Jake came in looking very distraught and defeated. “I know I need to lose weight, and exercise will help, but I’m afraid exercise might make my back pain worse.” I felt for him. He knew exercise would be beneficial for his health, but chronic back pain had kept him from pursuing many of the things he enjoyed, including the career he so desperately wanted. His greatest worry was that he might be “harming himself” and making things “worse” by doing certain activities. Adding insult to injury, he struggled to hold or rock his newborn baby to sleep because it “felt like knives were stabbing my back.” 

Maybe you can relate to Jake. Maybe your back pain has kept you from getting on and off the floor with your kiddos. You’ve also been trying to get back on track with exercise, but the last time you tried squatting, your back bothered you so much that you’re wary to try again. The word frustration doesn’t even do justice to how you feel. You're wondering, “Will I ever be able to get on and off the floor with my kiddos again without feeling like I’m 40 years older?” “Am I doing harm to my body by exercising if I’m in pain?” “Is there another method besides just pushing through it?” 

All fabulous thoughts. Let’s start by identifying what makes your body feel more or less comfortable. 

Garbage and Groceries

If your pain improves as you move throughout the day, or if a hot shower or hot tub makes your back feel ten years younger, that’s generally a sign your body is craving blood flow. 

Think of it like managing the basic tasks of living: getting groceries and taking out the trash. Why do you get groceries? To help nourish you and your family. Why do you take the trash out? Besides “because my spouse wouldn’t do it,” you want to get rid of the waste! Your body works the same. Your lymphatic system manages a lot of the by-products your body creates – garbage – and your blood vessels bring in a lot of the nourishment your body needs – groceries. 

Here’s the best part: within the body, you can take out the trash and bring in the groceries with the same thing: low-level movement. If only household chores were that efficient! Speaking of which, those chores that you get “tired of doing” are one of the low-level movements you can do to get your lymphatics and blood vessels moving. So, the next time you (or your spouse) doesn’t feel like taking out the trash, remind yourself (them) that you’re helping the body take out its internal “trash”.

When to “push through”

There’s great value in learning to “listen” to your body. But as we’ve discussed in previous newsletters, in the same way financial advisors wouldn’t have you check your retirement balance every day, you can “over-listen” to your body. I’ve been there and still am at times. But there are also times when the age-old mantra of “push through it” can be highly valuable. 

If your knee feels “achy” as you're warming up for squats or as you start running, that’s one thing. If, as you warm up or continue running, the whole garbage-out-groceries-in thing starts happening and it feels less achy, that’s promising. 

If your back feels “sore” when you first get out of bed in the morning, but after the first 30-45 minutes of your morning routine, it loosens up, that’s also promising. In general: If things feel better when you move, keep moving. 

When to proceed with caution

It’s one thing if formal exercise causes certain types of pain, but if even low-level movements (walking, getting out of bed, household chores) cause certain pains, that’s when you should seek support. What are those “certain types of pain?” Any pain that you would describe as “sharp, stabbing, or shooting,” I would advise staying away from whatever exercise or movement is flaring that.

“But Nick, rolling over and getting out of bed causes those pains. Did you just give me permission to not get out of bed and sleep more?” Nice try! All joking aside, I feel for you. When even those movements are extremely painful, life just isn’t the same. But know that that state doesn’t have to be your norm. There is a way out. Find someone or something that can help you not only identify what hurts – joint, muscle, ligament – but also why it hurts. They can also provide guidance on which postures to include or avoid based on your specific situation; for example, your back pain may only be “sharp” when you're hunched over folding laundry, so shifting to a more squatting pattern may help reduce stress on your lower back. 

Just as taking out the trash and getting groceries need to be done consistently to keep your home functioning, working on your body needs to be done consistently to keep it functioning. I know it’s easy to neglect things. “I’m not in that much pain, I don’t need to see anybody, it’ll just go away on its own, I’ll just keep pushing through.” All this may be true, but if your body’s giving you the signs of caution tape – sharp, stabbing, shooting pains – do something. Maybe come visit your friendly, neighborhood chiropractor.