It is a common misconception that more of anything is ‘better’. However, when it comes to exercise and indeed yoga, there is a strong case for less is more.
Pushing into shapes and poses on the yoga mat can be a counter productive stress signal to the body, whereas backing off, building your stretch tolerance over time and communicating with your nervous system with breathwork may help more.
With exercise and fitness there is a strong focus on numbers; lifting heavier, running further, pushing more- which indeed may be the correct approach depending on individual purpose BUT this heavily clouds rehab and movement with pain.
SO HOW DO WE GET OUR DOSAGE RIGHT?
First let’s follow the recent evidence, starting with the well researched advice that even limited moving with pain is better than no movement at all. We also know that perfect alignment or form is not as important as we once thought and although we love to talk of specific exercises, amounts of time, sets or reps, it is strongly looking like when it comes to pain those things do not matter. Instead of thinking one drill or specific sequence fixes, it’s more that you are moving and therefore communicating with brain and body that affords relief and results.
It’s why we feel better after physio or indeed massage – we have moved meaningfully, or with touch therapies, soothed the nervous system. So think less of perfect exercise specificities and more of creating positive habits and approaches ( another great reason to dismantle and reimagine your yoga practice to suit yourself)
Things that can be more important than specifics could include: time, access, fun, education, motivation, support, self efficacy, lifestyle etc.
So when we look at dosage for moving with pain, these factors remind us there is no magic number. A little is better than none, challenging yourself is good for creating change, feeling pain when exercising is ok (just as you would moving around the house), the use of variety can keep things interesting for you and your brain but also repetition can be a nice connection builder. All movement is good, nothing has to earnt, perfected or achieved and no records need to be broken.
In exercise there is a tendency to increase.
Increase intensity, load, reps, time etc. However, the big takeaway when dosing for pain is there is no goal to beat. No personal best to achieve. No new time to set. No bar of returning to being ‘pain free’.With the extreme minority of professional athletes, you do not need to get back to a certain place or target, in fact this approach to dosage can cause the exact opposite of response we want. Sounds strange?
Well we used to talk of becoming ‘pain free’ or call treatment ‘pain management’ but we know more now and refer to it more as mitigation. Think of a recipe that you learn by heart and begin to understand – sometimes it just dosn’t work well for no particular reason, some ingredients help soothe discomfort and some are spicy and flare the situation. Sometimes we need to measure and be careful with ingredients and other times we wing it and muddle through. Understanding your ingredients and their reactions, changes and states is of more use than x3 sets of 10 exercises.
There is also consideration needed for modality. All exercise and movement is good and needs to be treated as positive rather than dismissing or demonising certain types of movement and focus instead on tolerance, enjoyment and working with your nervous system and its threat responses.
Yoga in its physical form is body weight exercise, mobility and movement awareness. It may cover both variety and repetition. Other elements of yoga such as breathwork and meditation have potential to dial down the pain response, threat perception and soothe the nervous system.
In practice these elements can contribute to help rest, recovery, stress and sleep which are pillars we address as priorities in taming your pain, so interactions may be more important than interventions to build positive therapeutic outcomes.