Should you exercise when you are stiff or sore?

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.
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