For a long time now I’ve known that one of the key things that keeps me healthy is staying active. For me that means an hour of exercise most days. This is fine, I love riding my bike and live somewhere that I can ride year round. But two years ago I was struggling to manage chronic pain and struggling to get out of bed to keep my job. Dizzyness meant that standing up without falling over was difficult. A bike ride was impossible.

Knowing we need to excercise and being able to excercise are not the same thing. Many studies show that exercise is helpful in treating depression, anxiety, and migraines and can even be used as a preventative program.

What I want to talk about here is what to do when you can barely move because of your physical or emotional pain and how to get to the point where you are exercising daily.

Let me start by saying that this worked for me as part of my treatment for SUNCT and migraines. I believe it will work for others. If you try it and it works for you, please let me know.

Second, let me say this isn’t easy. This process took me almost 2 years. It was hard, and humbling, and painfully slow.

Here is the overview:

1. Get Treatment
2. Get Out Of Bed
3. Increase Your Activity Intensity
4. Set Realistic(ish) Long Term Goals

Let’s get started!

1. Get Treatment

This may be the hardest step to figure out where to start. For me it was admitting that the pain had gotten bad. Admitting to my wife that I was in pain. (Not easy for men to do). And taking the step of seeing a doctor. This put into place all the next steps once I admitted how bad it had gotten. The next month was spent in my doctor’s care getting treatment. I missed a lot of work but ended the month a lot better off.

If you aren’t making progress don’t be afraid to fire your doctor. Don’t put up with a life of constant pain. You deserve better.

My doctor had actually retired. I tried his replacement but he wasn’t a good fit for me. Health Grades is a great resource. Even if it meant a 90 minute drive twice a week I was going to go to the best doctor in the state.

This step took me three months. I went from “constantly in pain” to “often in pain”. That was enough for me to move on to step 2.

2. Get Out Of Bed

Okay, start thinking about exercise. Okay, now, slow down. I said this was going to be painfully slow. Don’t rush into this. For me, the problem was getting my heart rate up, at all, caused my pain to skyrocket.

I needed to start small. I looked at getting one of those step platforms:

But those are like $70! So instead I went out to the garage and brought the car ramp that I use for oil changes and put it in my office.

If you don’t have one of those get a step stool, a really large book, something. Just make sure it’s sturdy.

Once a day, I stepped up on this 10 times. Then I laid back down.

That’s it.

After a week I started stepping up on it 10 times on the hour, every hour. After a few weeks of that I increased to a full minute every hour. After a month I got rid of the ramp and I could walk around (slowly) for 5 minutes.

Walking for 5 minutes may not seem like a lot to most people, but if you’re reading this article, laying in bed in pain, then I know it seems like a lot to you. Try taking 10 steps today and see if you can get to 5 minutes a day in a few months. All you have to commit to today is the 10 steps.

A few more months and I was walking a full mile at a time. Providence had it that it was summertime just then and it was perfect for walking outside. My son had also just joined the running team at school and needed to be driven to practice. With the combination of treatment from my doctor and with me moving around more I was finally able to drive. I was thrilled to get out of the house so I started a schedule of getting up in the morning, driving him to practice, and then going for a mile walk with the dog while he ran four miles. It took us almost exactly the same time, which is a bit humbling, but it was still very enjoyable for all three of us:

As I said, my main problem is getting my heart rate too high. To make sure that didn’t happen I bought a Wahoo Tickr. This connects to your phone (iPhone or Android) to show you your heart rate:

As I walked I simply kept an eye on the Wahoo app and slowed down if my heart rate got above 100 or so. This is a very slow pace, but it worked.

By the end of summer I was walking (still slowly) 3 miles. I did a 5k with my church. I walked the entire thing and finished with a 70 year old woman. (Yes, I walked that slowly.) It was the end of the summer, in Atlanta, so it was hot. Every time we came to a tree we’d stop under it’s shade and talk. We both had to keep our heart rate low, me because of my nuerological problems, her because of heart issues. Her husband finished the 5k early and then ran around again and walked the last half again with us to the finish. He was 80 and quite the show off.

This step also took me three months. I went from “often in pain” to “sometimes in pain”. I felt confident enough to move on to step 3.

3. Increase Your Activity Intensity

The goal of this step is to go from being able to move, slowly, to being able to do whatever you want. For me that meant slowly ramping up from an hour where I had to closly monitor my heart rate to being able to ride my bike without restrictions. If that happens to be your sitation as well read my next post which will covers this in detail.

If your issues isn’t your heart rate or if you’re just not into riding a bike then find what you love. Experiment with different activites (swimming, kick boxing, rock climbing, hiking) and find something that becomes a hobby you look forward, not a daily chore that you dread. Don’t let all the progress you made in the first few steps go to waste because you become bored.

This step took me six months. I went from “sometimes in pain” to “occasionally in pain”. I was able to meet my first major goal of exercising outside again!

4. Set Realistic(ish) Long Term Goals

I’ve listed this 4th but honestly, you can do this step through the entire process. During step 1, when you’re in bed and perhaps unable to move, set some goals. Assume that this will all work out and you will get better. Pick something big. Something just an inch beyond realistic perhaps.

For me, I used to love to ride my bike long distances. The longest I ever went was 100 miles. So I set a goal of 200k, which is about 124 miles. This isn’t quite realistic when you are having trouble walking, but it’s a nice thing to think about when your stuck in bed. What equipment would I need to get? Should I buy a new bike? What ride would I sign up for?

I found a 200k ride at the end of July 2017 and, during step 2, the goal became a bit more realistic. During step 3 I actually became brave enough to say the goal out loud and a friend who was having knee surgery said he would set the same goal as part of his recovery.

Who knows if I’ll actually make it to the starting line for that ride, let alone finish it. But a long term goal like that can be very motivational.

Don’t forget to also make short term goals. I’ve found monthly goals work for me. Print out these goals and check them off as your accomplish them. Take pride in your progress, not matter how slow.

Final Thoughts

Putting this all into practice, here’s what this can look like on a month by month basis. I wrote out these goals on my white board and then put the date I completed them next to each one so I could see the progress I was making. If you wanted to do the same thing it might look something like this: