Pain and Physical Activity

I'd look at people walking down the street of somewhere and I'd think… God I wish I could do that.

I mean… if you can walk without thinking about it, if you can stand up and walk… walk out the door without thinking about it you don't realise just what a great thing it is, to be able to be mobile like that.

The pain that I experienced stopped me doing a lot of normal day things it stopped me, um… it stopped me going out to, just hopping in the car straight away and going around and getting some groceries because the energy that it took was just too much to do that.

I'm the type of person that is flat out.

I've always been flat out, I've always, I don't sit still, very rarely.

I'm just out, flat out.

Um… and then this has just sort of all crashed on top of my life and sort of the pain controlled me being able to doing physical stuff and, um… I've always been the type of person that I can't stop half way through something and sit down for a little bit.

I've just got to go do the whole lot and then at the end of the day crash.

Yeah well I was a very active person but after I hurt my ankle I was unable to, we used to a lot of walking and that sort of thing and no way could I do that and another thing I found it also restrictive in what I could do with the grandchildren before I broke my ankle we'd go out for the day, we'd walk over the harbour bridge, we'd come back home.

After I broke my ankle there's just no way I could anything like that again.

A lot of people who have chronic pain find that they've become quite physically inactive.

Now when you have acute pain yes it's important often to rest but when you have chronic pain resting is really not very useful and so it's important to get yourself going again, get yourself moving again.

Now there's a number of reasons for this.

First of all you need to keep your muscle strength, your muscle tone, if you don't use your muscles then you loose strength.

You want to keep your flexibility and it's also important for your cardio vascular health.

Now the other reason that you want to be active is when you’re… when you’re exercising your body releases endorphins which our bodies own natural pain killing medications and so with doing that you actually find that your pain levels will drop.

It also improves your mood and your general sense of well being.

And just remember when you're exercising pain doesn't always equal harm.

When I do water aerobics regularly I find… my pain, everything is a lot better because your muscles are looser and it makes, well, all movement so much easier.

I found the way I walked even everything… improves when you are doing these exercises.

Physical activity is really important when you've got chronic pain.

If you haven't been moving for a little while it can be very scary and doing a self assessment is a really good idea.

There's four things though that you probably need to have a think about before you just launch straight into it.

Am I able to do strength activities? Am I flexible enough? What's my balance like? And is my cardio vascular fitness good enough for me just to do this on my own? If you assess all those things and everything is good then your right to go.

If you do these assessments and your worried about any of them then I think it's a good idea to talk to your GP.

We do something that's called setting a S.M.A.R.T. goal.

So S.M.A.R.T. goals have got some steps around it and it starts like this… Specific… it's Measurable… it's Achievable… Realistic… and it's got a Timeframe on it.

So when we come back to specific what is it that you might want to do? You might have a dog that is getting fat and lazy and you want to take him for a little bit of a walk.

You think that's what I want to do, my dog really wants to walk, I want to walk with him.

Is it actually something that you can measure? sure it is.

Am I able to take the dog for 5 minutes? Am I able to take the dog for 10 minutes? is it an achievable thing? You think, yep, I've got a dog, I've got a lead, I've got some shoes, I can afford that, that's going to happen.

Realistic? Maybe walking all the way around the block with the dog might not be realistic and you might think I'll just bring it back and I’ll take the dog to the end of the street.

and the timeframe's important.

With a goal if you can set a timeframe on it, it's more likely to happen.

I want to get back on a bike and start riding.

Now to do that I've got to… get my body strong again so I've got to start strengthening muscles so what I decided to do was to join a physio class for strengthening and… in doing that I'm getting stronger and hopefully I'll be able to then get back on the bike but it's having a little bit, each time I go there, I have.

I get longer and longer on the exercise bike which I'm able to do.

But it meant that I had a goal or something that I wanted to do and break it down.

I'd really like to tell you about pacing.

It's a very very good strategy for people with chronic pain.

When you've got an activity to do that you can't change too much this is a skill that can really help you.

A good example might be going to the movies.

Pacing then is about planning.

It’s about going I've got this activity to do, it's an hour and a half, how can I break that up and keep it comfortable for me? I might be able to sit down for the first 20 minutes and I'll use my timer and I'll think that's my comfortable limit - I've self assessed that's where I'm at.

