Ask a Physiotherapist: Best MOVEment Activities for People with Pain (June 1, 2017)



  • Thanks for the ideas, @JeffJukesPhysio. For anyone interested in participating, check out our MOVEment Day page for more information or to make your own MOVEment pledge!

    @JeffJukesPhysio said:

    Thanks for the questions so far everyone. With MOVEment day coming up on June 11th, I wanted to follow up our discussions with some ideas for movement and activity that might be a bit outside the box but still great for getting the benefits of movement! Feel free to consider some of these:
    -table tennis
    -playing pool
    -dancing
    -bowling
    -rock climbing
    -water walking
    -dog walking



  • Thanks for the questions so far everyone. With MOVEment day coming up on June 11th, I wanted to follow up our discussions with some ideas for movement and activity that might be a bit outside the box but still great for getting the benefits of movement! Feel free to consider some of these:
    -table tennis
    -playing pool
    -dancing
    -bowling
    -rock climbing (indoor with a belayer)
    -water walking
    -dog walking



  • @JeffJukesPhysio I thank both Jeff & the Forum Moderator for your combined input. I'll check out the link(s) & go from there. Thank you again.



  • No problem @wannabepainwarrior. It sounds like you have taken some good steps to take charge of your rehab, so well done! As far as a possible next step for you, we do know that a multi-disciplinary approach to pain and long lasting physical and cognitive limitations is often a great path to take. Pain BC (the forum moderator) will post some options of places you can contact in this regard.

    @wannabepainwarrior said:

    @JeffJukesPhysio Jeff, I thank you for your response & your supportive comments & suggestions. Very much appreciated. What I find is that my level of injury & deteriorated condition is such that, although I have indeed repeatedly tried a self-constructed home-only rehab program, it has been & remains beyond my current capacity to manage sufficiently & to get any significant results. I do have movements that I do, but I have been progressively unable to maintain or increase them in order to maintain or increase my level of physical condition. This has included a minimal, decreasing exercise program from a local physio therapist. What I understand I am in need of is a professionally designed & managed pain & rehabilitation program (i.e. at a multi-disciplinary pain & rehab clinic). Could you recommend such a clinic in the Lower Mainland, or alternatively, the Okanagan?



  • @wannabepainwarrior It's great that you're trying to find more resources to help you. We're really glad to hear you're looking into the multi-disciplinary clinic route.

    You can find links to pain clinics around BC on the Pain BC website -- You can even filter and search by region. Just note - some of these services are private while others may be covered by MSP, but can have longer wait lists.

    @wannabepainwarrior said:

    @JeffJukesPhysio Jeff, I thank you for your response & your supportive comments & suggestions. Very much appreciated. What I find is that my level of injury & deteriorated condition is such that, although I have indeed repeatedly tried a self-constructed home-only rehab program, it has been & remains beyond my current capacity to manage sufficiently & to get any significant results. I do have movements that I do, but I have been progressively unable to maintain or increase them in order to maintain or increase my level of physical condition. This has included a minimal, decreasing exercise program from a local physio therapist. What I understand I am in need of is a professionally designed & managed pain & rehabilitation program (i.e. at a multi-disciplinary pain & rehab clinic). Could you recommend such a clinic in the Lower Mainland, or alternatively, the Okanagan?



  • Yes yoga is a popular one! Interesting fact about yoga is that there are (depending on who you ask) anywhere between 4-30 different types of yoga practice. Sometimes the typical yoga classes can be difficult for people with pain because of the challenge to the body. What you could do is research a gentle form of yoga to start with. Some of the gentle versions focus on easy, comfortable movements and breathing techniques (which we know helps with a sensitive nervous system in chronic pain) so this could be a good starting point.

    @lyc said:

    @JeffJukesPhysio I have another question: this one is about yoga. I've taken my relatives to yoga classes and noticed the class was way too hard for them, or they didn't know how to choose the right modifications in the class (they aren't very familiar with yoga). What do you suggest for people in pain who want to get into yoga?



  • @JeffJukesPhysio Jeff, I thank you for your response & your supportive comments & suggestions. Very much appreciated. What I find is that my level of injury & deteriorated condition is such that, although I have indeed repeatedly tried a self-constructed home-only rehab program, it has been & remains beyond my current capacity to manage sufficiently & to get any significant results. I do have movements that I do, but I have been progressively unable to maintain or increase them in order to maintain or increase my level of physical condition. This has included a minimal, decreasing exercise program from a local physio therapist. What I understand I am in need of is a professionally designed & managed pain & rehabilitation program (i.e. at a multi-disciplinary pain & rehab clinic). Could you recommend such a clinic in the Lower Mainland, or alternatively, the Okanagan?



  • @JeffJukesPhysio I have another question: this one is about yoga. I've taken my relatives to yoga classes and noticed the class was way too hard for them, or they didn't know how to choose the right modifications in the class (they aren't very familiar with yoga). What do you suggest for people in pain who want to get into yoga?



