Muscles and bones
Keeping active is important, but aches, pains and strains happen. Find guidance on a range of conditions, treatments and preventing future injury.
How can we help you?
Your questions answered about muscles, bones and joints
Get answers to common questions surrounding muscles, bones and joints with specialist musculoskeletal physiotherapist and Clinical Lead at Bupa, Mike Livesey.
Transcript
Who are you?
Hi, I'm Mike Livesey.
I'm a specialist MSK physiotherapist
and clinical lead at Bupa.
Come and ask me a question about MSK conditions
and injuries
What does MSK stand for and what are some examples of conditions?
So MSK stands for musculoskeletal, so
that's anything to do with our body.
So we're looking at the joints in our body,
the muscles in our body, and anything that acts on it.
So it's looking at your function and how that's adapted.
So classically in clinic, we'll see lots
of problems coming in with back pain, neck pain, shoulder
and knees, and they're our top four.
The main sort of breakdown of injuries we tend
to see is more acute injuries,
so they may be traumatic sprains and strains,
or more chronic persistent issues like arthritis.
What's the difference between a ligament and tendon?
A ligament is a structure that fastens bone to bone.
So we'll see these around joints
to help stabilise the joint.
These are inert structures so they don't move.
They're set at a limit
and they have a limit at what they can work to.
So what I mean by that is if you stretch the ligament more
than it can tolerate, it'll break down and cause an injury.
So for example, we'll see that regularly with ankle sprains.
If you roll your ankle off a curb,
the ligament will be overloaded
and it will go beyond what it can tolerate and it will tear
and you'll start to get pain, injury and loss of function.
Now, tendons are structures that fasten muscles
to bone, and these are more contractile structures,
so they're more active structures with the muscle.
They act upon the joint
and allow the joint to move for you to be functional
or do the desired exercise that you want to do.
These injuries
or the injuries with tendons we see tend to be more
with overload injuries.
When you do too much too soon
and the body can't cope with it and it breaks down.
What's the difference between a fracture and break?
So we do get asked this a lot between fractures
and breaks, and there is no difference.
They're exactly the same.
It's just a mix in terminology
and clinically, we'll use fractures as the word,
and these can be categorised into a
few different subcategories.
So the least bony injury we see is a stress fracture,
and that might be caused from more repetitive strains.
Maybe with running a more impact exercise,
you'll also get an undisplaced fracture.
These maybe could be known as a green stick fracture
or a hairline fracture, worsening fractures.
You can get a displaced fracture
where the bone actually has moved out of position
and may need realigning surgically,
and we get even worse from that is a communed fracture
where we find that the bone breaks into several pieces
and very often that does need surgical repair in order
to reduce the bone back into position for the body to heal
and repair.
What's the difference between a tear and rupture?
So tears can be really, really simply in sort
of three categories.
So a grade one tear is
where we tear a small number of fibres.
So that's normally about less than 10%
of fibres in the structure that are damaged and torn.
So functionally, this doesn't have loads of impact on us.
It can cause pain. It'll cause maybe some mild swelling,
but it's rare that it impacts your function
apart from causing pain.
These are injuries that tend to resolve quickly with rest
with activity modification.
And it's rare that you need
to see a professional for support with this.
A grade two strain
or tear, it's something that
causes more disruption to the tissue.
And we'll see that between anywhere between 10%
and 90% of our tissue is damaged.
So that can cause, as you can imagine,
significant amounts of functional change.
And with that, we see swelling, we'll see bruising,
we'll see inability to move
or even inability to load that structure
because of the pain.
And as you can imagine, with more tissue damage, it's going
to take longer for those tissues to heal.
They should still heal because there are structures
or the part of the structure is still attached.
However, you may find that it takes a little bit longer.
You may need a little bit of professional support
through a physiotherapist to aid your recovery
so you can get back to your function or your sport.
And then finally, we can have a complete rupture,
which would be a grade three tear,
and that's where the structure is completely parted
and we're left with two parts of the structure.
Classically, if that's caused with a trauma, we'll go
and see an orthopaedic surgeon to get advice
and support on that as to see whether they feel
that they should repair that surgically
or whether it could be managed conservatively
with physiotherapy.
Why is my desk setup at work important?
Desk setups are really important
because we can spend between 30 and 50% of our day working.
And so if your work is inactive
and you are desk-based, it's a lot
of time potentially in a sitting position.
What we need to look at is we need
to look at the equipment that we've got around us.
You should be sitting comfortably
with our feet flat on the floor.
Our knees should be around 90 degrees,
maybe a little bit less,
and our hips slightly higher than our knees. When we're
sitting, sit in a supportive chair to make sure
that you've got the ability to rest your back
and sit back at the back of the chair.
And what we want is we want your elbows
to be relaxed comfortably by your sides,
your shoulders relaxed,
and your forearms being able
to rest comfortably on the desk in front of you.
Try and avoid reaching out in front of you to your keyboard
and make sure your screen height is looking at about eye
level when you sat at the desk.
I think the main thing though for me is movement is
don't stay at your desk for too long.
There's several studies
that say actually just being inactive,
whether you're in a good posture
or a bad posture, can lead
to musculoskeletal pain and injury.
So it's really important that we get up
and we move regularly.
Movement is medicine. Don't sit for too long.
