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Writer's pictureMaya Phansalker

Do you have chronic pain? Maybe it’s time to rethink exercise.

As someone who has struggled with pain throughout most of my adulthood (although since working on it through mindfulness and other strategies, it’s more controlled and less frequent), I know how hard it is to be struggling with pain that limits mobility. And it can be very exciting to move a lot when pain is at bay. For the past few years, I have been doing intense HIIT workouts, going on long runs, taking long walks, practicing qi gong and lifting weights, sometimes doing two or three of these all in one day! It has felt great. This was all ok until I got pushed over the edge dealing with some personal family stress. It finally caught up with me and the past month or so has seen a lot of pain. At first, slowing down my movement left me feeling empty, gross and very alone. I was becoming convinced that I needed all that high intensity movement to feel ok.


What I’m beginning to realize is that as I took on a slower schedule at work (also very hard for me to do), I had been filling any space I had with movement. Of course, social media didn’t help, constantly telling me that I need to do more exercise and be fitter, stronger, faster, that as a 40+ woman, my metabolism is slowing down and movement will keep me acceptable looking. The problem is that movement creates stress in the body. It elevates cortisol and arouses the nervous system. For most people, this type of stress is good, and healthy people are typically good at pacing themselves. They know when it’s becoming too much and they have a good sense of when they need to rest. I don’t. I’m also a high stress person, I have trouble sitting still, not feeling some sense of urgency and I have difficulty pacing myself, and this is all despite doing 45 minutes of meditation every single day. My nervous system, although more regulated now then when I first started having pain, is stuck in a state of fight or flight.


When the nervous system is caught in a fight or flight response, it’s constantly on the look out for threats. Think about a gang leader who reacts with the threat of violence if you look at him the wrong way.



Even the smallest signal is taken as a deadly threat. This means that any little inflammatory process in the body can get interpreted as a real threat to physical safety. And threats to physical safety are interpreted by the brain as pain. Guess what? Exercise causes inflammation and very small micro-injuries in the body! So what might be just some muscle soreness for someone else, or even slight lingering inflammation from an old injury, becomes a source of chronic pain with that nervous system activation.


One of the privileges I’ve had in working with people with chronic pain in my psychotherapy practice is that I have learned a lot about myself. I’ve realized that most of my pain clients share this high intensity personality type, almost addicted to some stress inducing activity; be it high intensity exercise or competitive sport, obsessive cleaning, running around pleasing the unpleasable people in their lives, or some high intensity job. These folks, even when they aren’t in a high intensity job, will make it high intensity by not drawing limits on work hours or constantly saying yes. They will make relationships a people pleasing endeavor by constantly trying to anticipate the needs of others. They will make healthy exercise unhealthy by overdoing it.


Mindfulness can help lower the baseline activation of the nervous system, but with a hyper-aroused nervous system, the added stress of exercise won’t be managed with meditation alone. The underlying feelings of needing to move or work need to be managed in order to balance the whole lifestyle. The sad irony is that us high achieving, exercise addicted folks are often really good at operating at that level. We appear like we’ve got everything going for us. However, we often have a lot of trouble finding peace with balance and rest. Rest might make us feel gross, empty or alone. Recognizing and processing these feelings can be done through mindfulness, but it can be a real challenge without the guidance of an experienced therapist.


If you have chronic pain, or even a chronic illness, learning to balance exercise with other stresses in your life is really important. Maybe there will be times when high intensity exercise is good and helpful, but there will be other times when life stress combined with high intensity exercise is overwhelming to a hyper-aroused system. Instead of high intensity exercise, think about slow yoga, slow walks or just some peaceful time outdoors.


Learning to recognize these patterns in yourself may be very challenging, reach out for help with a therapist who is experienced working with chronic pain if this blog post speaks to you.



























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