Should you exercise when your back or any other joint is sore or stiff?
This is a question that I am often asked so I thought I would document my advice about this.
I will explain why I believe the answer is usually yes you should, but only with qualified supervision and, sometimes, the knowledge of your doctor.
Firstly you should never do anything that is going to aggravate any condition from which you may be suffering. So for any pain it is important to obtain a medical diagnosis of the cause. Once the cause is understood, or is at least known not to be a condition which would be exacerbated by movement, then controlled, prescribed exercise will help. Conditions which do need rest are broken bones, torn ligaments or muscles and severe bruising.
So, your diagnosis does not preclude exercise, you've not broken a bone, bruised soft tissue or damaged a ligament. But you are in pain, should you be exercising, and if so what should you do and what should you avoid?
If you are suffering pain, then don't exercise alone, always do it under the supervision of a qualified instructor, at least for the first few sessions. No, I am not just drumming up business for people like me, if your exercises are to be beneficial it is vital that you are engaging the correct muscles and making the appropriate movements. Once you and your instructor are happy that you know what you are aiming for, then it is not necessary to have supervision all the time. Even then, it is advisable to get a session from time to time to check you have not slipped back in to "bad habits".
Generally warm up exercises help to keep joints mobile. There are some specific exercises that will stimulate the release of synovial fluid into the joint capsule. This will help the joint to move more easily.
It is important to "listen" to your body. There is 'good pain' and 'bad pain'. Most people know whether a pain is to be ignored and worked through (good pain), or is telling you to stop doing what you are doing (bad pain). Often it is an indicator that you are not performing an exercise in the correct way, or sometimes that an alternative exercise is needed to protect and strengthen weaker areas. Whatever, don't just suffer silently, talk to your instructor who, with your help, should be able to work out how to improve the situation.
If you have Rheumatoid Arthritis you need to take more care. If your joints are hot and sore (in flare up) it is best to rest the affected area. But it is important to keep as much the rest of your body as mobile as possible. This is normally easily achieved with the use of static exercises and carefully choreographed dynamic exercises, avoiding the joint (or joints) in flare up.
If you have 'pulled your back', and there is no damage to discs, vertebrae or spinal column, there can be a number of muscular factors that are contributing to your pain. For muscular pain, exercise can help to loosen the affected area. Movements should be slow and small to encourage tightened muscles to release and this will, in turn, relieve the pain. You might also benefit from some releasing massage. Once the pain has subsided then slightly more rigorous, but still controlled, exercises should be performed to gradually improve the strength and suppleness of the supporting muscles.
For arthritis in the spine, gentle exercise will help to keep the spine moving. It may not relieve the pain completely but it will enable you to keep as much movement as possible. Again, increased support from toned muscles can provide a level of relief.
Another common condition I see is scoliosis. It seems that once combined with the aging process scoliosis does give more pain. If you find that you are stooping more this could be the combination of your scoliosis with osteoporosis or degeneration of the spine. In this case exercise may be painful as muscles are encouraged to bring you into a more upright position while the bones are degenerating and the scoliosis worsening. There is a balance to be found using small specific exercises which will help while avoiding many mainstream exercises which while helpful will cause more pain than is necessary.
Please note that if, with your back pain, you have any loss of feeling into your legs or any additional symptoms (such as loss of bladder control) I would suggest that you contact your doctor with some urgency, for further advice.
In general, if you have joint pain exercise helps to strengthen the muscles that support the joint. This is particularly effective for knee and hip joints. You should be aware that the "pure" forms of both Pilates and Yoga can put unnecessary stress or loading onto joints, particularly the back, hips, shoulders and knees. Seek out an instructor qualified in GP referral, or exercise for the older person who can modify a class to use only the exercises that encourage good muscle engagement. These are normally those with smaller movements that will minimise wear on the joint while maximizing the benefit.
If your pain makes it difficult to get down on to the floor, you might be able to lie on a couch. Or, if you can get to the floor, but find it uncomfortable once there, ask your instructor for a softer mat, cushions and/or blankets to enable you to get comfortable. Use of these accessories is not detrimental to your exercise, and you might as well be comfortable.
