Last week we discussed what pain is. You can refresh your memory here. This week the topic is about thoughts, beliefs and behaviour around pain. The reason this is an important topic to cover, is that it can influence prognosis. Hopefully you will find this article thought provoking.

how to break the pain cycle

Traditions and culture

Traditionally the advise around pain was rest. To some extent this advise it still out there and can be the accepted norm in some cultures. However, it is not necessarily the approach which will serve you the best. I know that this can seem tricky as you’re going against the advice you were brought up with. But the truth is that the research out there supports movement and activity to reduce pain over pain.

Pain breads Pain

In an initial injury there can be a need for rest and recovery. However, when something becomes more persistent and there is a lack of actual injury to tissues this changes.

When we are in pain we are often resistant towards engaging in physical activity. The thoughts around pain preoccupy the brain and the belief is that movement is going to exacerbate the pain. When this thought process is repeated it reinforces the belief system. Subsequently, our behaviour will be characterised by inactivity. Prolonged inactivity can lead to weak muscles, a sensation of stiffness in the joints, fatigue and low mood. All of these things can increase the perception of pain. As you can see we have entered a vicious cycle where pain is reinforced by our thoughts and beliefs. The results is unhelpful behaviours which don’t serve us.

Exercising when in Pain?

If we instead were to include some activity/exercise this will help to strengthen muscles, increase flexibility, reduce fatigue and boost mood. These are all things which can help reduce pain. It is a hard shift to make, but what we need to start doing is to challenge the thoughts and beliefs we have around activity and cause of pain. 

It is normal to feel some aches and pains due to exercise. These are not associated with harm to your tissue. DOMS (delayes onset muscular soreness) is a physical process which develop between 48-72 hours after exercise and can lead to soreness of muscles. It may last for a few days and some movements might feel more uncomfortable than usual. The main thing is that this is not a ‘bad’ pain. It is instead the effect of the muscles slowly getting stronger and adapting to change in load. As your body gets more used to activity the sensations will diminish and not be as present. 

Resist the temptation of going into an ‘all or nothing’ approach to exercise and activity. Instead start slowly and progress. We will discuss this further in coming posts, but the essential thing is that doing any physical activity is better than doing none.

There are different types of exercise that you can do. The most commonly discussed types are strengthening exercise, cardiovascular exercises and stretching. You can do these alone or combine them. In addition to this we have more strenuous activities such as gardening, walking and heavy house work such as hoovering which also count. The evidence out there does not necessarily specify one type of exercise over another. So pick what you enjoy, as you are more likely to stick with it this way.


Setting a goal can be helpful in addressing how you behave around exercise. Having a clear endpoint in mind with milestones to reach can be essential. I suggest you have a read of this article and then take a few minutes to create your own goal that is relevant to you. I would love to hear what your goal is, Why not drop me a line or comment down below?

Stay tuned for next weeks’ article in which we will discuss pacing and establishing a baseline.

If you want to a gentle start to exercise, please check out this free 7 day wellness program with gentle and short exercises to get you started.



Author: admin

Physiotherapist, Yoga instructor and Pilates instructor

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