Select Page

The problem of avoidance…

Blog Forums Exercise The problem of avoidance…

Viewing 15 posts - 1 through 15 (of 19 total)
  • Author
  • #15691

    A couple months back, I was listening to a report on NPR about chronic back pain. The researcher being interviewed reported that, in many cases, back pain was only made worse by excessive rest and inactivity. Even though it’s natural for the sufferer to avoid physical exertion when it causes pain, many patients became overly sensitized to the pain the more they tried to avoid it.

    Surgery often failed these patients, and the only way they could escape the pain was, ironically, by using their back more. When they stopped being afraid of exercise, they eventually controlled their pain to the level that they could function. They had to fight back and gradually build up their physical strength.

    Hearing this report was an “aha” moment for me, because I could articulate what I had been learning from experience: namely, that avoidant strategies are often self-defeating when it comes to chronic problems. When people with chronic pain are too protective of their sensitive body part, their pain may become worse. When people with chronic fatigue try to conserve their energy by lying in bed all day, their capacity for work becomes maladapted, and they’re even more fatigued than before.

    It’s amazing how quickly the body grows weak when it’s not forced to work. If you’ve ever seen how atrophied a leg becomes when it’s stuck in a cast for a couple of months, you’ll know what I mean. If you’re not fighting to keep your strength (from work, targeted exercise, or play), you’re probably losing it.

    It doesn’t seem fair that some people develop chronic pain and fatigue, while others seem effortlessly healthy, but I do think that avoidance can be counterproductive for the unfortunate people with chronic problems. For acute issues, rest and inactivity are often necessary while healing occurs, but if this inactivity lasts too long it seems that problems may just get worse.


    I posted this is in the exercise forum, but it’s also true that avoidance leads to problems with food. You can become lactose intolerant by avoiding dairy products, but in many cases you can also regain your tolerance by eating dairy and enduring a couple of weeks of gas. You become insulin resistant when you avoid carbs. And I hear that many vegetarians get a stomach ache if they try to eat meat, because they’ve lost the ability to digest it.

    One more example, while I’m indulging my tangents: Astronauts lose muscle and become weak because it’s too easy to move around in space. It seems our bodies need to be constantly challenged in order to thrive.


    Very interesting thoughts! It does seem like those who cut out food groups become more sensitive. Also, it seems that people who have fears in life and avoid those things become more paranoid over time.
    When you fall off a horse, get back on it right away or you never will. Not sure if I believe it but it does make sense.


    That is interesting and it makes sense to me too. When I started refeeding last year I basically stopped exercising because Matt had said it was important to rest plus I wasn’t seeing any results from it. Months later when I tried to start I couldn’t believe how hard it was to get back into it without crashing. I am sorry I stopped because I’m still not where I want to be. Sometimes my back goes out on me for no reason that I know of. I can’t do anything until it subsides except to try to walk around a bit to work the stiffness out.


    I was talking with an older gentleman the other day, and he has terrible back problems (probably normal degeneration, just 85+ years of it). He’s doing therapy, and that’s working wonders. But he also finds that if he goes for a walk AFTER a 30 minute ‘warm-up’ on a recumbent bike, he does fine. If he skips the bike ride, he can’t make it more than a block before he’s hunched over in pain.

    Use it or lose it… reminds me of the animated film, Wall-E, where the humans all had hovercrafts to ride… and were 300+lbs and unable to walk. :)

    I agree, there’s a difference between resting and healing, and rebuilding and maintaining… metabolism, health, muscle, etc. I think that can apply to just about everything.


    @Christina- You raise a great point about the psychological side of this issue. If we give in to our fears, then they may just get worse. Fear of ordinary foods is so common in the internet health community, and it’s sad to see how that fear take over people’s lives.

    @Linda- Sorry to hear about your back. I hope you can get your conditioning back and get rid of that pain. I also find a light walk can be helpful when I’m feeling sore.

    @Tina- I’s really inspiring that this gentleman has been able to fight back against his pain, despite his advanced age. There’s an older retired couple who I often see walking around the park near my house, and they can really move! Seeing strong, physically fit people at that age reminds me not to make excuses for myself when I feel discouraged. I don’t want to end up like the people from Wall-E (I haven’t seen it, but it sounds like a pretty accurate forecast for the future of our society).