  • Another great resource is this Introduction to Activity Management article.

    @JeffJukesPhysio said:

    This is such a good question! This is something I hear from my patients very often. It’s so hard to move when you feel like you are doing damage or making something worse or it just hurts to do it! In this situation, it would be important to see your health care provider to determine if its safe to be moving. If, as a team, you are able to determine that its safe to move and you are not making any injuries worse or at risk of structural issues, then starting with a gradual exposure to movement plan would be best. Oftentimes, knowing and being reassured that you are not doing any damage can help us work with the fear of movement and progress to being able to do more over time. We also know that understanding your pain can help with feeling better during activity and knowing that its okay to be active and moving. There is a great video that really nicely sums up our current understanding of chronic pain. Relative rest is okay and important too, however long term rest can be detrimental to our health so we like to get moving once its safe!

    @Forum_Moderator said:

    Here's a question submitted to us in advance of today's forum discussion:

    When I start moving and exercising, I feel like I am making my pain and injuries worse, so why should I be moving when I feel better when I rest?



  • This is such a good question! This is something I hear from my patients very often. It’s so hard to move when you feel like you are doing damage or making something worse or it just hurts to do it! In this situation, it would be important to see your health care provider to determine if it's safe to be moving. If, as a team, you are able to determine that its safe to move and you are not making any injuries worse or at risk of structural issues, then starting with a gradual exposure to movement plan would be best. Oftentimes, knowing and being reassured that you are not doing any damage can help us work with the fear of movement and progress to being able to do more over time. We also know that understanding your pain can help with feeling better during activity and knowing that its okay to be active and moving. There is a great video that really nicely sums up our current understanding of chronic pain. Relative rest is okay and important too, however long term rest can be detrimental to our health so we like to get moving once its safe!

    @Forum_Moderator said:

    Here's a question submitted to us in advance of today's forum discussion:

    When I start moving and exercising, I feel like I am making my pain and injuries worse, so why should I be moving when I feel better when I rest?



  • Another great resource is Pain BC's Find a Practitioner page on the Pain BC website.

    @JeffJukesPhysio said:

    To answer further @wannabepainwarrior - It is certainly not easy to get back to exercising and moving with pain. A couple of important things to remember:

    1. Our bodies love gradual exposure to new things and new loads – what this means is with movement and exercise if we start really small (i.e. maybe a walk around the block) and then slowly and gradually build up the amount of movement then we are less likely to create a painful, protective response
    2. Again, start with something you like to do! Moving and enjoying what you are doing helps to release some of the chemicals inside our bodies that help us feel better!
    3. If you haven't been in touch with a physiotherapist yet, The Physiotherapy association of BC has a "Find a Physio" option on their website so that you can locate someone near to you.

    @JeffJukesPhysio said:

    Thanks for the question and for sharing your story @wannabepainwarrior. It sounds like you have been through a lot in the past few years. I want to congratulate you first of all for seeking out advice and options for managing your condition! What we know about starting a rehab program is that we need to start small and slow. Good general advice would be to start with a few minutes of some kind of movement/activity that you enjoy doing. After doing this you can typically start to slowly progress as long as you feel okay after the initial activity that you do - using a 10% per week increase can be a nice place to start. Remember that its okay to be a bit sore and tired after moving and being active as long as its nothing intolerable.

    @wannabepainwarrior said:

    Hi Jeff. Thank u for being here. I'm 55 and was T-boned in a bad car accident 9 1/2 years ago, had another car accident 4 1/2 years later, then a bad slip + fall on ice in January. Rural BC result: untreated, unmanaged traumatic brain & bodily injuries -- persistent chronic pain (fibromyalgia, myofascial pain syndrome, arthritis, bursitis), headaches, migraines, nausea, chronic fatigue, poor stamina, issues w/ memory, balance & dizziness, sleep, and being accident prone -- all of which obviously impedes my movement desires & plans. No rehab to date, sporadic pharmaceutical interventions. Ongoing progressive decline in function -- physically & cognitively disabled & unable to manage certain basic ADL's. Capacity for physical activity extremely limited & decreasing. Now walk with 2 canes. What would be your Top Best Things & a suggested Action Plan to get & employ more movement into my daily life?



  • To answer further @wannabepainwarrior - It is certainly not easy to get back to exercising and moving with pain. A couple of important things to remember:

    1. Our bodies love gradual exposure to new things and new loads – what this means is with movement and exercise if we start really small (i.e. maybe a walk around the block) and then slowly and gradually build up the amount of movement then we are less likely to create a painful, protective response
    2. Again, start with something you like to do! Moving and enjoying what you are doing helps to release some of the chemicals inside our bodies that help us feel better!
    3. If you haven't been in touch with a physiotherapist yet, The Physiotherapy association of BC has a "Find a Physio" option on their website so that you can locate someone near to you.

