Assessing your present activity level

Are you more or less active than you were a year ago?

If less active, how has your life changed? Write down any changes you have noticed in your notebook.

If more active, again write down any changes you have noticed.

Becoming less active can happen suddenly or slowly over time. Have you cut down on or stopped doing any activities because of your pain problem? If so, write them down in your notebook.

You may have noticed some advantages in reducing activity levels. Tick any that fit your own situation:

   Not having to take as many painkillers

   Having less pain

   Not having to do jobs or activities like vacuuming or making the beds

   Not having setbacks with pain

   Sleeping better most nights

   Moods remaining stable

   Others?

People in pain may find that they stop doing some activities or getting into certain positions – for example, bending to take food out of the oven. Sometimes this is done to reduce the amount of pain. At other times there is a fear of making the pain worse or even getting stuck in one position!

It is important to understand that moving more freely and loosely is more likely to get you back to your usual activities. Your body is designed to allow movement in lots of different directions. Moving will help your body cope with pain better.

TIP

Remember, the longer you continue to rest, the harder it becomes to get going again.

There may also be some disadvantages in reducing your activity level. Tick any that fit your own situation:

   More joint and muscle stiffness

   Loss of movement

   Loss of stamina

   Poor sleep

   Feeling tired

   Shortening of scar tissue

   Loss of muscle strength

   Mood changes, e.g. feeling down, low, frustrated or angry, as cannot do things

   Higher risk of osteoporosis

   Higher risk of developing heart disease

   Fewer endorphins to reduce pain and lift moods

   Returning to normal activities becomes more difficult

   Poor circulation of blood, especially in the arms and legs

   Poor sex life

   Others?

There are many myths about physical activity and exercise. How many of these have you heard before?

•   It has to hurt to do you any good.

•   No pain, no gain.

•   You need to go to a gym to get proper exercise.

•   You have to do a lot of it before you feel any benefit.

•   Exercise makes you tired.

•   You need special clothes.

•   Exercise damages joints.

•   Exercise will make your pain worse.

•   Others?

Frequently asked questions about increasing physical activity

‘WHAT DOES BEING PHYSICALLY ACTIVE MEAN?’

There are three components to being physically active:

Stamina: Being able to ‘keep going’ at jobs, hobbies and exercises.

Flexibility: Being able to use a wide range of movements, e.g. to reach down to put your socks on or reach into your back pocket.

Strength: Being able to do hard work, like digging, lifting or vacuuming.

‘WHAT IS FITNESS?’

Fitness means having the physical and mental ability to carry out the daily activities needed for work or leisure.

Increasing physical activity may mean following a planned exercise routine.

Consider which of the three parts of becoming fit and active you would like to work on. Do you want more strength, more stamina or more flexibility? You may even want all three!

‘HOW WILL I FEEL WHEN I START INCREASING MY ACTIVITY LEVEL?’

You may feel more tired at first, and you may develop new aches and pains. This is normal and will get easier with time. Initially, you may only be able to manage quite a limited amount of physical activity because of poor stamina and strength. Getting started and continuing every day can be a real effort, so remember to reward yourself (see Chapter 7).

‘WHEN SHOULD I EXPECT TO FEEL A CHANGE AS A RESULT OF INCREASING MY ACTIVITY?’

A change is usually felt within a few days and real improvement would be felt at three to four weeks. These changes get more noticeable, depending on what activity you choose, how often you do it and how long you keep it going. Slowly your fitness will increase.

‘HOW WILL PHYSICAL ACTIVITY HELP ME MANAGE PAIN, ESPECIALLY IF IT MAKES ME ACHE?’

It will:

•   Help you to do and achieve more every day

•   Lift your mood

•   Help you get back to work and hobbies

•   Improve your muscle bulk and strength

•   Reduce your joint stiffness

•   Improve your flexibility

•   Stretch scar tissue

•   Control your weight and improve your body shape

•   Improve your stamina

•   Improve your sex life

•   Improve your sleep pattern

•   Increase your bone strength

•   Reduce your blood pressure and risk of heart disease

•   Release your body’s natural painkillers, endorphins

•   Help you get through setbacks

•   Help you feel good about yourself

•   Help you gain more confidence to get on with your life

‘I’VE NEVER BEEN VERY ACTIVE SO WHAT CAN I DO?’

Increasing your activity levels and committing to getting fitter doesn’t have to mean running around a football pitch or playing tennis. Getting fitter can start at any age and from any level of fitness. There are many ways of increasing your activity levels to improve stamina, flexibility and strength, such as:

•   Using the stairs more often

•   Hanging out the washing

•   Standing up to do the ironing or cooking

•   Cycling inside on a static bike or outside

•   Parking the car and walking further to the shops

•   Walking at a faster pace

•   Taking a shower and stretching more

•   Doing exercises at home on a mat

•   Stretching to wash the windows

•   Dusting a room

•   Dancing to a favourite song

•   Getting off the bus two stops earlier and walking home

•   Playing hide and seek with the grandchildren

Apart from improving your fitness, there are a lot of other advantages to getting more active. For instance, you can get out more, meet new people, reduce your stress levels, take your mind off your worries, and lose some weight.

‘HOW DO I START GETTING FITTER?’

Imagine that your best friend is about to start a fitness programme. She has a pain problem. What type of programme would you suggest to her? Perhaps you would say:

•   Pace and plan it – little and often (see Chapter 8).

•   Set yourself short-term and long-term goals (see Chapter 6).

•   Use a timer – and stick to it. No extra minutes!

•   Record the number of exercises on a sheet or in a diary. Look back at it regularly to see your progress.

•   In the beginning it helps to choose a set time each day.

•   Don’t push yourself too far, too fast.

•   Gradually increase the amount you do over several weeks.

•   Stick at it but remember that changes take time!

•   Get someone else involved.

•   Find activities that you enjoy.

•   Don’t push through the pain.

•   Take adequate pain relief beforehand.

•   Reward yourself (see Chapter 7).

•   Put on some music or a video.

•   When the ‘feel good factor’ kicks in, don’t do more repetitions of an exercise or a few extra minutes.

•   Vary the types of physical activity.

•   Build in some exercises or activities to improve stamina, flexibility and strength daily. Simply get out of breath more often!

•   Think of the advantages of becoming more active.

What physical activity goals would you like to achieve? For instance, perhaps you want to be able to walk to the local shop? Use your goal sheet or your notebook. Then work out your physical activity plan.

You will probably need some strategies to keep you going and enable you to check your achievements. Here are some ideas. Tick those that you think you could use:

   Use a diary of activity goals. Include time to be spent on each activity and reward when you achieve it.

   Change your routine often, and remember to begin again slowly.

   Reward yourself often.

   Recognize and acknowledge your improvements.

   Accept praise and compliments.

   Work with a friend.

   Work on strength one day and stamina or flexibility the next.

‘WHAT ABOUT SETBACKS?’

Tick those that may cause an activity setback for you?

   Poor weather

   A pain increase

   Holiday

   Family crisis

   Work

   Childcare arrangements

   Fatigue

   Others?

Setbacks happen but it is important to understand why they happen, and see what we can learn from them (see Chapter 16).