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Increasing Activities Smartly

You are having less pain. Therapy is working. What activities, and how much can you do now? First, know that having less pain does not mean that all is cured. Tissues still need healing. It is often a dangerous time when you get feeling better. The temptation is to catch up on all the things that you have not been able to do because of your pain. Many a good result has been ruined at this stage when the patient does too much. Having less pain does not mean that tissues are healed and strong, nor does it mean that your body will handle much activity without causing a return of your pain.

However, some movement, the right kind in the right amount, is beneficial. So how do you know how much you can do? First, listen to your body. There will often be warning signs before your pain gets bad. Do not let your pain rise significantly. Remember also that your pain may be blocked, and for a while may not give you warnings. So, start with a little activity, such as walking. Do much less than you might think you can or “should”do, and forget about the three miles per day you did a year ago. Things have changed. You want to establish a baseline of activity that you can absolutely handle without increase in pain while you are doing it or afterwards. Then you know that you can increase gradually and slowly from this baseline. Doing too much at this stage, even with good intentions, causes a return of your pain, is quite discouraging for you and all those who are trying to help you.

Once you know what you can do without causing significant pain increase, then very slowly and gradually increase the activity. Let’s say that you start walking one block in five minutes, at a slow pace. You handle this O.K. The next day you walk six minutes. At some point you will begin to feel some discomfort. Back off a minute per day for several days, and then try the extra minute again. The body will strengthen and toughen if it is given the right conditions. Also remember that the body strengthens in the rest period, and not during exercise.

Then take this principle of establishing a baseline, increase gradually and slowly, and apply this to other activities, such as driving, sitting, standing, house cleaning, yard work and work. Your physician and physical therapist are here to help you through this very important stage.

The biggest mistake patients make when they are feeling better is to do too much too soon, and not listening to their body signals. It’s not enough to be tough, you must be smart. When you increase your recovery smartly the outcome is always a better outcome.

— Richard Fowler, P.T.

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