In this post, we use two real-world examples to discuss how exercise can be both the cure and the cause of pain.
Exercise is universally promoted as medicine — but the same prescription that heals can also cause issues. The difference doesn’t always reside in the exercise itself.
Two recent real-world examples illustrate how dose and load determine whether an exercise helps someone feel better, or makes them feel worse.
The same exercises, performed too frequently
A new client recently started working with me. From the initial assessment and her first session, I was fairly confident on the areas that were holding her back from returning to running.
At the end of our first session I gave her 3 exercises with instructions on how often to use them before I saw her again.
The exercises made her feel good, so she increased the frequency — cue a concerned email several days later on how she now felt worse than before we started.
We discussed the importance of allowing time for her body to create an adaptation following the exercises, and how she had provoked a reaction rather than created any damage.
She’s now back on track.
Key point: the exercises didn’t change — the dose did. More is not always better; the right amount at the right time is what creates change.
The same exercise, two different outcomes
In another scenario, a client had returned from an extended break. After a brief assessment of where she was currently at, we went through a scaled back version of a programme we had previously used.
Her form was good and the exercises didn’t seem too challenging.
The result? Several days of muscular pain around her shoulder.
In a follow-up session we reduced the load further for this area and focused on a particular shoulder motion that seemed limited. She left with the pain significantly reduced.
Key point: the variable that changed was the demand placed on the system relative to its current capacity, which I had initially over-estimated.
Summary
It’s true, exercise is medicine. And like all medicines, the dose is key.
This includes frequency, load, speed, and the range of motion you’re working in.
In a system that’s signalling pain, a change in any one of these can create a response.
Tread carefully, respect what your body is telling you, and remember, even professionals make mistakes, so you might make a few too.
In the long run, it’ll be worth it.
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