08/12/2024
How much exercise is too much?
A lot of my patients ask me this question. “How do I know if I’m doing too much?” - it’s a tricky balance to find. Too much and the patient risks injuring themselves further, too little and there’ll be no pain-related benefit in doing the activity/exercise. The most common pattern I see is a patient doing too much and making their symptoms worse, and then going cold turkey and regressing to a point of deconditioning.
So how do we find the sweet spot?
To start we look for a level of exercise that is well within their normal regimen but also non-pain provoking. For example, if a runner normally does 30 miles per week, and their symptoms don’t come on until after 5 miles of running, then we can normally assume that running 10-15 miles per week in no more than 3 mile chunks is relatively safe. A good rule generally, is no more than a 2-3/10 pain level (be honest with yourself!).
Next we look at progressively overloading the patient. If we’re able to sustain 15 miles per week pain free, then gradually increasing week by week to 17 miles, then 20, then 23 and so on so forth is a safe, sustainable way to get the patient back to their normal activity. Starting small and building gradually is the safest way to go about things. Gradually increasing load for 3 weeks, and then regressing for 1 week allows for a safe and steady increase.
If even minimal activity is causing a flare up of symptoms (e.g. even 60 seconds of running), then a short cessation of activity may be required. This is where alternative cross training can be really useful. What activities can you do pain-free? These can be implemented alongside treatment so as pain and symptoms reduce, reimplementation of exercise can increase.
This can be adapted to all patients, sporting or non-sporting.
For more help & a tailored rehab/treatment plan, don’t hesitate to book in for a consultation at rejuven8 health hub
