shows that people can and should exercise when they have osteoarthritis. In fact, exercise is considered the most effective, non-drug treatment for reducing pain and improving movement in patients with osteoarthritis.
Conclusion
We have looked at some of the many issues that present when it comes to Fibromyalgia and exercise, and we have looked at the research on the different forms of exercise. As it stands with everything we have discussed, most likely the safest and most beneficial form of exercise for those with Fibromyalgia is Tai Chi.
Tai Chi looks to give individuals a form of exercise that can be built upon, without adding too much stress to an already stressed system. As we mentioned earlier, the true key is to find the reasons why you have nociplastic pain in the first place. As it is far easier to exercise with reduced pain levels and higher tolerance.
We hope you enjoyed reading this and we especially hope we managed to answer some of your burning questions.
At the end of the day, pain is multifactorial and comes down to hundreds of interplaying factors.
People generally have some issues with the specific hypermobility knee exercises that are currently out there. They either don’t work or they yield very little results. This is largely due to the simple fact that the current treatment around exercises for those with hypermobility, are built on a false premise and simply do not take into account the nuances that come with this population.
The gold standard at the moment for hypermobile knee exercises, and indeed any exercise for those with hypermobility, seems to be the old “build muscle around the joint to help stabilise it” approach.
This old outdated approach that has seen many hypermobile people simply lose interest in, after seeing it return such little results, comes with 2 main issues. Issues that most people don’t really talk about.
Building muscle requires sufficient load and consistency to do so. How is anyone with unstable joints supposed to use such load required to build muscle and not get injured?
Muscle gains are slow. If we use women as an example, and whilst ensuring that training and diet are on point, we could expect to see around a 10lb gain in muscle mass over the course of a year. However, there are no studies that follow muscle gain in those with hypermobility. So how much muscle are we supposed to add to create stable joints: 5lb, 25lb? and how are we supposed to even add muscle tissue when we can’t handle the load required to build muscles in the first place?
There are also other issues, such as why do women with high muscle mass still dislocate, whilst others with less muscle mass dislocate less?
The current treatment seems to fall apart somewhat when we start to question it. No wonder this current treatment has caused so much distress and gaslighting to those with hypermobility when it doesn’t even make any sense. We have seen so many people in the studio who have all reported the same thing, they did their physio, it didn’t work, and they were blamed for not trying hard enough.
Many people have used many different forms of exercise to help stabilises hypermobile knees, and whilst we often see swimming or hydrotherapy as a form of great exercise, please remember there are issues with these.
We live on land and we need to be able to deal with the various forces that enact upon us. Whilst swimming can be a great form of cardiovascular exercise, it is not doing a great deal in the form of stabilising our joints, and it takes away the loading forces that will help up in the long run, which can decondition us further.
There is also an issue with the use of hydrotherapy, those 39-degree waters will vasodilate our blood vessels, forcing our hearts to work harder to pump blood around, as well as causing blood pooling, potentially making us dizzy and faint. Which is not want we want when we are in a large body of water.
Load is a crucial part of stabilising joints, however, it needs to be the right form of load. Open chain exercises such as the leg extension machine you would find at any gym, are a good example of bad load, putting large leverage forces through tissue, which those of us with hypermobility can not properly handle(yet).
A good hypermobile knee exercise needs to be transferable to everyday life, meaning the benefits of it cross over to other movements and other activities.
There seems to be much demand for a simple and effective hypermobility knee exercise. So, below you can find one of our favourite hypermobility knee exercises, which is aimed at helping those with hypermobility and Ehlers-Danlos syndrome, by addressing some of the real issues that need to be addressed.
Keep in mind, that a large problem with hypermobility exercises, in general, is that individuals tend to have trouble contracting the right tissues or even feeling the muscle they are exercising in the first place. This is why a tactile cue, used with a closed chain exercise, is a great way to train the tissue and your brain, in an exercise that is transferable to everyday life.
For this type of exercise, it is far better to use time, rather than sets and repetitions. You can start off performing this exercise for up to 1 minute twice per day, and spend the next 3 weeks trying to get up to a total of 4 minutes.
When you’re in pain, you have one thing on your mind – please make it stop. Luckily there are many pain management options out there, some work faster than others, and some even have an immediate effect. And while opioids can serve an important function, my advice for patients is to try a non-medication approach first. The following pain-relief tips are sustainable and most importantly they’re often times effective for many types of pain conditions when combined with a comprehensive treatment plan.
Being active is great for your health as seen in many studies. It can help strengthen muscles and extend your life, when combined with a comprehensive pain management routine. Any physical activity should first be discussed with your doctor, and be adjusted based on your ability to tolerate your symptoms and function; however, there are plenty of low-impact exercises that can have a positive impact on your pain. Walking is one of them. It can be done anytime and almost anywhere, and the simple act of moving can work wonders on relieving certain symptoms, especially chronic back pain. Some ideas on how to incorporate walking into your daily routine could include: take your dog for a quick stroll first thing in the morning when you may be feeling especially stiff, choose the farthest parking space, use the office restroom or the walking route that’s out of your way at work.