    @JeffJukesPhysio said:

    Thanks for the question and for sharing your story @wannabepainwarrior. It sounds like you have been through a lot in the past few years. I want to congratulate you first of all for seeking out advice and options for managing your condition! What we know about starting a rehab program is that we need to start small and slow. Good general advice would be to start with a few minutes of some kind of movement/activity that you enjoy doing. After doing this you can typically start to slowly progress as long as you feel okay after the initial activity that you do - using a 10% per week increase can be a nice place to start. Remember that its okay to be a bit sore and tired after moving and being active as long as its nothing intolerable.

    @wannabepainwarrior said:

    Hi Jeff. Thank u for being here. I'm 55 and was T-boned in a bad car accident 9 1/2 years ago, had another car accident 4 1/2 years later, then a bad slip + fall on ice in January. Rural BC result: untreated, unmanaged traumatic brain & bodily injuries -- persistent chronic pain (fibromyalgia, myofascial pain syndrome, arthritis, bursitis), headaches, migraines, nausea, chronic fatigue, poor stamina, issues w/ memory, balance & dizziness, sleep, and being accident prone -- all of which obviously impedes my movement desires & plans. No rehab to date, sporadic pharmaceutical interventions. Ongoing progressive decline in function -- physically & cognitively disabled & unable to manage certain basic ADL's. Capacity for physical activity extremely limited & decreasing. Now walk with 2 canes. What would be your Top Best Things & a suggested Action Plan to get & employ more movement into my daily life?



  • Here's a question submitted to us in advance of today's forum discussion:

    When I start moving and exercising, I feel like I am making my pain and injuries worse, so why should I be moving when I feel better when I rest?



  • @lyc It might be helpful to your family member if you helped them to fill out a Personal Action Plan to help them set goals for their movement. You could even be their "accountability buddy" so that they could check in with you about how they are progressing.

    If you need a little help creating the Action Plan, you can view this helpful video.

    @lyc said:

    Hi, I have older family members that struggle with chronic pain. I'm keen to support them to encourage them to move more, but I'm not sure what the best activities are for them. I've suggested some but they seem reluctant. Any tips? What can I do with them that helps them move in a way that helps them that we can do together?
    For example, even walking seems too difficult for one of my relatives.



  • @lyc Yes it can be a great family activity! Shallow water classes are an awesome way to move and exercise with the support of the water. If there is a pool in your area with warmer water (some community pools have this option) this can be quite comfortable when in pain too.

    @lyc said:

    @JeffJukesPhysio Thanks, appreciate the suggestions, and I agree that the pool might be a good place to start. Like maybe a shallow water aquafit class? I think that's something we could do together as a family!



  • @JeffJukesPhysio Thanks, appreciate the suggestions, and I agree that the pool might be a good place to start. Like maybe a shallow water aquafit class? I think that's something we could do together as a family!



  • Thanks for the question @lyc and good for you for helping out - we know that having a good support system around us when we are in pain can be hugely helpful. Perhaps asking your family members about things they have done in the past that have gone well or that they enjoyed doing might be a good place to start. We know that when the person in pain has good expectations going into an activity that this can be helpful with how they feel during the activity! Other options for when walking is hurting is to start with some chair exercises (i.e. marching while seated), or gentle stretches for the legs and arms while in the chair. Most of the things can be a joint activity where you sit facing each other and do the movements together! The other option that some people in pain like is go to the pool and do some movement in the pool - this helps take some load off the body when being upright and walking is hurting!

    @lyc said:

    Hi, I have older family members that struggle with chronic pain. I'm keen to support them to encourage them to move more, but I'm not sure what the best activities are for them. I've suggested some but they seem reluctant. Any tips? What can I do with them that helps them move in a way that helps them that we can do together?
    For example, even walking seems too difficult for one of my relatives.



  • @lyc Great question! It's wonderful that you're looking for ways to support your family members!



  • Hi, I have older family members that struggle with chronic pain. I'm keen to support them to encourage them to move more, but I'm not sure what the best activities are for them. I've suggested some but they seem reluctant. Any tips? What can I do with them that helps them move in a way that helps them that we can do together?
    For example, even walking seems too difficult for one of my relatives.



  • Good question as it's often difficult to know how to progress! Movement progression will always be an individualized plan, so speaking with a physiotherapist can help with choosing the right plan for you, however we can often use a couple of general rules of thumb:

    1. Pain should not increase much while you are moving or exercising
    2. It's okay to have some mild soreness or pain during activity
    3. You may feel tired during exercise and this is okay!
    4. Try and minimize long lasting pain after the movement or exercise – this can be done be tracking how you feel before, during and after movement or exercise. You ideally shouldn’t feel more sore or painful for the 24 hours after the movement or activity
    5. If most of these are happening then you are likely safe to keep going and eventually progress! If not, perhaps choose a different movement or activity and see if these rules work for that.

    @Forum_Moderator said:

    Here's another question from our community:

    If I start doing some kind of movement or activity, how do I know if its okay to keep going and then progress?


Log in to reply