Fitness and Exercise – Michigan Spine & Pain

Is Pain Making You Tired?

Pain and fatigue often go hand in hand, especially when there is chronic, long-term pain. The exhaustion and weakness that can accompany pain may develop slowly or appear suddenly. When developing a pain management strategy, coping with fatigue should also be part of the plan.

Here are some factors that contribute to the pain/fatigue cycle, and tips for how to break free:

Physical Stress

Use it or lose it…

Reducing your physical activity because of pain can weaken muscles and make you tire more easily. Talk with your pain management team and work out a realistic exercise and activity plan.

Tip: Enlist friends and family to help you achieve your activity goals and help you regain your confidence. A walk with a friend seems shorter than a trudge alone. Just remember to be realistic and tell them when need to stop and rest.

You don’t move like you used to…

Whether you’re limited by an injury, living with arthritis pain, or recovering from surgery, pain can cause you to adjust the way you move. This can create unusual stress on muscles and joints and cause more pain – and more fatigue.

Tip: Be aware of how you position your body whether you are moving or at rest. If, for example, you are favoring an injured knee, be aware that the other knee is now taking on more than its usual share of the load and will tire more easily – and be more prone to injury.

Play now, pay later…

Overdoing it can increase both pain and fatigue. Learn your limits and adjust your activity accordingly. Don’t let overexertion on a “good day” lead to a series of “bad days.”

Tip: Pay attention to the signals your body sends you and don’t try to push past your limit. Discuss any problems or setbacks with your medical team. Don’t wear yourself out trying to prevent fatigue!

Emotional Stress

Emotional stress can also contribute to fatigue. Injuries can change your everyday life in an instant. You feel a loss of control and the burden of adjusting your lifestyle during treatment and recovery. Long term pain can be emotionally as well as physically draining. Depression is a common, and serious, side effect of chronic pain. Depression can contribute to fatigue and fatigue can feed the powerless feelings that lead to depression. It’s important to break that cycle.

Tip: Do what makes you happy. Stay connected with family and friends. Continue activities that give you joy. If you find yourself avoiding the people and activities that you previously enjoyed, talk to your doctor right away.

Hidden dangers…

Finally, keep an open dialogue with your doctor about any new (or increasing) weakness or fatigue to make sure there aren’t any underlying illnesses or health conditions responsible. Don’t assume that pain alone is the culprit.

Here are some factors that contribute to the pain/fatigue cycle, and tips for how to break free:

Physical Stress

Use it or lose it…

Reducing your physical activity because of pain can weaken muscles and make you tire more easily. Talk with your pain management team and work out a realistic exercise and activity plan.

You don’t move liked to… you use

Play now, pay later…

Overdoing it can increase both pain and fatigue. Learn your limits and adjust your activity accordingly. Don’t let overexertion on a “good day” lead to a series of “bad days.”

Emotional Stress

Hidden dangers…

Not Just Hot Flashes…Joint Pain During Menopause

Among the many symptoms of menopause, an underlooked one is joint pain.

Women in menopause transition (perimenopause) and actual menopause often have more pervasive complaints: hot flashes and night sweats as well as pain or discomfort during sexual intercourse.

In addition, however, a significant segment of this population also experiences increased pain in joints like ankles and hips as well as back pain. Aches, stiffness and swelling around the joint and sometimes heat are typical symptoms of menopausal joint pain. These may be worse in the morning, improving as the day continues.

Why?

The presence of estrogen protects joints and as estrogen decreases in the body, it can contribute to some of this discomfort.

Prevention and Treatment:

Non-steroid anti-inflammatory medications like ibuprofen and naproxen sodium may provide relief but should be taken as sporadically as possible.
Stress increases all pain experiences, including these pain episodes. Decreasing life stress (sometimes impossible) can improve these pain outbreaks.
Drink enough water. Again, women who wake up in the night and go to the bathroom perceive that they should decrease their water input, but that is not the case.
Get enough sleep. Unfortunately, many menopausal women have interrupted sleep due to night sweating. This subset also became more susceptible to pain. Sleep is restorative, not only psychologically, but allows you to tolerate and even ignore minor pain outbreaks.
Women who exercise more actually had greater complaints about back pain. So, the answer is to change your exercise regimen to stave off back pain. Move away from running on hard surfaces and even treadmill work for a time and add in swimming and yoga and Pilates, at last temporarily.
Maintain an ideal body weight. Extra body weight puts more strain on all your joints. Menopause is a typical age when women gain weight. It is critical to eat nutritional food that doesn’t contribute to weight gain during this time.
Consider a calcium supplement.
Discuss hormone replacement therapy with your health care provider. This should only be considered if your symptoms are severe, as HRT adds a risk of breast cancer for many women.
Massage may provide significant relief to overall body pain.