Massage is a popular pain-relief option due to its many pain-relieving benefits; however, making an appointment at the spa can be prohibitive due to time and cost. So if you are one of the many individuals whose day is filled with work, errands and other responsibilities, a handheld at-home massager can be a much needed relief. For example, the Wahl Deep Tissue Massager is one of the most powerful massagers currently available. It offers customized relief through a combination of interchangeable heads and variable intensity control.
One of the biggest advantages of incorporating at-home massage into a comprehensive pain-management regimen is convenience and the fact that it provides relief fast. Massage relieves muscle tension by enhancing blood flow, which causes muscles to relax. It also decreases inflammation by activating genes that can naturally reduce swelling, it reduces pain intensity by diminishing bodily substances that create and prolong pain and it improves recovery by stimulating mitochondria, the “energy packs” driving cellular function and repair.
Water can be an easy way to stem pain at the source. Keeping water nearby and making sure you drink at least eight 8-ounce glasses daily can make all the difference when trying to combat pain. In general, your body needs water to work properly, to lubricate and cushion your joints, to protect your tissues, to keep your temperature normal and to get rid of wastes. A lack of water can lead to dehydration and drain your energy even further, leading to exhaustion and more painful symptoms. Water is a key element in keeping balance in your body and overall health.
I already covered the miraculous effect water can have on your body from the inside, but it has soothing powers from the outside too. Depending on the source or your chronic pain, a warm bath can offer respite from your discomfort. Being submerged in water reduces the stress of body weight and gives all-over support, easing pressure on your joints. What’s more, the warm and even temperature stimulates blood flow throughout your body helping to loosen stiff, painful muscles.
We can all build resilience, but our circumstances are not all the same. Some women face more barriers than others. The common barriers we all face include:
Poor reimbursement by health insurance for many pain treatments
A society where pain is undertreated, and the conditions causing it are often misdiagnosed
I discovered this world of barriers in 1994 after a surgical injury to my spine caused severe pain, and I was unable to sit, stand or walk more than a couple of feet with a walker for the next 15 years. I basically had to navigate the world lying down.
“Resilience” is often defined as the capacity to recover from difficulties—having a certain toughness. When you have chronic pain, it is less about recovering and more about adapting to new circumstances, because the pain persists; it is ongoing or continuous. Perhaps the definition of resilience as “springing back into shape” or “elasticity” is a better fit. All of us have the capacity for resilience, and tapping this resilience can help us move forward.
To me, resilience is the ability to adapt and thrive despite ongoing and difficult circumstances. For example, figuring out how to continue to do my job when I could only lie down enabled me to continue to pursue my interests and have an income, although I couldn’t do things in the same way or participate in work that required travel.
It’s a fact that resilience in our society is mostly about resources. Women with good medical care, a job that offers a living wage and access to sick leave fare better—whether the difficulty is coping with an inadequate health care system or recovering from the impact of a natural disaster, for example. This matters because resilience is partly about our inner reserves and partly about what comes to us from the outside in terms of both resources and difficult experiences.
Trauma occurs when difficult experiences overwhelm our inner reserves. If we have more resources, the difficult experience may not overwhelm us. Regardless of our circumstances, cultivating resilience can help us buttress those inner reserves.
First, focus on those things you can control. Chronic pain is difficult because it endures; it can feel like it has always been and will never end. Taking things a day or even a moment or an hour at a time can really help because the pain intensity is rarely exactly the same at every moment. Seize moments that give you an opening to do something that feels useful; often, those moments can accumulate. If you are having an especially grueling period, give yourself permission not to be productive and be kind and gentle with yourself.
Second, use any social and cultural resources available to you. They provide emotional buffers. Pain is an assault on intimacy. You may not be able to participate in shared social activities, and your family and friends can’t see or experience what you do. Chronic pain can separate us from others. But we have to find ways to cultivate this needed connection. Early in my pain experience, I found it helpful for my friends to sit with me and describe their vibrant hiking and camping experiences—the activities that once were such a big part of my life. When I was bedridden, I would sometimes virtually accompany friends to dinner or small parties or even join via cell phone while my friends ran errands or went through the ordinary tasks of their days.
I’ve tried numerous techniques over the years that helped, including meditation and relaxation therapy, journaling, drawing and deeply taking in fine art. Resilience can show up unexpectedly. For example, when I started to draw, I barely had the energy to put pen to paper. Then, I noticed that sketching helped me focus outside of myself and awakened different parts of my brain. An entirely new reserve of energy surfaced. Looking at art on the thousands of museum websites that have their collections online opened up new worlds to me, while not requiring the focus of reading an entire novel or watching a play.
