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It is generally believed that when our body hurts we have the tendency of staying still and avoiding any painful movement to avoid worsening the symptoms. This is very appropriate for an acute injury so that our body can heal the damaged tissue. However, excessive rest can have an adverse effect and make things worse in patients with musculoskeletal disorders.

Decreased movement results in de-conditioning, but also can lead to fear of movement resulting in a loss of awareness of the motion of the affected area. So consequently we move less, get stiffer, our muscle weakens and we have secondary pain due to inactivity. In addition, it has been shown that pain-related fear has an important role in the transition from an acute injury pain to chronic pain in low back patients. Some patients perceive movements or stimulus as a threat, increasing the stress/anxiety towards specific activity and as a result, creating a fear-avoidance behaviour which leads to further misuse of the body and long-term disability.

Furthermore, the pain experienced can be influenced by stress, excessive attention to pain and unhelpful beliefs. Consequently, the pain of that initial injury has become bigger and bigger due to other factors even though the healing time of the injury has been already finished. So how can we break down this vicious loop? A good start is moving safely, recovering that lost awareness of your body and re-learning how to move adequately, improving confidence during activities, breaking down the pain-movement association in our brain and decreasing that perceived threat.


You may think “but how if it’s hurting?” The answer is pacing, little by little with the help of health professionals to support you and reassure you through this process.  You cannot win a marathon if you didn’t train for it before, so after prolonged inactivity due to pain is similar, it is important to build up the strength and movement little by little, to promote the tissue adaptation to the new activity, setting goals to finish your own race to get out of such loop.

Pilates is a highly beneficial movement therapy after an injury to the support it provides the body. At the Body Refinery, you can find physiotherapists to help manage your discomfort and start getting active in a safe way. They will help you to start decreasing the threat of movement with progressive exercises, a safe environment and reassurance to recover progressively the normal motion of your body.

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