Talk to us as you traverse the transition into menopause so we can help craft safe solutions to your everyday pain.

It’s Back to Walk Time in Michigan

When was the last time you had to shovel your front porch or scrape the ice off of your car? If it’s been more than a few weeks, then spring may actually be here in Michigan. It’s true that April snowshowers happen, too. But odds are that it is warm enough and the sidewalks and roads are clear enough that you can get back to walk.

If you’re a regular walker, you don’t need much preparation. Just lace up the shoes and get out there. But, if there’s a permanent dent on your couch since the fall, you might need to baby yourself before embarking on a walking program.

Here are some tips to get you on the road:

Try on your shoes. If you’ve lost weight or gained weight, the fit might not be right. Walk with them in the house for a while and determine if they are comfortable and in good enough shape.
Set the mood for your walk. If you need a partner, find one. If you prefer meditative walking, pick a time to walk when you won’t be bothered by landscapers, children, or lots of obstacles in your path. If you need music to motivate you, get your playlist ready. Or maybe you like podcasts or audio books.
Get your gear on. Do check the temperature and wind before you leave. It’s better to wear layers in order to stay warm and strip them off if you become overheated. If the temperature is below 40 degrees, starting off with a hat and gloves will be more comfortable, but you may want to take them off later. Wear sunscreen, sunglasses and even a hat.
Stretch and move before you walk. No more static stretches where you stay in one position and hold it before you walk; the latest science says that you just need to increase your range of motion and get your blood flowing for five minutes before exercising in earnest. This can be accomplished through toe touches, twists, arm circles, jumping jacks (which can be one-legged if the traditional kind is too taxing) and a boxer shuffle.
Hit the road. Walking is great. We all know how to do it and we have mastered it for a long time. Find a route that is safe and interesting. If you have no stamina, walk for 10 minutes and then turn around and go back. If this is your only exercise, try to work up to 30 minutes of walking per day.
Stay hydrated. Drink a bit before your walk, drink if you need to during your walk and drink again when you return.
Cool down. If your walk is vigorous, then walk at a slower pace before you stop exercising altogether. After your walk, you can do some of those static stretches including hamstring stretches and quadriceps stretches.
Evaluate, recalibrate and go back out again. Reflect on your walk. What was good? Did you think you wanted to be alone but then you were uneasy? Did you pick a road that had poor sidewalk conditions? Do the dogs on the corner annoy you? Change what didn’t work and hit the road the next time with the changes in mind.

Walking is America’s most favorite exercise. It’s easy, it’s cheap and requires no equipment. Walking is of great benefit for many conditions that cause pain. We encourage all of our patients to hit the road.

Exercising (Exorcising?) Your Pain Away

photo by Rudolph A. Furtado

Exercise is good for everybody, even people who struggle with pain. Exercise helps build strength, improves balance, contributes to feelings of well-being through the creation of endorphins and is a significant factor in maintaining appropriate body weight.

Researchers in pain management are circling around three exercises that show promise in contributing to a healthy lifestyle: Pilates, Yoga and Tai Chi.

All three exercise groups are beneficial because:

They include slow, controlled movements.
They don’t involve any sudden movements or jolts, meaning they are low-impact.
They encourage strengthening core muscles, including the trunk as well as limbs.
They help patients focus on breathing.
They often include quiet meditation.

Before you embark on any exercise program, check with your health care team. They will recommend the best practitioners and will also tell you what exercises and positions to avoid, like flexing your back or neck or certain positions that might put too much pressure on hip or knee joints.

Go visit a class or watch a video if you are going to exercise from home. See if the motions look doable to you. Meet with the instructor prior to attending and discuss your exact needs.

During any class or demonstration, follow your doctor’s orders. There is no longer any support for “no pain no gain” exercise regimens. If you are in pain, stop the movement; ask the teacher for some sort of modification or just sit quietly until the group moves on to the next task. On the other hand, do not shy away from a little exertion or a bit of a stretch. It is okay to break a sweat (less likely in Tai Chi, however.)