    On this same topic, my wife broke her ankle playing soccer recently, and she just got her cast off today. I’ve been really impressed how she’s pushed herself to walk around and get her strength back. She won’t be playing soccer any time soon, but she didn’t allow the injury to turn her into a couch potato–though I probably would have. I think that healing requires the right combination of stress and rest.


    Thanks David. I have been having trouble figuring out how much exercise is enough & not overdoing. Man, I feel like I’ve gone down a rabbit hole since I started trying to recover metabolism & don’t know where I am anymore. By the way I also am glad you are back here & sorry about your wife’s ankle. Sounds like she is on the way to recovery already.


    I over did the exercise this week.

    I’m trying to get my tennis game back in shape – since I have a (casual) tournament coming up at a business conference.

    I hit against the ball machine for an hour last Friday, and again on Monday, walked the dog and did some yard work over the weekend, then an hour of yoga on Tuesday… and Tuesday afternoon I was COLD.

    I did take the dog for a casual walk (no jogging) Tuesday afternoon, and Wednesday (it was a BEAUTIFUL day out). But otherwise, no exercise, and my temps are coming back up again.


    Linda and Tina- It sounds like you’re both struggling to find the balance between exercise and rest. I think that’s perfectly normal, and in my opinion, occasional exhaustion and even minor injuries are the price of progress. The first several months I started exercising, it was often so painful that I vowed I would never let myself get out of shape again. Reconditioning your body sucks.

    If we want our bodies to get stronger, we have to give them a reason. Ideally, we could progress slowly and never suffer any setbacks, but in the real world even athletes overwork themselves and have to take time off sometimes. If we hold back because of fear of going to far, then we’re probably going to do too little.

    The same activity that puts you in traction today, will seem effortless in half a year or a year, but the only way to get to that point is to endure. “No pain, no gain” is a cliche, but I think it’s true. Obviously you have to rest when you overdo it, but the chances are, you’ll be a little stronger once you recover.


    i’m not much for the “enduring” anymore; that’s what most of my life has been, and while it’s probably built character, i’ve had enough of it.

    and interestingly enough, slow and steady also leads to gains. it’s the progressive challenge that does it, and the progress does not have to be huge. i’ve got a lot of mobility issues due to illness, giving up on exercise, and becoming more and more sedentary, and i watched some very interesting lectures by dr kelly starrett on how we should rebuild our bodies. he’s a physio therapist who works with a lot of pro athletes. when i started out i could not do a barbell backsquat because i could not get my arms back far enough without excruciating pain. i started working my shoulders with a series of light to heavy resistance rubberbands, then a PVC pipe, then a broomstick, and gradually my shoulders became mobile enough to no longer scream in pain. i hadn’t even noticed how my mobility had decreased over the years; if you had asked me, i would have said my shoulders are perfectly fine. you really do lose it if you don’t use it.

    quite often pro athletes are not actually all that healthy because they push themselves constantly. it’s interesting to see how the body adapts not only in old men who don’t move for fear of back pain, but also in young athletes who push themselves with bad form — they can end up with serious damage in parts of the body that didn’t evolve to do the things they unconsciously force it to do.

    i am definitely a convert of the “get back on the horse” school. it turns out that DOMS (delayed onset muscle soreness) which one can easily get from strenuous or unused-to exercise actually improves if instead of resting you give the same muscles a very slight workout the next day (just walking will do it). i was surprised to learn that this isn’t all in my mind, but there is an actual physiological effect happening in the muscles themselves.


    I don’t have the mental stamina that I used to either. My 20s were almost wasted because of chronic illness, and honestly I barely survived. In the end I experienced what I could only call, for lack of a better word, a complete nervous breakdown. I just couldn’t deal with the pain and fatigue anymore, and I fell apart as a person.

    There’s no way I could survive another ten years like that. The belief systems that kept me going were shattered.

    I might have sounded a little arrogant with my “no pain, no gain” pep talk in the above posts, but it’s not just braggadocio. It’s just necessity for me now. Every day when I go to the gym I remind myself that, even if working out sucks, the alternative is far worse. A little pain in the gym is much better than the pain of chronic illness.

