A guide for exercising with chronic pain

Exercise is almost always safe for veterans living with chronic pain, especially when it is combined with appropriate recovery strategies such as good sleep, nutrition and balancing work and rest. 

All exercise is appropriate for people in pain – it just needs to be adapted to your goals and current capabilities. Working with a professional and following a safe-movement guideline for pain is vital. 

The benefits of exercising with chronic pain 

When a healthcare professional like an exercise physiologist or physiotherapist prescribes exercise to a veteran for chronic pain, the goal is not to simply get them stronger or fitter.  

Instead, the aim is to use movement to reduce fear of movement, build confidence and gradually expose them to activities they may have been avoiding.  

This helps retrain the nervous system, reduce sensitivity to movement, and improve their ability to participate in meaningful daily activities. 

While exercise may not eliminate pain completely, it can help veterans move more freely, improve function, and regain confidence in their bodies. 

For a veteran who may be returning to exercise after a prolonged period of pain, this can play a key role in not only managing pain but also improving their overall health and wellbeing.  

Regular physical activity can reduce the risk of developing conditions such as heart disease, type 2 diabetes, osteoporosis, some cancers and help to prevent future episodes of pain. It also can help improve a veteran’s mental health and quality of life.  

Using a safe-movement guideline for pain 

A simple strategy that can be used when exercising with chronic pain is the "Rule of 10". This combines two scales of level of pain vs the intensity of the workout: 

1. A pain scale from 0-10 (0 = no pain, 10 = extreme pain) 
2. A Rate of Perceived Exertion (RPE) scale from 0-10 (0 = no effort, 10 = maximum effort)

The idea is that these scales have an inverse relationship – where one increases, the other should decrease.  

For example, if someone's pain is 8/10 on a particular day, they may choose to exercise at an RPE of around 2/10. If their pain is 3/10, they may be comfortable exercising at an RPE of 7/10. 

This approach allows people to stay active while respecting their current symptoms. Rather than avoiding movement completely, they can adjust the intensity of their exercise to match how they are feeling on the day. 

Consistent movement within a person's tolerance can help build confidence, improve function and support long-term recovery.  

When monitoring pain levels, it can be difficult to tell the difference between soreness and an injury:

• Muscle soreness typically develops 12-48 hours after exercise, feels achy or stiff, and improves over a few days.  
• An injury is more likely if pain is sudden, sharp, associated with swelling or bruising, significantly limits movement, or continues to worsen over time.  

If you're unsure, monitor how the symptoms change over the next few days and seek advice from a healthcare professional if the pain is severe, worsening or affecting your ability to perform everyday activities. 

Don’t let the complexities of pain stop you! 

Pain is complex and can be influenced by many factors, including mood, emotions, stress, poor sleep, smoking, previous experiences, and beliefs about pain. 

Because of this, the amount of pain you feel is not always an accurate measure of tissue damage or tissue health. 

It is common for people living with chronic pain to experience some discomfort during exercise. This does not necessarily mean they are causing harm or making their condition worse. Instead, it can be helpful to view pain as information that may be influenced by a range of physical, psychological and social factors. 

When pain does increase, try to find strategies that help you manage it. For some people, this might be movement such as walking, stretching or gentle exercise. For others, it may be deep breathing, mindfulness, relaxation techniques or connecting with supportive friends and family. 

There is no one-size-fits-all approach. The key is finding strategies that work for you and allow you to continue participating in meaningful activities while building confidence in your body's ability to move. 

Support at Mates4Mates 

At Veteran & Family Wellbeing Centres, Mates4Mates exercise physiologists, physiotherapists and mental health clinicians work together to support veterans living with pain.  

They can help you set meaningful goals, provide evidence-based advice, and develop an individualised plan to help you return to movement safely.  

Whether your goal is to improve daily function, get back to exercise or better manage your pain, our team will work alongside you every step of the way.  

To find out how Mates4Mates can help support you, reach out to us on 1300 4 MATES (62 837) for a confidential chat.   

  
Written by Baxter Mahutonga, Mates4Mates Clinical Lead – Physical Rehabilitation Services and Physiotherapist