If you were an exercise lover before your pain episodes, these three exercise types may or may not be a perfect fit for you. For some, Yoga, Pilates and Tai Chi feel slow or contemplative. The music is quiet, but not peppy, and the pace can feel cumbersome. But taking a slow route back to health and wellness is a reasonable detour, before making your way fully back into more vigorous cardiovascular workouts or even weight-bearing strength routines, both of which are crucial components to a lifetime of physical fitness.

Just a Little Bit: Micro-Resolutions for Pain Sufferers

Photo: postmemes.com/meme/rearranging-my-new-years-resolutions/

Doing a little more and a little less.

These might be the components of successful New Year’s Resolutions for everybody, especially those in the pain community.

Why do people fail to stick with their resolutions? For many, their goals are too ambitious; it is too challenging to make massive changes all at once.

Instead, we encourage you to make incremental changes that can have staying power.

For pain patients, consider choosing from any of or all of these small changes:

Drink one more glass of water a day. First of all, the 8 glasses of water is a myth. For the most part, you should drink when you are thirsty and you’ll be fine. However, remember that water is the best drink with which to hydrate your body. So, consider substituting water for coffee, soda, juice or milk. If you drink no glasses of water a day, start with just one. Drink a glass of water before your morning coffee or with it or to replace your second one.
Be physically active for 30 minutes per day. This can mean parking five minutes from your office door, so you add ten minutes of walking. It can mean taking a break during the day to stretch or do light weightlifting. It can mean walking the dog for longer in the evening, or walking in place or doing calisthenics during your evening screen time.
Take 100 extra steps each day. It’s not much. But it’s a measurable and achievable goal.
Do one less thing that you currently feel obligated to do. Pain patients need to spread out their time of activity and reduce stress; it is critically important for pain patients. You’d be surprised what really doesn’t have to get done. hat church event that you have chaired…maybe it’s time to train your successor. The family dinner that you regularly host will be just as enjoyable if you don’t cook it yourself. The golf game at 7:30 a.m. isn’t truly mandatory.
Spend five minutes a day noting your physical and mental state. Keep a journal with old-fashioned pen or paper or in your smart phone. Keep track of how much pain you are experiencing from a scale of 1-10 (ten being the worst). Also jot down what your anxiety level is.
Keep a food and drink diary for one week. Lots of people have pain this correlates to certain food and beverages, but they can never get a handle on it, because they have no data.
Schedule one complete physical. Let your physician spend the time to go over all of your health issues and pain complaints.
Do one thing you enjoy. To heck with the rest of them. Whether it’s a movie that nobody else likes, a museum that you can’t get your spouse to visit with you, or going out with a friend whom only you like, just do something that makes you happy.
Get 30 more minutes of Go to bed a half an hour earlier than normal. Turn all the screens off, even if you depend on them to lull you to sleep and just relax in your bed until sleep overtakes you.

This year, resolve to make small changes that can add up to improved health, and we hope, to decreased pain.

Hip Pain Sufferers Should Hit the Water for Relief

New research on arthritis in hips indicates that exercise really can be beneficial and an effective component of a pain management strategy.

Many Americans suffer from osteoarthritis. The major body areas where osteoarthritis is prevalent are in hips, knees and in the back, as well as in the joints of the hands and feet.

People who are at risk for arthritis include older patients, those who have suffered previous injuries to joints, as well as obese patients who experience arthritis at a higher rate in knees and hips.

Recent research on hip pain from osteoarthritis was conducted at La Trobe University in Bundoora, Australia. The researchers, led by Kay M. Crossley, compared the pain relief of patients with hip osteoarthritis following water exercise as well as land exercise.

The water-based exercise appeared to give patients the greatest pain relief in the short-term and long term. The land-based exercise also gave some short-term benefit but did not appear to result in long-lasting pain relief. Both types of exercises were deemed far more effective than manual manipulation without exercise.

The best exercise program appeared to be at least twelve weeks in length, incorporating water aerobics and gentle swimming routines that are designed specifically for hip pain sufferers. The exercises targeted strengthening as well as increased range of motion. The participants participated in the program at least three times per week.

