Chronic pain and exercise and why I went to my physiotherapist for help

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woman lifting barbell
Photo by Leon Ardho on Pexels.com

OK, so I wanted to start doing more resistance training again.   Currently my resistance training is my dogs pulling on the leash when we go walking. While that certainly does give me a solid upper body workout, it’s not consistent, nor conducive to gradualling building strength and capacity.

I also do archery, which is also a great upper body workout.  I usually shoot about 4 times a week, with a recurve bow.  It’s also great fun. My bow is about a 36-pound draw, so I am reasonably strong.  Possibly, more accurately, ‘reasonably strong for someone living with multiple chronic illnesses’. 

I do tire quickly, though.  Part of the reason I want to do a proper resistance training program is to get stronger for archery, so that I can shoot longer, have longer archery sessions.    To build my stamina and increase my strength.  If it’s easier to pull back 36 pound bow, I’ll be able to do it for longer. Maybe I’ll even be able to go every day.

So that was the thinking. 

I started two weeks ago, and I created a very easy program for myself.

Here’s what I did.

Upper body exercises

All exercises are 3 sets of 10 reps.

Bench press                                    –                           15kg

Bent over dumbbell rows             –                           8kg

Seated shoulder press                  –                           3kg

Bicep curls                                      –                           5kg

Overhead Triceps extension        –                           5kg plate

Lateral raises                                  –                           3kg

Lower body exercises

Goblet squats                  bodyweight to sitting level and stand up

Dumbbell lunges             bodyweight 

Romanian deadlifts        20kg

Calf raises                         bodyweight

Dumbbell step ups          bodyweight

My upper body was fine. I was barely even sore. But it is a very easy, lightweight start.  That was what I was aiming for, and I got it right for my upper body.

Now my lower body was a whole other thing.

I woke up at around 1am that night in horrible pain. And I mean *horrible*.  It was electric, diffuse, horrible pain all through my legs. I’ve heard others call it an ‘electrical storm in my muscles’ and is a great description.   A painful electrical storm.

I couldn’t control my legs, they wouldn’t do what I wanted.  Or they would…eventually.  Response was slow.  Talk about ‘lag’.  Standing was near impossible and walking was impossible, until I figured out my legs were responding, just very slowly.

I sat on the stairs and lowered myself down on my butt. I did not feel safe trying to walk downstairs.  I scooted on my butt, but it was the slowest ‘scoot’ you ever did see!  It was more a painful, slow, lowering of my body, one step at a time, with most of my weight on my arms.

Thank the gods for still having good upper body strength!

This was all a great big shock to me. I did not expect to respond this way…I guess this is what happens when you over do it when you have CIDP. I know how inflammatory arthritis responds to exercise, and too much exercise.  But this neuropathic pain? This is new. A surprise. And not a nice one.  But its all a learning experience, isn’t it?

I took my usual pain meds, opioids, and the pain reduced a little.  But it was still unbearable. I took another dose.

Long story short, I was in agony all day, unable to do anything.  The next day was an improvement, but I still spent most of the day lying down. I wasn’t able to work or get my orders out. It was the first time that I have NOT gotten orders out inside of 24 hours.  I pride myself on getting my orders out FAST, so that was a big hit to me. I am NOT doing that again!

Day 3 my legs started to feel more normal. I was walking normally; my legs were responding on normal time.  Before I felt like my upper body was leaning forward and my legs were catching up, far behind. Very odd sensation and very unpleasant.   Now I felt like I was walking normally, if a little more slowly.

Note, this is NOT muscle pain from overdoing it, from doing a hard workout.   I have been a gym junkie all my adult life I know what gym muscle pain feels like. I’ve had DOMs and the cliched ‘can’t lower yourself onto the toilet cos it hurts too much’ thing.    I know what it feels like when you’ve worked hard in the gym and pushed your muscles too far.

This was NOT that.

This was something else entirely. Something I’ve never felt before. 

And it took three days to feel vaguely normal.

Those three says were incredibly painful, and I was completely disabled for most of that time. It was a wakeup call.

I made a big mistake.

So.

Solution?  Lighten the weight.  Reduce the reps.  And try again.

I tried. I failed. I felt terrible. I felt depressed.

So.

I went to see my physio, because I need support to do this.  The whole experience was very disappointing, upsetting even.  Frustrating too.  And even though I knew what to do, I knew how do it, I wasn’t doing it properly. 

I realised what I needed was some advice, with a dose of support and encouragement. Quality advice.  I knew my physio would give me all of that.

He gave me two options:  do it the easy way.  Take it right back to a tiny load.  Try doing 5 reps, one set of everything. And only increasing once every two weeks.  And then increasing the load by 10%.

Or, do it the hard way.  Start with 5 reps but do 2 sets.  If that goes OK, increase every week, by 10-20%. Whatever makes sense with the weights I’m using.   If it does not go OK, decrease the weight. And see what happens.

Option one has the benefit that it will definitely NOT cause pain.  Because I can definitely do very light load.  I know it will not set me on the couch for two to three days, it will not disable me and it will not hurt.  But the downside is it will be very slow. Slowly working up to find my baseline may take weeks from now.  Many weeks.

As we know, I’m a very impatient person.

Option 2 might cause pain. It might be too much.  It might mean a day or two on the couch again.  While this would be very disappointing, my natural optimism (and perhaps my habit overestimating my abilities, says I want to do it this way.   If its too much, I wait until the pain is gone and I reduce by 20%.  And try again.

So today I am starting again.

I will be doing the same upper body. It was fine. I may even increase a little.

Lower body though will be much, much less.  There will be 2 sets of each.

Squats – 5 reps

Lunges – 5 reps each leg

Romanian deadlifts – 10kg

Calf raises – 5 reps

Step ups – 5 each leg

And then I will see how I pull up. This is about a quarter of what I did before, even less.  So I hope this does not cause me severe pain.  A little pain is fine.  And to be expected.  Maybe even appreciated as a sign of progress.

But we will see.

I will keep notes on what is happening and how I’m going.  It should be interesting.

Most of all, I will be honest.  This is a challenge, and I have already messed it up once.  And now I’m trying again, with support from my physiotherapist. 

I don’t want people to think this is a walk in the park, it’s not. It’s a serious undertaking, and I’m hoping it’s going to help me maintain muscle strength in my arms and legs.  It will take a lot of energy, it will reduce my upright hours, hours that I currently don’t have enough of.  And it may not help.  But at worst, even if it doesn’t help. at least I will feel like I did all I could to prevent muscle wastage and further disability.

I’m seeing my physio again in four weeks, to check in and see how I’m going. I’ll be posting progress reports here as well.

I don’t want people to think this is easy. Its not. But it IS doable.  And it IS worth it.

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