Exercise and chiropractic
Exercise is for everyone
Exercise can be intimidating, It can feel out of reach for some people, they don’t know what’s right or wrong, or where to start… This may partially explain why only 45% of Australian adults meet the current physical activity guidelines! (1). This insight will take you through some strategies to improve your exercise adherence, what you can do when pain is stopping you from exercising, as well as the role a chiropractor can play.
When it comes to exercise, something is always better than nothing! So don’t feel bad if you’re unable to comit a lot of time to it. Exercise can mean a lot of different things and comes in all sorts of forms; it doesn’t have to be just going to the gym. We find it useful to not even call it exercise, because this may imply that it needs to be structured and performed in a certain way – which is definitely not the case. So, from here on let’s just call it activity!
To illustrate this point here are some activities that we still consider exercise:
- Walking the dog
- Playing with your children
- Dancing
- Gardening
- House work
Most people understand all the positive effects of activity on our physical, mental, social health. But just like we know we should be eating better and getting more sleep, it’s hard to change habits when they’ve been there for a long period of time. Let’s work through some strategies to help you stick with it.
If you’re unsure how your current levels of activity compare to the recommended guidelines, check them out here:
Building habits and maintaining adherence
The cornerstone of finding the right activity for you is pretty simple – you need to enjoy it! This is probably the most important factor in maintaining adherence, the less it feels like a chore or something you ‘have’ to do, the better! This can be enhanced by building a social network for your activity. This can be done is multiple ways:
- Joining a sports club or gym with classes
- Participate in community events such as Parkrun (https://www.parkrun.com.au/)
- Encourage a friend to join you and keep each other accountable
Another way to make sure you stick with it is to base your physical activity around a goal, something to work towards. This may be something activity related like wanting to run the City to Surf event, or it could be something different like being able to get up all the stairs at work without stopping. But when you make a goal, it’s important to make sure it’s a SMART goal!
Specific – “I’m going to go walking on Monday, Wednesday and Friday”
Measurable – “I’m going to walk 1km this week, then 1.5km next week”
Achievable – “Based on my current fitness, it’s very possible for me to walk 5km”
Relevant – “I’m walking more so it’s easier for me to play with my grandchildren”
Timely – “I’m going to be able to walk 5km within 6 months”
“But I’ve got no time to exercise”
Lack of time is probably the most common barrier to staying active. Although we can’t give you more time in your day, we can give you some tips and strategies to implement more movement throughout the day. Again, activity doesn’t have to be all done at once, or be structured perfectly in order to be effective! Here are some examples:
- Micro breaks at work – getting up every 15-20 mins
- Walking meetings
- Take the stairs instead of the elevator
- Take a yoga mat to the office and take 10 mins during the day to stretch
- Park an extra block away from work
What about when pain stops you?
Another barrier that stops people from being active is pain. Be it acute pain (short term) or chronic pain (long term, see last month’s insight – https://www.dmchealth.com.au/how-to-manage-chronic-pain/). Naturally, we’ll do less on the days we’re in pain, and more on the days we feel good. However, this may lead to a phenomenon called the ‘boom-bust cycle’ (figure 1) and will likely lead to less activity over time.
Figure 1. The boom-bust cycle
As you can see, the pain will start to come on earlier and earlier until we struggle to do any amount of activity without pain! One way to combat the boom-bust cycle is through activity pacing (figure 2).
Activity pacing
The goal of pacing is to find your baseline for a certain activity, and slowly building your capacity over time. Once you’ve identified what activity you want to work on, use the process below and think about some ways you can implement them.
- Set a goal
What activity do you need/want to do? E.g., To be able to walk down to the shops without stopping (20 mins away).
- Work out a baseline
Figure out what you can currently do without flaring your pain. Maybe you can only get half without before you need to take a break? That’s your baseline (10 mins).
- Repeat your baseline daily
Now you know your limit, take 20% off that to give yourself a buffer (8 mins) and repeat this as much as you can.
- Gradually increase over time
Try to increase by 10% each week, until you’ve reached your goal. Figure 2 shows how even on ‘bad days’ you can still do your baseline amount but be sure not to overreach your target on your ‘good days’ as this may put you back into the boom-bust cycle!
Figure 2. Activity pacing
If you’re struggling to think of ways to modify your activity, here are some examples of different variables to think about:
- Frequency – how long, how far, how many times per week
- Intensity – how quickly you walk, how many breaks you take
- Environment – walking on grass vs road, hills vs flat ground
The role of the chiropractor in exercise
In an acute episode of pain, it’s difficult to do any activity, as our nervous system is over protective. It can also be a scary time if you don’t understand why you’re in pain, or your concerned that exercise will make it worse.
Figure 3 shows how we approach treatment. The orange ‘passive care’ line indicates hands on treatment like spinal manipulation, massage, dry needling. These can be great way to reduce your symptoms to decrease your pain, improve your quality of movement and give you more confidence to start activity again. The green ‘activity’ line indicates how we gradually incorporate more rehabilitation such as mobility and strengthening exercises over time as you progress.
Figure 3. Passive to active care continuum
Ultimately, our role is to encourage physical activity in all its forms, breaking down barriers to it, and keeping you moving the best you can.
References
About the Authors
David McNaughton is a clinician and a researcher. He is the director and principal chiropractor at DMC Health & Wellness. He has an extensive background in the diagnosis and management of chronic pain. In addition to his clinical studies, David holds a Master’s of Research and PhD in Psychology. He regularly publishes his research in peer reviewed medical and psychology journals. David has taught both undergraduate and postgraduate studies in Chiropractic and Psychology at Macquarie University.
Isaac completed a Bachelor of Chiropractic Science and Master of Chiropractic at Macquarie University, and is currently enrolled in a Master of Research. His research aims to understand the clinical decisions health practitioners make about diagnostic imaging. His clinical interests include spinal pain (neck and back) and sporting injuries. Regardless of the condition, his goal as a chiropractor is to work collaboratively with patients.
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