Although these research results would not appear at first glance to be ground-breaking, they are instructive. Many physicians are reluctant to encourage exercises to hip pain sufferers, urging them to rely on pain relief medications and manipulation first. Doctors are aware that not all hip pain sufferers will be willing to exercise. In addition, hip pain sufferers need to exercise with the guidance and supervision of pain management physicians, as well as physical therapists. The best scenario is coaching on specific exercises that can reduce the effects of osteoarthritis.

In general, the studies confirm that bedrest and inactivity are the wrong approaches to joint pain, which improves with regular physical activity and movement.

What’s the Best Exercise for You?

The short answer: The one you’ll actually do.

Your friends might love ice hiking, but if you hate the cold, don’t count on their exercise regimen working for you.

Answer these few questions to try to find what you will be likely to like and therefore do!

How fit are you? If you haven’t exercised in a really long time or are dealing with a recent injury or illness, you need to start off slowly and build up your endurance.
Do you have issues with knee, back or hip pain? If so, you should consult with your health care team as to what exercises will alleviate your pain and which ones should be avoided.
Familiarity breeds contentment or contempt? If you prefer to develop a predictable routine, then by all means find an exercise you like and don’t worry about doing the same thing every day. Maybe you can alternate two exercises. On the other hand, if you are easily bored by exercise, find ways to mix up your exercise routine. Pick from among several possibilities. Make it totally unpredictable and choose a number from a hat to see what you’re doing that day. If you exercise to TV programs or DVD’s, select a different one each day or choose something you have never done before. Go gym shopping and try out all kinds of fitness classes, even ones that are completely foreign to you.
Have your incorporated both cardiovascular exercises (the kind that make you breathe more heavily and increase your heartrate) and strengthening exercises? You need both.
What exercises do you know how to do already? Stumped? You know how to walk, so that’s one you can do, indoors or outdoors, weather-permitting. Add others to the list if you enjoy swimming, hiking, bicycling, dancing and stair climbing.
Do you like your social life and your exercise routine to be together or apart? Some people can only be motivated to work out if they feel their presence would be missed by others. They need classmates or workout buddies. Others find running alone to be a time to unwind and don’t want to be hampered by a running buddy, no matter how well-intentioned. You may be one of those in the middle of the spectrum: you can do you sit-ups and bicep curls at home, but a walk with friends sounds pretty enticing.

Really think about the answers to these questions and begin to craft a plan for regular exercise. Aim for 30 minutes of exercise per day as a starting point.

Get moving!

Avoiding Overuse Injuries

Sometimes our body aches because of the presence of disease, like arthritis or fibromyalgia or various headaches, like migraines. Sometimes, we are in pain because of injuries to the bones or muscles.

There are several common injuries that are typically the result of overuse, either from athletic pursuits, work routines or regular daily life activities. Overuse kind of sneaks up on you. It may start off as a twinge that goes away and over time develops into more constant or consistent pain associated with specific activities.

Frequently occurring overuse injuries are:

Shin Splints (Leg pain which worsens with running or walking)
Tennis Elbow/Golfer’s Elbow (weakness and/or pain inside or outside the elbow)
Runner’s Knee (pain behind the kneecap, made worse with running, walking, jumping, cycling and ascending or descending steps)
Rotator cuff tendinitis (shoulder pain felt when lifting the arms straight up or in a circular motion like a swimming stroke)
Plantar Fascitis (usually felt in the feet and ankles upon first waking up)
Achilles Tendinitis (typically presents as ankle pain)

Overuse injuries are the result of too much exertion, combined with muscle weakness. The major ways to prevent the above injuries include babying yourself a little bit by not hitting the same muscles day after day. When you work out, be sure to warm up before true exertion. Most importantly, after exercising or after a long period of working, take time to stretch and cool down. Be sure you are moving appropriately. Contact a coach or trainer to check your form or consult with a physical therapist to demonstrate what hurts and learn compensating exercising to increase strength, flexibility and reduce pain.

If you are trying to increase exertion or activity, do so gradually, not all in one spurt of activity. If you’ve led a sedentary life, you can’t go from sitting on the couch to running a marathon. Start by adding 15 minutes of exertion and add a maximum of 10 minutes per day.

Being more active is a great goal. Being safe and avoiding overuse injuries should also be a concurrent objective.

The Balancing Act

Having good balance is critical. You need good balance to function efficiently and safely. Sometimes injury and disease processes can impair balance.

There are two kinds of balance: static balance and dynamic balance. Static balance is your ability to stay upright and in good position while staying still. Dynamic balance is your ability to maintain proper balance and form while moving around (walking, exercising, transitioning from sitting to standing).