After 20 minutes you might stand up and actually stand in the aisle for a little while, maybe lean against the wall, maybe do some stretches, and then I'll be able to sit back down again.

I got a little egg timer and, um… I used to put in three minutes at a time, and I'd do something for three minutes and then I'd rest and, for like maybe a minute.

Trying to completely switch my brain off, which is quite difficult, but just by doing it by breathing exercises, just breathing in and out and just… just taking a step back.

Then I'd get up and do something for 3 minutes and then I'd, you know, rest for another minute and… being a person that was always flat out and had to do everything that was killing me because I had to learn to pull everything back because if I was going frantic and doing all these things I couldn't walk, I couldn't function, whereas when I paced out and I learnt to just have that minute, like when the pain starting to hype up I'd just pull back and let your body relax again.

whereas when you're all tightened up and you're still pushing your body that's when the body gets more stressed and your pain becomes more heightened whereas… when you just take it back that little bit more, um… and I mean you don't have to sit on three minutes forever, I’ve… I mean I’m up to an hour and a half where I can stand.

There's a couple of other things though when you're getting active that you need to have up your sleeve and one of them is having a flare up plan.

when you're not being active for a while it's really quite scary that you actually get going and the next day [breathes in] the pain is so flared up that you actually just want to get back on the couch again and never move again.

And having a flare up plan you think “Oh, I thought this might happen but I've got my plan in place I'm just going to cut my activity back.

When I had the flare up I rang in and said that I wouldn't be to work where I would help out, um… that I wouldn't be there for a week and I went to the physio, um… I went and had more x-rays to make sure that I didn't do any real damage Um… and then I went onto a maintenance plan, a flare up plan for myself and that was to rest more, to stop doing all the therapies that I was doing at that actual the time, so the last two weeks I took off a lot of the therapies, just went to a physio to make sure that the muscles were still going and there was no damage being done.

I do lots of hot baths, I did lots of icing… you’re putting ice on the different joints, um… lots of time, spend quality time with Poppy so that I changed for my body to breathe to breathe through the pain that I experienced.

That's the thing that can happen if things don't go well - the other plan that's worth having is actually when things do go well.

I actually want to have a plan that now allows me to upgrade.

Each week you're going to go a little bit further than you did before not ramping up too quickly, likely to lead to a flare up, so just slow incremental steps on your way.

That's a good start to getting going with your physical activity.

This one day Rebecca said to me, she said, “Gavin why don't you stand up and walk over there?” I looked at her and I said “I can't do that, I can't walk over there." and she said “Just walk over there… leave your sticks here and walk over there.” and of course I did you know, I walked like a duck you know, flapped my arms, something like that, but I walked without the sticks and that's the first time I'd done that since the accident… my accident where I broke my femur and um… I went home that day and I said to Bev, my wife, I said um… “I’ve been walking without sticks” and then every night before I went to bed in the, in the… corridor upstairs, I'd walk up and do… “I did 45 steps walking without my sticks last night"and the group would go, “Oh good boy, you've done very well…” and I well I think I'll do 50 next time, so that's the sort of thing I did.

So physical activity is really important and you've done some hard work: you've set a goal, you've self assessed and you've put it on your plan - all of those bits of information are on this fantastic website and I hope that you can put it together and get started.

If it's a bit of struggle for you, get yourself a team, see your GP, practice nurse, physio or exercise physiologist - they're great people who can help you.

You can do it.

Even if it's difficult and you're not sure, just get started and begin and then you'll soon feel that you're really on top of things.

When you're in pain the worst thing you can do is stop.

You need to keep moving to keep everything going because if you stop everything tightens up and everything gets worse, but if I'm watching TV I don't sit down for the evening and watch TV - that's the worst possible thing you can do with pain.

You need to get up and wander around and then come back and sit down.

But if you sit down all the time you're going to be worse off than if you do a bit of moving around.

Now is a great time to fill out the physical activity and flare up section of your health plan.

If you haven't already done so click on the health plan button below the video and download the PDF.

Print it out.

After each video fill out the relevant sections.

You only have to fill it out once.

Take your completed health plan along to your GP or your health professional.

This is a great starting point to managing your pain.