Exercise & chronic health conditions... we can be friends!

As a health professional & personal trainer, I feel obligated to coach clients in a way that allows them to understand the difference between physical activity & exercise for long term health & benefits. This may be perception of pain through exercise, overcoming a fear of movement or even overcoming mental barriers to get out of the house & begin/ maintain an exercise program.

In todays’ world, we as trainers are helping a vast range of people to move & become active whom have a range of different backgrounds, chronic health conditions, mental health implications, injuries, pregnancy & rehabilitation statuses. We achieve this by working alongside current NICE guidelines to promote exercise & physical activity as non- pharmacological management (Lima, Abner, & Sluka., 2017).

So, why are the long-term benefits & management recommendations always overshadowed by opioids, complete ‘rest’, excuses to stop exercises & negative mindset towards physical activity as a management tool?

A (good) trainer should be able to adapt, refer out or plan & train the client who suffers from chronic health condition(s) {note chronic health conditions, not other medical/ conditions, unless in their scope}. A client with pain after pushing themselves through instructor based choreographed classes, HIIT fast paced classes with large numbers of participants or simply saying “they cannot exercise due to pain” is something which needs further investigation & they should seek out the help of a personal trainer/ allied health professional to differentiate between; pain & analgesia induced exercise (Lima, Abner, & Sluka., 2017). We don't need to fear monger people, we need to educate & assist them.

Current research confirms structured exercise to be an integral part of rehab for chronic conditions & pain with evidence showing a decrease in pain perception & increase in mood elevation after exercise, which is doubly beneficial due to chronic illness having a high association with depression & anxiety disorders (Glowacki, et al., 2017). Avoiding movement & conforming to a sedentary lifestyle shows higher; complication rates, co-morbidities, depression & use of health care systems/ opioids… so why are we still fighting for people to get moving?!

Sometimes, physical pain (let’s use a knee for example) can be helped through personal training (plus allied health as required) with different exercises, loading techniques & teaching the client how to engage muscles properly. Isolation work, alternative exercises & strengthening of supporting systems may be required to help ease this pain over a period of time (yes, it won’t be overnight or a magic quick fix), but to recommend complete disuse, heavy pain relief & avoidance of all exercise which may cause discomfort could be doing more harm than good.

When a fitness or allied health professional suggests exercise & physical activity to help someone with chronic health conditions & pain, they aren’t implying a person to be lazy or belittling their health issues. This suggestion is backed by evidence-based research which shows a positive change in attitude towards exercise & 75% improvement in activities of daily living tasks performed by individuals (Davies, 2019). So when they are making this suggestion, they aren’t trying to hurt feelings, they’re trying to improve them!

When asking if the individual has considered exercise to help their chronic health condition, overall, we’re thinking about the improvement in one’s quality of life. I know, as a trainer I would rather help someone move better, with as little to no pain as possible than to be told there is nothing they can do but ‘learn to live with it’. We need to get over the ‘common aging factors’ of ‘pain comes as you get older, it’s a way of life you cannot do anything about it’, or ‘my back & knees hurt, it’s just old age’, or ‘I have an injury, it can’t be improved’ etc.

To help improve quality of life without reliance on medical systems, waitlists for treatments & constant opioid use, GPs need to prioritise physical activity for chronic pain to help people move better in day-to-day life (Davies, 2019) & fitness professionals need to liaise with the medical & allied health professionals to create a better system & accessibility to the general population overall.

Awareness is key & education is important from all aspects. Client willingness to participate & change their mindset through education, movement & long-term goal setting is also of high priority. Fitness professionals being able to refer on when needed to allied health professionals, can benefit the client’s overall quality of life from something they may have thought they had lost.

As a passionate health care professional, I will always strive to do best by my clients & work with them to progress forward. Knowing not everything fits nicely into one ‘pre-packaged basket’ & no two clients fitness journey is the same, can make all the difference in someone’s health & fitness journey when working with them.

If you are struggling to be active, or maintain an exercise routine, or are not sure why things hurt when you exercise? Seek out some help from a trusted source to move forward… hell, to start moving at all! If a trainer isn’t sure how to help you or is out of their scope & wants to avoid working this area, if pain persists, ask for a referral to a physio, GP, sport scientist or other trainer to help you move forward instead of ‘standing still’.

Remember, we need to educate everyone; Physical activity & exercise is not limited to "drill sergeant boot camps" & HIIT classes that are "too hard, too much effort, not enjoyable for me" etc. There are literally millions of things one can do to be active & walking is one of the most underrated forms of physical activity out there. If your mind goes straight to a 'big box gym' when you think of 'exercise', we need to broaden that mindset!

Its not easy having a chronic condition, so it is important to keep presenting the overwhelming positive impact exercise & physical activity has had in people’s quality of living; both mentally & physically whilst also promoting appropriate times to rest, address the issue at hand & adapt as required. If you are struggling with something mentioned above & aren't sure what to do next, there is always help available, you may just have to take the first step & ask for it, but never be afraid to do just that!

Here to longevity, working with your body, not against it & to keeping active throughout life; how ever you can or enjoy doing!

Happy Friday.

- Shelley

Jurassic PT

www.facebook.com/jurassicpt.com.au

@smc_jurassicpt