In summary, the correct form of exercise is almost always beneficial. So, yes you should exercise, but carefully and under the guidance of an expert and with the knowledge of your doctor.
Sunday 26 October 2014
Friday 10 October 2014
Is there an age when exercise becomes bad for you, risky or inappropriate?
At what age does it become bad, too risky or inappropriate for you to exercise?
In my opinion the answer is there is no age beyond which exercise should not be attempted!
I may be biased having worked in the world of exercise all my life and coming from an active family but my opinion is backed up by recent research and national recommendations.
The current government recommendation for those aged over 65, is
1. To be active daily
2. To accumulate 150mins weekly of ‘moderate intensity activity’ in bouts of at least 10mins at a time
3. To exercise twice weekly for strength, flexibility, balance and co-ordination
4. Minimise the amount of sedentary time. (sitting)
5. Some activity is better than none, and more provides greater health benefits
This might sound onerous, but in reality it can be achieved very easily.
Let’s look into these guidelines a bit deeper to see how easy it is to meet them and what the benefits are.
First we can consider why should we exercise at all?
• All muscle wastes away if it is not used: the motto use it or lose it really is true.
• Skills such as balance and co-ordination deteriorate with age. However they can be maintained and even improved with regular practise. This deterioration is the main case of older people falling so easily, so controlled exercise will reduce your risk of falling.
• Bone density also deteriorates with age meaning falls are more likely to result in fractures. Controlled exercise will improve bone density hence reducing the risk of fractures.
• Posture can deteriorate as we age for all sorts of reasons, most of which are correctable by specific targeted exercise: don’t become a stooping person!
• Your cardio-vascular system ages with you. We get higher blood pressure, less efficient blood flow around the body and much reduced oxygen uptake by the body, leaving us feeling less like exercise, when in fact we need more! See point 1.
• If you are suffering from arthritis, exercise is known to be beneficial, reduce levels of pain and improve mobility.
Second, what is moderate intensity activity (point 2 of the recommendations)?
Activity, here, can be defined as any movement that increases your heart rate from its normal resting rate. The measure of moderate intensity is different for every individual. It is not advisable to use any generic figures for this, the best approach would be to ask any appropriately qualified instructor.
What activities could count as moderate intensity?
Walking is brilliant provided it is on a regular basis and is appropriately vigorous. We can check whether you are being vigorous enough by testing your activity level in a SELECT class. If you walk your dog daily it is quite possible that you already meet the guidelines for cardiovascular exercise.
Interestingly, golf is found to be of limited benefit. It is not aerobic, it promotes misbalanced strength and flexibility in the body and research shows no bone density improvement. This would not count.
Gardening is also classed as non-beneficial. The bending, reaching and kneeling all puts stress on the body rather than strengthening it.
Swimming is similar to walking in that it can be great for cardio if it is done regularly and with appropriate vigour. However it doesn’t improve bone density or balance. And if you suffer any joint issues, breaststroke should be avoided.
Other exercises to consider that can be beneficial are, cycling, rowing or cross-training in the gym.
So what exercise is available to address point 3 of the recommendations?
Generally these exercises are specific routines that are performed in classes, in the gym, in a swimming pool or at home. The important point here is to ask an appropriately qualified instructor for guidance on what would be the most beneficial forms for you, and also to teach you how to perform the movements without them being detrimental to you.
Pilates is probably the most suitable form of exercise as it is controlled and specific in its aims. It doesn’t encourage excessive movement, and primarily uses the body’s own weight for resistance. This means it is particularly accessible even for people to do at home.
I have developed a specific variant of Pilates designed to be particularly beneficial for people with injuries, aches and pains, bad backs and posture difficulties. In “I Move Freely” Pilates classes I use biomechanic exercises to gain the maximum benefit in loosening stiff joints, backcare exercises to strengthen yet protect the spine as well as strengthening exercises for the muscles which give support to our skeletal structure. Posture is addressed with work to open the shoulder girdle, thus preventing the shoulder rounding which can easily lead to ‘hunching’. Also, I avoid some traditional Pilates exercises (e.g. roll downs, the 100 or double leg lifts) which put pressure on the lower back, neck and pelvic muscles. Provided you exercise correctly and regularly in class and continue to use the correct muscle engagements throughout the week when doing normal everyday activities you will be gaining strength and stability.
