In a recent conversation I had with a physical therapist who had been in practice for over thirty-five years, the most frustrating thing he had encountered was that only thirty-five percent of patients presenting for treatment of chronic musculoskeletal pain would do their prescribed exercises at home between therapy sessions.

Sixty-five percent would not. This is astounding! After all, this group of people was in the midst of suffering with debilitating chronic pain that was severe enough that they were prescribed a course of professional treatment by their doctor. 

What would explain why so many of them could not be motivated to regularly perform a group of what are relatively simple exercises that would relieve their pain and prevent future recurrences? Let’s look at some of the most common reasons and see if there are any solutions to them or at least some work arounds.

1. Cultural reasons: If exercising has never been a regular part of a person’s life, especially for people over fifty, it is difficult for them to start now, even in the face of debilitating chronic pain that is diminishing the quality of their life. Solution: Begin slowly. Try to devote five minutes each day to performing rehabilitative exercises. Keep increasing the amount of time until you are devoting enough time to be able to complete the entire prescribed regimen. Try not to backslide. If you miss a day, do not quit. Just pick it up again the next day.

2. “It hurts and I am afraid that by exercising, I will make it worse.” This is very logical thinking. However, despite being logical, it is wrong. If you do nothing, it will get worse. If one wants to get better, one has to find a way to confront the pain. Solution: Find a way to move the affected body part without increasing the pain. When first beginning, it may be that you can only move the body part a few millimeters and press only very lightly on the contraction spots inside the affected muscles. This is exactly what initial progress looks like. With daily repetitions, the body part will be able to move greater and greater distances without an increase in the pain.

3. “Maybe if I leave it alone, it will get better on its own and go away.” Just like reason 2, this thinking feels very logical. However, just the opposite is true. What current scientific research has shown, is that if the pain has not gone away in two to four weeks, it will not go away on its own and very likely will still be present months or even years later. Solution: A change in thinking will have to be made. A new attitude will have to be adopted; one that embraces sentiments that include the following: “I am entitled to live without chronic pain; I will do everything in my power to confront the pain; I will not get discouraged; and I will persist in trying to achieve this goal no matter how long it takes.”

4. “I can’t get down on the floor. It hurts too much.” Indeed, you may hurt too much and be too immobile to get down on the floor and get back up again. However, this is not a reason to do nothing. Solution: Every movement, exercise and application of pressure to contraction spots that calls for getting down on the floor can be done comfortably while lying on a bed.

5. And finally, the ultimate rationale for not confronting chronic pain: “I am a very busy and a very important person and I just don’t have the time”. Hmmm. Indeed, you may be! However, If you continue to neglect your chronic pain and continue to do nothing, you will find yourself becoming less “busy” and less “important” as your chronic pain inexorably robs you of your mobility, energy, vitality, sleep and your joie de vivre. Solution: Carve out the relatively small amounts of time from each of your busy days that is needed to stop the progression of the chronic pain. The  gains in the quality of your life are simply to great to be neglected.

One way to get started is to read The Book entitled, “A Way Out Of Chronic Pain, How It Happened and What To Do About It” [https://store.bookbaby.com/book/A-Way-Out-Of-Chronic-Pain]. This book will show you how to identify which muscles underlie chronic pain states in all of the major body parts, how to eliminate sites of shortening inside of them, how to lengthen them if they have shortened and how to relieve excessive tension inside of them. If you can accomplish these goals, you will have taken an important step in regaining lost range of motion and eliminating sources of chronic pain that may be affecting you.

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