All adults, young and old, can benefit from exercises that work on strengthening and improving balance. Older adults, in particular, should tackle balance-increasing activities as they can help to prevent falls, which can be harmful or even fatal for seniors, and can lead to loss of independence and mobility. Balance issues can also impair athletic performance and daily living skills for all people, regardless of age.

Consider incorporating exercises into your routine that address endurance, strength, balance and coordination. Here are a few suggestions:

Sitting down and standing up without using your hands for support
Standing on one foot (you can do this holding on to something or not)
Walking on a line (or if advanced, a balance beam). To do this, you need to walk with one foot directly in front of another. You can hold on to a friend or a wall for support, if necessary, but try to progress to doing it unaided.
Leg Raises: Stand alone or behind a chair. Lift one leg at a time, first to the side and then to the back. Switch legs. (You can even do this while standing in line…ignore the stares of the other people, they are imbalanced.)
Tai chi is a slow, deliberate series of movies that emphasizes balance and gentle stretching.
Certain beginning yoga and Pilates moves also incorporate balance, but they often require strength. Your pain level may or may not allow these more involved calisthenics.

Please check with your health care team before embarking on any exercise program.

Fitting in Fitness on Vacation

Taking a vacation is great for your body and your soul. It is a time to connect with family and friends, to change up your routine and hopefully to escape from the chores and responsibilities that await you at home.

Vacations can come in a variety of shapes and sizes: a quick camping trip that is easy on the budget and forces you to uplug from the wired world and plug into nature and family, a trip to a resort that takes care of all of your needs and has entertainment and luxury all within reach, a trip to a favorite beach or mountain to enjoy a different vista and revisit familiar restaurants and fun activities, a busy sight-seeing trip, taking in cities and famed sites, and enriching youself through culture and art.

Wherever you vacation, you do not need to take a vacation from healthy behaviors, especially if your healthy habits also contribute to experiencing less pain.

One of the easiest healthy habits to continue on vacation is movement and exercise. If your vacation gives you a bit more time, than you can utilize the time to pamper yourself with enjoyable fitness activities. Here are some ideas as to how to stay fit on vacation:

Bring walking/exercise shoes, even if you have to take something else out of the luggage and leave it at home. Even if you don’t plan on exercising every day, not having the right shoes will surely eliminate even the possibility of exercise.
Sign up for walking tours. The possibilities are endless. There are dozens of walking tours in New York, Chicago, and cities everywhere as well as regularly scheduled easy to difficult guided hikes in national and state parks. Cruise ships often have city walks and rainforest/nature walks as one of their many offerings.
Swim every day! Access to a pool, beach or lake allows easy opportunities for relaxing movement that can also burn calories. Even floating is better than watching TV, but try to amp it up and at least tread water or better yet, swim more vigorously.
Check out the exercise room, but exercise caution. The state of cleanliness and repair can vary tremendously in workout rooms in hotels, cruise ships and resorts. Cruise ship exercise rooms are our favorites. They tend to be immaculate, and they often have machines looking out over the water. Hotel exercise rooms sometimes are just “meh”. If the equipment looks even the slightest bit dirty or worn out, take a hike and exercise outside.
Stretch out or do a little movement in your room. If you have access to Wifi, you have the ability to look at thousands of videos on Youtube on a phone or tablet. Fitness Blender has hundreds of free videos that range in length and intensity, so you can just stretch after a long drive or flight, or even carve out time for a 1000-calorie epic exercise session.

Vacations can give you the time to rejuvenate. Fitting in fitness ultimately will result in a more energizing vacation.

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Is Pain Making You Tired?

Physical Stress

Use it or lose it…

You don’t move like you used to…

Play now, pay later…

Emotional Stress

Hidden dangers…

Physical Stress

Use it or lose it…

You don’t move liked to… you use

Play now, pay later…

Emotional Stress

Hidden dangers…

Not Just Hot Flashes…Joint Pain During Menopause

It’s Back to Walk Time in Michigan

Exercising (Exorcising?) Your Pain Away

Just a Little Bit: Micro-Resolutions for Pain Sufferers

Hip Pain Sufferers Should Hit the Water for Relief

What’s the Best Exercise for You?

Avoiding Overuse Injuries

The Balancing Act

Fitting in Fitness on Vacation

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