By Jett Koshowski, RMT
Many patients that I see as a massage therapist struggle with chronic musculoskeletal pain- pain that stems from your muscles, joints, tendons, and ligaments. There are many remedies out there that people try, for this type of pain: over-the-counter medications like Advil, Tylenol, and Robax, bodywork interventions such as massage, chiropractic, and physio, as well as products meant to change every-day habits like standing desks and special orthopedic pillows. While these are all great options for managing chronic pain, there is one method whose effectiveness is frequently underestimated: exercise! More specifically, resistance training, also known as strength training. This article will dive into the ways that resistance training can ease and prevent chronic musculoskeletal pain.
Basics of Pain and Training
Let’s talk about what resistance training really is, first of all. Resistance training is structured exercise, making your muscles contract against an external force. An easy example to conceptualize is a bicep curl, wherein the external force is a dumbbell (for example), and the act of elbow flexion will activate your bicep muscle, this being repeated for 3 sets of 10 curls- structure. While none of that is exactly rocket science, I still think it’s important to make clear exactly what I mean by resistance training. Beyond that, there are two points in that definition that we will come back to later in this article.
Now that we have a better understanding of what resistance training is, I’d also like to discuss how chronic pain starts. While the path to chronic pain is not the same for everyone, however many of the same key ingredients are present across a variety of cases: chronic injuries, frequent inactivity, be it at work or in your downtime, often coupled with repetitive actions related to a job or hobbies, can lead to certain muscle groups becoming overworked and tight, while others are unable to pick up the slack. From there, postural and joint malalignments can develop, which can compress on nerves and create painful trigger points in our muscles. In some cases injuries don’t heal properly, in others, the adaptations that develop during the recovery process can cause muscle imbalance, or sometimes there is no injury, and it’s the lifestyle components that lead to pain- as previously stated, the path is not always linear.
Impact of Resistance Training
With all of that out of the way, how can resistance training help? Let’s start with the basics: resistance training massively improves the strength and endurance of your muscles by increasing the number of myofibrils in each muscle fiber, as well as increasing the number and speed at which motor units are recruited- this, in turn, aids with the stability of your joints. Resistance training doesn’t only affect your muscles, though, it also has an effect on your bones, increasing their density and reducing the risk of conditions like osteoporosis. How will that affect your chronic pain, though? Postural and joint malalignments that contribute to pain can be corrected by targeting weak muscle groups and applying a resistance training program- as those muscles grow stronger they will pull affected structures back into alignment, thus allowing all of your muscles and joints to function better, reducing the risk of injury and overuse. Strong muscles are more resilient to the everyday forces we apply on them, things like picking up your kids, carrying heavy grocery bags, and even smaller tasks like household cleaning and gardening come without the risk of aggravating old injuries, or causing new ones. Though research is somewhat limited, resistance training has shown efficacy in reducing pain and fatigue among people experiencing conditions like arthritis, fibromyalgia, and cancer.
Your Journey with Resistance Training
If you’re someone who’s experiencing chronic pain, and you haven’t tried resistance training yet, how should you get started? Let’s return to our definition of resistance training: structured exercise, making your muscles contract against an external force. Two key points to dive into more are structure and external force, we can start with the latter. When you think of an ‘external force’ you may think of things like dumbbells, cables, and other equipment that can run up a hefty bill, whether you’re purchasing them to use at home or getting access via a gym membership. Obviously, those are great tools to have at your disposal when doing resistance training, but it’s important to note that those are not requirements for getting started, or even as you progress further through your fitness journey. The weight of your own body and appendages is enough to act as that ‘external force’, exercises like push-ups, sit-ups, and more specific exercises like side-lying hip abductions will all see great results if done properly.
Now let’s talk about structure. One of the massive benefits of resistance training compared to other activities is that it is done in a safe, controlled manner, with rest periods built in- between sets, and between training days- so that at lower intensities the risk of injury is minimal. While activities like cycling and running, or working a job that involves heavy lifting or other kinds of labour will make you stronger, yes, they also carry more risk of injury- not just acute injuries like sprains and tears, but overuse injuries that will develop overtime from improper form. So how should you build your resistance training program? Without knowing what’s ailing you specifically, common areas of weakness among people that I treat are your core, glutes, and back. Strengthening muscles like your rectus abdominus, rhomboids, mid traps, and your glute minimus, medius and maximus, will give you a good foundation to live your life with less pain, and a reduced risk of injury. If you’re looking to get a little bit more specific, targeting the muscles that support your painful joints, and even muscles themselves that you feel pain in, with careful strengthening exercises, will set you on the path to living pain-free. The next piece of putting together a resistance training program is dosage- how often, and how intense. The protocols used in studies researching resistance training for chronic pain vary widely, however there are a few things that are consistent. Exercising 2-3 times a week, even in shorter sessions (roughly 40mins) for 8 weeks, will net you noticeable results in terms of pain reduction; it should be noted the importance of listening and being responsive to your body when beginning resistance training- if you’re feeling sharp pains during training sessions, don’t push yourself further, either reduce the intensity of what you’re doing or stop altogether.
In my experience as a practitioner, the clearest path to reducing your chronic pain is the holistic approach, incorporating hydrotherapies, bodywork, changes in habit and routine, with exercise being an extremely important piece in that puzzle. Resistance training is often left to the wayside, as it requires a certain focus, effort, and consistency over a period of time to get the best results. Hopefully this article can serve as a guide if you’re experiencing chronic pain and haven’t tried resistance training, or have tried in the past and are looking to give it a second shot.
