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Week 2

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Reason 2

Exercise Reduces Pain and Functions as a Pain Killer

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Pain can result from injury or inflammation. When there is pain in a certain place, the basic instinct is to not move that body part through fear of making the pain worse. However, in the long term, avoiding movement or exercise does more harm than good. The lack of movement will cause the muscles surrounding the body part to become weaker. The weakness will reduce the support the muscles are able to provide to the joints, therefore increasing the pain and risk of further injury. A vicious cycle sets in and needs to be broken.

The difficulty is that exercise can both cause pain and relieve pain. However, it is known that long bursts of unaccustomed activity are likely to increase pain, whereas regular and short periods of accustomed activity are less likely to have this adverse effect. In fact, prescribed exercise is an effective treatment for most painful conditions

[1]. The key is to slowly and incrementally increase the duration and intensity of exercise. Finding the right balance is essential.

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How is pain transmitted within the body?

Imagine a needle prick to the finger. Sensory organs in the fingertip recognise the injury and send the signal through a nerve cell called a neuron. It takes three neurons and two junctions for the pain signal to travel from the finger and finally reach the brain. A neuron is a long structure. The first of the three neurons involved in the transfer of the signal starts at the skin and runs through the body, stopping just inside the spinal cord. It then transmits the signal to a second neuron via a junction. The signal is transmitted through the junction using chemicals called neurotransmitters. Once the second neuron has received the signal, it then sends it to the base of the brain, where there is a second junction. After passing this second junction, the signal then goes through a third neuron from the base of the brain to the area of the brain which detects pain. It is only then that the brain recognises that a needle has pricked the finger, causing the painful sensation. It takes a long time to describe this process, but the transfer of the signal is extremely quick in real-time.

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The vicious cycle needs to be converted into a victorious cycle

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Ageing healthily – associated with consuming plant-based foods

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Along this path, especially at the junctions, the signal can be enhanced (amplified) or suppressed (dampened). This modulation of the signal is akin to how a drum can be made to sound louder or quieter. When a drum is struck, a sound is heard. Tightening the drumhead will increase the sound, whilst loosening the drumhead will dampen it. Similarly, structures within the brain can enhance or dampen the pain signal. In cases of chronic pain, the brain enhances the pain signal. This causes even mild touch to be felt as severe pain. However, the good news is that regular exercise can dampen the pain signal, reducing the severity of pain sensation.

Exercise functions as a painkiller

In addition, exercise also acts as a painkiller and mood elevator [2]. This may be occurring through what is known as the

endocannabinoid system [3]. It is well known that cannabis is a psychoactive

drug that contains the active chemical cannabinoid.

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Tightening a drumhead increases the volume of the sound. Loosening the drumhead will decrease the volume of the sound.

Interestingly, recent research has found that the body itself can produce substances that are similar to the cannabinoid present in marijuana. The substance produced by the body is called endogenous cannabinoid, levels of which increase with exercise [3]. This is how physical activity produces an elevation in mood or a “high”. This “high” might be the reason why some individuals get addicted to exercise. Cannabinoids, in addition to giving the “high”, also reduce the pain sensation.

However, there is no recommendation for the consumption of cannabis. Cannabis consumption is harmful to health. We are only discussing here endocannabinoids produced naturally in the body.

As stated earlier, the intensity and duration of exercise must only be increased slowly over a period of time. “Too much too soon” would be a “boom and bust”. With consistent, gradual increases, the “vicious cycle” can be converted into a “victorious cycle”.

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Too much too fast, will be a boom and bust,
But if the muscles sit and rest, the joints will only rust,
So, in your diary, find a space,
To exercise in any place,
A regular, consistent, and increasing pace
Will help you succeed and win the race.

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Metaphor 2 – My Back Feels Weak, Can I Make It Strong Very Quickly?

What is the story?

Patricia was late for work. She was worried about missing her meeting, so she drove above the speed limit down the motorway. She was caught by the police and fined for speeding. She ended up missing her whole meeting and had to pay the speeding fine.

So, what went wrong?

Patricia believed that the quickest solution to the problem would be to speed down the motorway. If she had followed the rules of the road and remained within the speed limits, she might have reached her workplace in adequate time and without the consequence of a speeding fine.

How can we relate this story to our health?

When patients first injure their back or any other body part, some are incredibly keen to get up and be active straight away. Activity is essential, but too much too soon is not good.

We need to pace ourselves to prevent further injury. It is essential to exercise in a controlled manner and gradually increase the intensity as our tolerance levels rise.

Moral of the story

After injury, too much too fast will be a “boom and bust”.

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Exercise Notes For Week 1

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“Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.”

“At vero eos et accusamus et iusto odio dignissimos ducimus qui blanditiis praesentium voluptatum deleniti atque corrupti quos dolores et quas molestias excepturi sint occaecati cupiditate non provident, similique sunt in culpa qui officia deserunt mollitia animi, id est laborum et dolorum fuga. Et harum quidem rerum facilis est et expedita distinctio. Nam libero tempore, cum soluta nobis est eligendi optio cumque nihil impedit quo minus id quod maxime placeat facere possimus, omnis voluptas assumenda est, omnis dolor repellendus. Temporibus autem quibusdam et aut officiis debitis aut rerum necessitatibus saepe eveniet ut et voluptates repudiandae sint et molestiae non recusandae. Itaque earum rerum hic tenetur a sapiente delectus, ut aut reiciendis voluptatibus maiores alias consequatur aut perferendis doloribus asperiores repellat.”

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Remember the traffic light system should be used when you exercise.
Please do not go through the red light or break the pain barrier!

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Short intro of encouragement to compliment the notes above.

Please now go to the video page and begin you exercise plan for the week.

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Head and Neck

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Lower Back

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Otago

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References

Sluka KA, Frey-Law L, Hoeger Bement M. Exercise-induced pain and analgesia? Underlying mechanisms and clinical translation. Pain. 2018;159 Suppl 1(Suppl 1):S91-S97.
Naugle KM, Fillingim RB, Riley JL 3rd. A meta-analytic review of the hypoalgesic effects of exercise. J Pain. 2012;13(12):1139-1150.
Watkins BA. Endocannabinoids, exercise, pain, and a path to health with aging. Mol Aspects Med. 2018;64:68-78.

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