Pain, movement and exercise


The Pilates method teaches you to be in control of your body and not at its mercy” Joseph Pilates


Pain is normal

First and foremost, it is important to recognise that pain is normal.  It is a protective measure; a way of letting us know we are in danger of being injured or that we have been injured.  Pain is also an important part of healing.

Pain is defined as an unpleasant conscious experience< and is controlled by the body’s central nervous system, which is a network of nerves that connect the brain to the rest of the body to allow the input of information.

When a body part is damaged, nerve endings are triggered and send warning signals to the brain, which makes the body feel pain in that location, as a reaction to the body potentially being under threat. Protective behaviour commences, in order to minimize further damage and allow time for healing, and may include immobilization of the area, resulting in protective muscle spasm that causes us to avoid movement. Once the body part has healed, the nerves endings in the area should calm down and stop sending warning signals to the brain. The pain should cease, allowing us to return to normal movement and function.

However, pain doesn’t always equal damage. Sometimes, the central nervous system becomes sensitized, especially if the pain has been around for a while and it thinks we still need to protect the area, even though it has already healed and there is no more injury or tissue damage. This is what occurs in cases of chronic pain, where pain continues for long periods of time without any real source of continuing harm. In such cases, there is a problem with the pain processing system, not the body. When an area becomes sensitized, we can expect the pain to be felt sooner and more strongly, to the extent that even a minor, non-painful stimulus can trigger the pain response.

It has also been shown that emotional states such as anger, depression, stress and anxiety will reduce tolerance to pain. Although it is hard to believe, research provides strong evidence that a significant portion of chronic back pain is caused more by emotional and social factors than actual physical damage to tissues.



What about chronic pain?

Chronic pain states cause us to adapt the way we move and we may even avoid movement altogether, due to fear of flaring up our injury or causing damage. This is known as fear avoidance and is the main contributor to the continuation of chronic pain. A lack of movement feeds the pain cycle, making the pain worse and prolonging recovery.

Moreover, when we are told that our postures are causing pain or our movement patterns are dysfunctional, we begin to obsess about trying to adopt a perfect posture and create perfect movement, rather than just focusing on creating natural movement. There is no perfect movement or perfect posture – we are individual beings and our bodies are very good at adapting to the demands of our environment and the activities we engage in.

What you believe about pain can have a very big impact on your recovery. If you have helpful beliefs (e.g. that some pain is part of recovery, does not mean more damage, and that it is safe to move), then you are less likely to experience ongoing pain. If you have unhelpful beliefs (e.g. that hurt equals harm, therefore I am doing more damage by moving), then your recovery is likely to be slower and you will be more susceptible to developing persistent, or chronic, pain.


Movement, the answer to manage pain?

>Research has shown that movement and exercise are very helpful for reducing pain and improving function for people with low back pain and that it is a key component in a successful recovery.

One of the primary ways that movement can reduce pain is through the phenomenon of sensory gating or pain gating. This means that while your nervous system is processing signals resulting from active movement or touch, it has less ability to perceive and process pain signals. A good example of this is when you stub your toe and instinctively rub the area. In the same way, coordinated, controlled and mindful movement will reduce the perception of a painful stimulus and will relieve pain.

Improving your movement skills can reduce a perceived threat related to movement. Efficient movement calms a threatened, over-sensitized nervous system and reduces pain. Movement also helps to improve the circulation of blood and lymph, flushes away toxins, and lubricates and nourishes the joints, keeping them healthy.

Some other benefits of movement and exercise are: it helps regulate sleep patterns; reduces stress and anxiety; elevates your mood; improves immune function (your body’s ability to fight infection or illness); improves general health; helps with weight control, and helps to maintain brain health.

As Joseph Pilates said, “change happens through movement, and movement heals!”




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