    I’m totally with you about making gradual improvements, and I love your story about how you trained to do barbell squats. That’s exactly what I’m talking about. Set a goal, do what’s necessary to achieve it, and then enjoy how your body adapts to the new challenges. You could have given up when you realized your shoulders were inflexible, but instead you solved the problem by gradually improving your fitness. That’s awesome, and you should be proud.

    I still get some DOMS from squats and deadlifts, but it gets easier the longer I do the exercises. For the first couple months of squatting, I’d limp for a couple days afterwards. Now the effect is relatively minor. And I agree that doing some cardio the same day and the day afterwards is also helpful. The body can adapt to practically anything.


    it’s an “old school” message (i grew up with it), but you didn’t sound like you were bragging; it just seems to be your experience. if that works for you, more power to you — and it does sound like it is working well, congrats! you work hard and you’ve improved your life, and i think that’s awesome. some people get buoyed by triumphing over clear adversity, and pain makes adversity very clear — that sort of works for me in the intellectual realm, where i like hard challenges, so i understand.

    but it’s never worked for me physically where painful challenges demoralise me, and it kept me from exercising when i really should have (which i never knew to be anything but painful). “no pain no gain” is a message that scares off a lot of people and can lead to dysfunctional relationships with exercise, and i want to tell those people that it isn’t actually true. not all gain requires pain and not all pain leads to gain.

    i could have tried to force my shoulders with the barbell, and squat with horrible form. there was no shortage of people who tried to be encouraging by saying stuff like “if it hurts you know you’re really working it” and “no excuses!”. but i know that when i feel pain, it is a signal that i have pushed too far, and that i need to do something smarter than push through it. so when i did my shoulder rehab i was most definitely not going for pain. it wasn’t easy, my shoulders were aching, and i could feel that i had worked them, but it also was never actively painful. my weightlifting in general has not been painful. and i love it, in part for being pain-free. and it’s working; the best thing about lifting is that progress is so easily measurable.

    which probably explains why i’m still doing it months later instead of looking for something else, or falling off the wagon entirely. i’ve even started running (today i ran for 8 out of 30 minutes, a personal best for at least 2 decades), primarily to assess whether my lifting improves cardiovascular fitness (yup!). and for the first time since i can remember i didn’t hate it. my leg muscles have gotten strong enough so my ankles and knees no longer hurt (more proof that so much weight loss talk directed at me was so much bullshit). that made running FUN. i was huffing and puffing like a steam locomotive, but i was not in pain. that was totally amazing. and of course i want to do more of it.

    so if “no pain no gain” scares anyone, don’t listen to it. go for painless, slow, steady progress instead. it’ll also get you there; tortoise-style instead of hare. ;)


    I think no pain no gain could mean that you need to do a sweat driving and tough workout to get results. I don’t think it means actual physical pain that is bad for your joints or back. That type of pain is a sign that the person either isn’t fit or healthy enough or the exercise is not for them. I think a lot of unfit people push it too far. I think that someone overweight needs to just walk and lose weight before they try to take it further.


    For whatever it’s worth, I think that pain and discomfort are often confused.


    @David I agree with the avoidance even when it indeed seems unfair. Back in my Lyme-days other fellow Lymies were constantly urging me that I should rest,take naps etc.but I never felt like it and I think if I would’ve given in to it I would’ve probably completely fallen apart and dwell in the fatigue.
    But yeah,it’s hard for me to find a balance in resting&when to push through fatigue…..well actually finding&keeping balance in general in life.

    On a sidenote,I know you mentioned you run. I’ve signed myself up for The Urbanathlon in June organized by Men’s Health.(Yes,I like reading that magazine as a woman;))
    Even though I’m entering in the short circuit of 5-6km…..I’ve never ran/jogged in my life and now need to start with training to be able to run at least that amount of kilometers. (And then there’s the obstacles)
    The reason I want to participate is for one that I need some kind of goal to focus on in my life and second because I always felt fatigued,sluggish and not like running or any exercise in the past…and I’m also a bit clumsy at times. So,I want to prove to myself that I can do this….and hopefully it’ll be the start of many mudruns/obstacle courses to come,in other words a new hobby.
    Do you have any advice for a noob about how to start,nutrition,practical tips etc.

Viewing 15 posts - 1 through 15 (of 19 total)
  • You must be logged in to reply to this topic.