How to get exercise despite feeling pain

Don't skip exercising because you fear more pain or injury. Follow these tips to protect yourself and get the most out of your exercise routine.

• "The trick is to remember that you're not 25 anymore. If you've had pain for a long time and haven't exercised, you have to start slowly and gently. If you do too much, then you'll have pain and say, 'I can't possibly exercise,'" says Christine Zampach, PT, DPT, MEd. She's a rehabilitation coordinator at the University of California, San Francisco, Pain Center.
• That being said, if you're not used to exercising, it can be hard to tell the difference between the good pain that can result from exercise and the bad. Here's how.

•  When you begin an exercise you're not used to, your muscles get sore because of tiny tears, which cause swelling and pain.
• Slightly sore muscles are a good thing because, as the muscle repairs, it grows stronger.
• Unless the soreness is severe or lasts more than a week, don't worry.

• Give your pain a number each day before you start exercising. The number should be lower two hours after exercise or at least no worse, says physical therapist Michelle Shufelt. If you have new localized pain—in a knee or ankle, for example—that increases while you exercise, stop and have the pain checked by a doctor. Once you've verified that your pain is not serious, it's time to make exercise part of your regular routine.

• Most doctors, when they recommend exercise, talk about how much it will help our pain or how it will help ward off illnesses like heart disease and Cancer—but it's pretty tough to roll out of a warm bed and get walking for a benefit that may seem intangible.
• Even though most of us know that moving is the right move for reducing pain, we know what we feel now: We'd so much rather nurse our aching hips in a chair than head outside or to the gym. It takes several weeks to create a new habit.
• Until exercise becomes as ingrained as brushing your teeth, and even after, use these cues to keep you glued to your exercise schedule.

• Put your walking shoes by the bedroom door so you see them first thing in the morning.
• Put a Post-it note on your refrigerator reminding you to exercise.
• Ask a friend to call to remind you.
• Schedule your exercise as you would a dental appointment — in your calendar.
• Set an alarm clock for when it's time to exercise.

• The ideal exercise prescription will vary, depending on your type of pain. The key is to start with something you know you can do, says Christine Keating, MD, a physical medicine and rehabilitation physician at Ochsner Health System in New Orleans.
• Still skeptical about how big a bite exercise can take out of your pain? Check out the improvements that researchers have found.

• Potential Benefit: 45 percent reduction in pain
• Exercise: walking, strength training and stretching
• What It Takes: three times per week

• Potential Benefit: 24 percent improvement in function, 30 percent improvement in knee pain
• Exercise: aerobics and strength training
• What It Takes: three times per week

• Potential Benefit: significant reduction in migraine intensity
• Exercise: 30 minutes of aerobic exercise
• What It Takes: three times per week

• Potential Benefit: 50 percent reduction in pain, 60 percent improvement in back-related function
• Exercise: Yoga
• What It Takes: one hour and 15 minutes once per week

• Potential Benefit: 11 percent reduction in fatigue, five percent reduction in pain
• Exercise: moderate-intensity exercise such as aerobics, strength training and yoga
• What It Takes: three hours a week

• Potential Benefit: 75 percent reduction in pain
• Exercise: stretching the arch of the foot (pull the toes backward toward the shins)
• What It Takes: 10 times, three times per day

• Potential Benefit: 25 percent reduction in pain
• Exercise: 20 to 30 minutes of brisk aerobic exercise
• What It Takes: three times per week