What if you don’t feel able to take part in a class nor want to go to the gym?
SELECT is a small group class (max 4 people) I run specifically to cater for you. Because the attendees are very limited the exercises can be completely tailored to your individual needs.
For example, if you cannot get down to the floor, or you cannot stand for any period, we can provide chair based exercise, or we have exercise couches. If you find it uncomfortable on normal exercise mats we can provide memory foam mats which protect any protruding, or painful parts from the hard floor.
As another example, If you have specific recommendations from your GP or physio, we are experienced at working with your practitioner to make sure the exercises are appropriate to your needs.
SELECT allows me to shape the class to each individual whatever their requirements.
Consequently, SELECT makes getting started easy, it is friendly, focussed to your needs, will address concerns you may have about your body as it ages and work towards keeping you independent and active – fit for life for all of your life.
If you are unsure in any way about attending a class or what exercise is suitable for you, please arrange to pop in for an informal chat and see how easy it is to incorporate exercise into your life.
In my opinion the answer is there is no age beyond which exercise should not be attempted!
I may be biased having worked in the world of exercise all my life and coming from an active family but my opinion is backed up by recent research and national recommendations.
The current government recommendation for those aged over 65, is
1. To be active daily
2. To accumulate 150mins weekly of ‘moderate intensity activity’ in bouts of at least 10mins at a time
3. To exercise twice weekly for strength, flexibility, balance and co-ordination
4. Minimise the amount of sedentary time. (sitting)
5. Some activity is better than none, and more provides greater health benefits
This might sound onerous, but in reality it can be achieved very easily.
Let’s look into these guidelines a bit deeper to see how easy it is to meet them and what the benefits are.
First we can consider why should we exercise at all?
• All muscle wastes away if it is not used: the motto use it or lose it really is true.
• Skills such as balance and co-ordination deteriorate with age. However they can be maintained and even improved with regular practise. This deterioration is the main case of older people falling so easily, so controlled exercise will reduce your risk of falling.
• Bone density also deteriorates with age meaning falls are more likely to result in fractures. Controlled exercise will improve bone density hence reducing the risk of fractures.
• Posture can deteriorate as we age for all sorts of reasons, most of which are correctable by specific targeted exercise: don’t become a stooping person!
• Your cardio-vascular system ages with you. We get higher blood pressure, less efficient blood flow around the body and much reduced oxygen uptake by the body, leaving us feeling less like exercise, when in fact we need more! See point 1.
• If you are suffering from arthritis, exercise is known to be beneficial, reduce levels of pain and improve mobility.
Second, what is moderate intensity activity (point 2 of the recommendations)?
Activity, here, can be defined as any movement that increases your heart rate from its normal resting rate. The measure of moderate intensity is different for every individual. It is not advisable to use any generic figures for this, the best approach would be to ask any appropriately qualified instructor.
What activities could count as moderate intensity?
Walking is brilliant provided it is on a regular basis and is appropriately vigorous. We can check whether you are being vigorous enough by testing your activity level in a SELECT class. If you walk your dog daily it is quite possible that you already meet the guidelines for cardiovascular exercise.
Interestingly, golf is found to be of limited benefit. It is not aerobic, it promotes misbalanced strength and flexibility in the body and research shows no bone density improvement. This would not count.
Gardening is also classed as non-beneficial. The bending, reaching and kneeling all puts stress on the body rather than strengthening it.
Swimming is similar to walking in that it can be great for cardio if it is done regularly and with appropriate vigour. However it doesn’t improve bone density or balance. And if you suffer any joint issues, breaststroke should be avoided.
Other exercises to consider that can be beneficial are, cycling, rowing or cross-training in the gym.
So what exercise is available to address point 3 of the recommendations?
Generally these exercises are specific routines that are performed in classes, in the gym, in a swimming pool or at home. The important point here is to ask an appropriately qualified instructor for guidance on what would be the most beneficial forms for you, and also to teach you how to perform the movements without them being detrimental to you.
Pilates is probably the most suitable form of exercise as it is controlled and specific in its aims. It doesn’t encourage excessive movement, and primarily uses the body’s own weight for resistance. This means it is particularly accessible even for people to do at home.