Third, don’t expect too much of yourself. The only way to be resilient is to accept the new normal and your current capabilities. We can’t expect to do all the same things in the same ways that we did before chronic pain. If your work life is challenging, consider asking your employer for accommodations. Under the Americans with Disability Act, employers are required to make appropriate accommodations for you. You can ask to telework or request projects that are less deadline-intensive when you are in a flare-up. If you can afford it, consider a part-time or flexible schedule when things are especially difficult. Whether these accommodations will be provided will depend on your employer’s circumstances too—such as how large and well-resourced they are.
I was fortunate because I worked in the Civil Rights Division at the Department of Justice when my pain began—the office that enforces the Americans with Disabilities Act—so they were especially accommodating to me.
And, reach out: Ask for help. Resilience isn’t about going it alone. When things get rough, I try and focus on these five concepts:
Pleasure. Find what makes you feel good and hold on to it.
Patience. Pain is an endurance test, so it is really important to be patient with yourself.
Perseverance. Find a way to reach out to others, to make and sustain social contacts.
Pause. Take time out when you need to rest, and try and find those things that give you a sense of relaxation and stillness.
Perspective. Even with the most intractable chronic condition, there are always ebbs and flows. Holding on to the times that are better and remembering them is important, so you don’t feel like you’re just stuck in an unrelenting rut.
If you’re not taking regular breaks to move around during your workday, your muscles may rebel after being scrunched in your desk chair hour after hour.
The rebellion might be felt in your neck, shoulders, back, hips and legs when you do finally stand up. Stop the insurrection with these three simple stretching exercises you can do without even leaving your workstation or office.
Start with the lateral lean. Stand up straight and clasp your hands behind your head. Turn your head toward your left elbow and then lean your torso in the same plane to the right — don’t bend forward or backward. Hold the stretch for 30 seconds and then repeat the stretch to the opposite side.
Next move to the standing hip flexor. Despite its name, it helps the legs as well. Lightly place your left hand on your desk for balance and bend your right knee, bringing your right foot behind you toward your right glute. Grip the right ankle with your right hand to gently press the heel toward your butt. Contract both sides of your glutes and keep your knees close together and your spine straight. Hold for 30 seconds and then repeat with the left leg.
Finish with the open and closed upper body stretch. It helps prevent both lower back and shoulder pain. From a standing position, hinge forward from the waist, letting your arms hang toward the floor. Take a few deep breaths and then slowly stand up straight as you move your arms out to the sides in line with your shoulders. Rotate your thumbs backwards with your palms facing the ceiling. Think of bringing your thumbs together behind you as you open your upper chest toward the ceiling. Hold for 30 seconds and repeat up to four times in total.
Take three minutes every two or three hours — more often if you can — to do these simple moves. Your body will thank you.
Is arthritis pain getting in the way of your fitness plans? That need not be the case.
In fact, physical activity can be vital to your continued mobility.
Osteoarthritis is a joint disease that affects about 27 million Americans — most often in the knees and hips, but also in the lower back and neck.
Doctors describe it as a degenerative disease — meaning the joint has worn down. Usually that’s from simple wear-and-tear over the years, or from overuse.
This occurs when there’s a breakdown of the cartilage that covers the end of each bone. The cushioning effect is lost. The result is pain, swelling and problems moving the joint that’s been affected. Over time, the bones themselves can be damaged.
It may be hard, especially at first, but physical activity is key to treating osteoarthritis. Studies have shown that exercise not only helps reduce pain but also improves mobility.
Being active should help with weight loss, too — and excess weight contributes to the pain of osteoarthritis.
Start slow and simple, suggests the Arthritis Foundation. Just walking around the neighborhood can help. So can a fun and easy exercise class.
Adding some strengthening exercises will help build muscle around whatever joint is affected by osteoarthritis. Range-of-motion exercises can help you become more flexible and less stiff. Simply start with gentle stretches that take your joints through their full range of motion.
Yoga and tai chi can help relieve stiffness and improve flexibility, too.
Whatever activity you choose, just make sure it’s easy on your joints. No twisting and pounding. Besides walking, good options are biking, water aerobics, swimming and dancing.
A key to success, though, is to pay attention to how your body tolerates your new activity. And be patient. When you have arthritis, it can take your body longer to adjust to new activity, notes the U.S. Centers for Disease Control and Prevention.
If you haven’t been active, start with just three to five minutes of activity twice a day. Once your body has adjusted, add 10 minutes to your activity time. Then add 10 minutes more, and so on, until you’re as active as you want to be.
For those who have a hard time even walking at first, consider working with a physical therapist. This specialist can create a program tailored to your abilities — and one that can adapt as you get stronger.
One important reminder: Check with your doctor before adding new activity and any time you experience unusual pain or swelling in the joint affected by osteoarthritis.
