Why Mainstream Fitness Fails Women with Chronic Pain (and What Works Instead)
If you’re a woman in perimenopause or menopause, you are no stranger to the avalanche of advice to get active.
- Do strength training for your bone health!
- Do HIIT for metabolic health and body composition!
- Do Yoga for balance and flexibility!
- Do pilates for your core!
- Don’t forget cardio for heart health!
It’s overwhelming! Especially if you are struggling with back pain, knee pain, hip or shoulder pain. And this doesn’t even touch on the pressures we face as women who are aging in a culture obsessed with youth. Or the reality that at this stage of life, we are often busier than ever, even as our energy is in serious deficit due to poor sleep and fluctuating hormones.
The fact is, we know that physical activity is important. That it’s great for our mental health, that we feel better when we do it. But when you are living with chronic pain, getting active feels impossible.
You know you should get active and eat right, but you’ve tried before, and it almost always ends with a painful flare-up that sidelines you.
You are not alone, and I’m here to tell you: Nothing is wrong with you. The avalanche of high-pressure, all-or-nothing fitness advice simply doesn’t work for your body. So, what does?
The Truth About Chronic Pain
First, let’s validate your experience. Chronic pain is pain that has lasted beyond normal tissue healing time (3–6 months). It persists due to what are called noci-plastic factors—changes to your nervous system’s protection system.
You may have been told that scans look fine. Or done every procedure and surgery available to you and still your pain is unresolved or worse. And you have likely questioned whether the pain is “all in your head”. I’m here to tell you it’s absolutely not in your head. Your pain is real, it’s as bad as you feel it is, it’s limiting you to the extent that you feel limited.
But chronic pain is no longer about your joints or muscles. It’s more about your brain and nervous system. This has been validated again and again in research. This is actually good news because, just as your nervous system learned pain, it can be unlearned.
So HOW do you unlearn pain?
Let’s start by acknowledging the movements that that you have been avoiding, may hold the keys to your recovery. This may seem counterintuitive, but it’s exactly what we work on in my program.
But, just because exercise is helpful for almost all musculoskeletal pain conditions, that doesn’t mean that the mainstream fitness advice will work for you. Not because you are broken, or because you will never be able to get back to the active life you always thought you would have at this stage of life. Because there is a better way for you. And know this, if you are a woman in midlife living with chronic pain…getting active is even MORE important for you than your pain free peers.
So in this post, I want to help you with the biggest hurdle to exercise and give you some simple, immediate tools that you can use to get back to the fitness habit that will not only help with your pain, but will give you your confidence and strength back.
But first…
The road to getting active is not paved with shame
I start here because I’ve been working with midlife women in pain for a long time. I know how hard you are on yourself. I know that you are embarrassed about getting out of shape. that you are terrified of setting foot in a fitness class or gym for fear of judgment that you think you deserve. Let’s take a deep breath and acknowledge this… I’ll hold.
Now take a moment to have compassion for yourself. You did not choose this. You would not wish this pain or shame on your worst enemy. You are playing the cards you’ve been dealt as best as you can. And you are looking for help. Give yourself some credit for that.
What is in the past is done. What you do in the future is what really matters. So let’s talk about what’s next.
You probably believe pain is the insurmountable barrier to getting back to the activities you love.
But for most of us, pain is actually the manageable obstacle. The real roadblock? The All-or-Nothing Mindset.
When you commit to “getting back to fitness,” your very sensitive brain and nervous system perceives new or different movements as a major threat. Add to that the shame we feel about our lack of fitness, and the ego saying “you used to be able to do this!” and guess what? We push through pain, and discomfort and we pay for it —this is the “all”—You’ve been through this cycle enough to know that the result isn’t a new exercise habit. It’s a flare.
What happens next? Like all surviving humans, you are deeply committed to avoiding things that cause pain. So you conclude that this activity is harmful for you. That your days of doing it must be over.You avoid it in the future — this is the “nothing.”
Why is this so monumentally harmful for you? Why is this mindset a path to more pain and disability? Because the primary predictor of how severe and disabling chronic pain will be is Fear.And more fear and more avoidance means more pain.
The true cost of the all-or-nothing trap? Avoiding movement only causes your nervous system to become more protective, tightening the grip of pain and leading to other co-morbidities.
Your mission is to transform this mindset. Not to exercise through pain, but to teach your body that it is safe to move again. Here’s how.
Your 4-Step Roadmap to Move Beyond Pain
We can use movement to send “good news” to your nervous system and update it to a platform of safety. Here is the compassionate and effective 4-step roadmap I use with midlife women to help them get moving and reclaim their lives:
Step #1: Enhance Interoception
Your brain is a predictive organ, constantly guessing what is happening in your body. When pain becomes chronic, the brain can perpetuate a faulty prediction, ignoring new sensory data. Interoception is the practice of observing the pure state of your body—your painful places, your breath, your body tension. It teaches your nervous system to find credibility in the fact that your tissues are safe, even when it’s predicting pain. You’ll find copious resources for updating the brain’s faulty predictions about pain inside of my program.
Step #2: Simple Somatic Movements
Chronic pain causes a loss of sensation vocabulary. We stop feeling anything other than pain. This step is about relearning that vocabulary through movement that is novel, playful, and affirmative. The goal is to take risks with movement without consequence, thereby proving to your nervous system that movement is safe. The movements you do in a fitness class or gym, or even in a walk around your neighborhood, anything that flares you, have consequences. My job is a coach is to help you identify ways to experience those movements that are divorced from the predictions and associations that trigger a pain response. Somatic education is my favorite way to do that. Many of my clients describe it as magic. But it’s not, it’s just your really amazing brain and body adapting and learning.
Step #3: Facilitating Whole Self Safety
Pain is a protection mechanism, and your nervous system uses it as its favorite defense. Stress magnifies this threat response. And can make pain flares worse or even independently cause them. Here are physiological tools for calming the hypersensitive nervous systems so that you can flare less and more mildly
- Prioritizing sleep
- Hydrating
- Setting boundaries
- Addressing perfectionism
- Practicing self-compassion
Have you noticed that — A poor night of sleep or high stress can trigger a pain experience—even if nothing has changed in your knee or back? Congratulations, you have noci-plastic pain!
Step #4: Graded Exposure
Start so small that it feels silly, even ridiculous. This is how you send good news to your nervous system. At first, movement should be pain-free. Once you establish a baseline, you increase duration or intensity by only 10% once you can move with only a small amount of discomfort. Poking into pain is necessary to teach your body new limits, but it must be done gradually and with intention.
Notice that this is a very different approach to just diving back into your pre-pain fitness routine? It’s softer, it’s kinder, and it will get you back to the level of fitness you desire more reliably and quicker than the all or nothing strategy!
Ready to Transform Your Mindset?
I hope so, because it really could be the key to putting this pain condition in the rearview. If you are ready to heal your chronic pain using an evidence based, neurocentric approach we should chat. My comprehensive programs provide the support you need to live a future that is free from chronic pain and full of the joy and confidence you’ve hoped you could still get back to.
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