I have developed a specific variant of Pilates designed to be particularly beneficial for people with injuries, aches and pains, bad backs and posture difficulties. In “I Move Freely” Pilates classes I use biomechanic exercises to gain the maximum benefit in loosening stiff joints, backcare exercises to strengthen yet protect the spine as well as strengthening exercises for the muscles which give support to our skeletal structure. Posture is addressed with work to open the shoulder girdle, thus preventing the shoulder rounding which can easily lead to ‘hunching’. Also, I avoid some traditional Pilates exercises (e.g. roll downs, the 100 or double leg lifts) which put pressure on the lower back, neck and pelvic muscles. Provided you exercise correctly and regularly in class and continue to use the correct muscle engagements throughout the week when doing normal everyday activities you will be gaining strength and stability.
What if you don’t feel able to take part in a class nor want to go to the gym?
SELECT is a small group class (max 4 people) I run specifically to cater for you. Because the attendees are very limited the exercises can be completely tailored to your individual needs.
For example, if you cannot get down to the floor, or you cannot stand for any period, we can provide chair based exercise, or we have exercise couches. If you find it uncomfortable on normal exercise mats we can provide memory foam mats which protect any protruding, or painful parts from the hard floor.
As another example, If you have specific recommendations from your GP or physio, we are experienced at working with your practitioner to make sure the exercises are appropriate to your needs.
SELECT allows me to shape the class to each individual whatever their requirements.
Consequently, SELECT makes getting started easy, it is friendly, focussed to your needs, will address concerns you may have about your body as it ages and work towards keeping you independent and active – fit for life for all of your life.
If you are unsure in any way about attending a class or what exercise is suitable for you, please arrange to pop in for an informal chat and see how easy it is to incorporate exercise into your life.
Thinking about taking up Yoga?
THINKING ABOUT STARTING YOGA?
Before you do you should understand the potential benefits and dangers (yes dangers) of practising Yoga.
Yoga has been criticised for being potentially dangerous by causing injuries and aggravating existing conditions such as arthritis. Some authors of critical articles have themselves been injured in a Yoga class, others get their information 2nd hand by talking to participants in Yoga classes. Research can be difficult to verify as there have been no specific clinical trials so information is usually taken from surveys.
An extensive survey of yoga practitioners in Australia showed that about 20% had suffered some physical injury while practicing yoga. In the previous 12 months 4.6% of the respondents had suffered an injury producing prolonged pain or requiring medical treatment. Headstands, hand stands, shoulder stands, lotus and half lotus (seated cross-legged position), forward and backward bends, produced the greatest number of injuries. Respondents commonly took the blame for the injury on themselves, citing reasons such as ‘pushing it too far’ and not warming up, along with being too competitive. Read the source document here
The same article also asked the participants for the effect that Yoga had had on a range of over 500 specific medical conditions from which they suffered. The results were positive:
• Much better 53.3%
• Better 29.3%
• Little better 12.5%
• No change 4.5%
• Little worse 0.3%
• Worse 0.0%
• Much worse 0.4%
In my opinion there are many health benefits for both mind and body to be gained from taking up yoga. The relaxation element is good for sufferers of depression as well as in rehabilitation from cancer and the management of heart disease. The flow through a succession of poses can help with stress management and improved posture
Injuries seem to come from beginners pushing themselves beyond their ability and instructors with little training, or experience, who cannot evaluate each participant’s ability and offer alternative positions. Looking at the list of positions which incurred most injuries, head and shoulder stands should only be performed under close supervision by those working at an intermediate level. Lotus and half lotus positions place the knees in positions which will aggravate any existing damage to ligaments or cartilage whether originating from an injury or wear and tear. Forward and backward bends put load on the spine which can aggravate any degenerative conditions and potentially cause back pain rather than ease it.
Ensure that you choose an instructor who has experience and a class which works at your level. Watch out for exercises which may not be suitable for you (see injury section above) and listen to your body.
As an exercise professional I am keen to see everyone partake in some sort of exercise, it’s a question of finding what suits you and for many Yoga will be ideal. Give it a try, but carefully.
Subscribe to:
Posts (Atom)