Keep your joints moving and keep yourself healthy.
How often should I move when I work at my desk?
I think the take home message
for when we're sitting at our desk
and how often we move is move regularly
and keep it flexible.
If people are tied to their desks,
we definitely recommend moving every 30 to 40 minutes
to make sure that you're changing your posture regularly,
but it's safe to slouch.
Don't be worried about sitting in an awkward position.
Just make sure you're not there for too long.
Make sure you stand for a short period.
If you've got the ability to be able to have a sit
to stand desk, to stand for a short period, then
that's great and sit.
Use the front of the chair, use the back of the chair
and vary your position.
I think the take home message is the next posture is your
best posture.
What are the best ways to prevent muscle stiffness?
So muscle stiffness is often seen after exercise.
So if you overload
or you do too much with exercise,
you can develop muscle soreness, which can lead
to muscle stiffness.
Now, delayed onset muscle soreness is very common,
and if you don't manage that well, that can lead
to more persistent stiffness problems.
So how do we negate that?
Now, the best thing to do is make sure you manage your
exercise with adequate warm-up and adequate cool down.
So what we want to look at doing with a warm-up is we want
to gradually increase the heart rate.
We want to put the body through more dynamic movements.
The aim of a good warm-up is
to get the blood flow into the muscles,
get the muscles switched on, get that link between brain
and body firing really quick, so we're reducing the risk
of the body not performing well,
and we know that that's going to mean
that you're less likely to fall or trip
and you're going to have better control of your movement.
The best way after exercise to cool down is
to gradually reduce your heart rate back to a resting level
and calming the tissues down.
So when we're performing,
movement muscles will naturally shorten to provide you
with movement and get the joints moving
so you can move forward or jump higher or move quicker.
What we want to do after that is we want
to return those muscles back to their normal length.
So that's where you can put in your static stretches,
stretching out all the muscle groups that you've used during
that activity to make sure it's specific to your sport
or to your activity,
and that will massively reduce the risk of
post-exercise stiffness and muscle stiffness.
Now, there's other things alongside managing exercise well.
So hydration's really important.
We tend to find when people are dehydrated,
they have a higher incidence of muscle cramps
and they're more likely to develop muscle
stiffness following that.
So keep yourself well hydrated if you know you've got a
performance or an activity or an event coming up.
There's a lot of research behind the effectiveness
of hyper hydrating, so putting plenty of fluid in your body
so it's able to perform well,
and the nutrition is supplied regularly through the body.
We classically see sort of muscle cramps at nighttime,
so good advice is to try
and keep flexible if you are prone to getting muscle cramps,
which we do see with people in later life is maybe look at
stretching before bed and waking up and trying to stretch it
and keep it moving in the morning.
But I think the main thing is adequate warmup,
adequate cool down, and keeping strength and flexibility.
How much should I exercise to prevent joint problems?
It is difficult to give you a generic answer on this
because we're all different.
So exercise is really individual.
Somebody who exercises regularly will need
to challenge their musculoskeletal system more in order
for it to adapt and get strong, as opposed
to somebody who's maybe more sedentary in their lifestyle,
who maybe will only have to exercise at a lower level.
The most important thing I think, is listen to your body.
If you start to exercise where you've not done before
and your body starts to give you signs of distress by pain
or getting aches, or you find it's affecting your function,
then modify your activities
and reduce what you're doing at that time.
Let your body build up slowly.
It takes about six to twelve weeks for our muscles
to get strong, and it's important that we have strength
around our joints to help keep them healthy.
We can avoid injuries to the joint
or problems to the joint by monitoring our weight as well.
There's a lot of strong research to say that people
that are overweight put more load through their hip
and their knee, and that can lead
to more degenerative conditions like osteoarthritis.
Should I avoid weight training exercise?
So weight train exercise is really important
in our weekly exercise routine, we talked about
physical activity recommendations, working aerobically,
but also there's evidence to say that we need
to be working with strength training.
Our bodies adapt to strength training by becoming stronger,
which means we can move our joints more effectively
and we become more functional.
The research shows that after the third
and fourth decade in life, we start
to lose muscle mass if we're inactive,
and that can range between three to 5%
of our muscle mass per decade.
So it's really important
that we keep regular strength training within our exercise
regime, and it's not too late to start.
There's research to show
that in later life if you still engage
with a strength programme, you can still
show strength improvements.
The key of it is ensuring that you do enough
that you do the high enough intensity in order for your body
to adapt and for it to change.
So take home message is stay strong.
Can too much exercise be bad for me?
So exercise is really important.
Too much exercise of course is bad for you,
but regular exercise isn't.
So when we get to a point
where we've done too much exercise,
our body start to tell us about it.
So what we find is we start
to get more post-exercise soreness
that doesn't resolve quickly.
So instead of your exercise soreness lasting maybe an hour
after exercise and having a little bit
of stiffness the following day, that you are in pain
for two days, three days,
and that recovery is taking longer then absolutely,
you've overloaded your body.
And that's when we tend to start seeing injuries
and people start to get pain,
and that affects their function.
So listen to your body as the take home message.
If you find that you're starting to get aches
and pains, adapt your exercise, modify it and reduce it.
Give your body time to adapt
and give your body time to recover.
I think the most important thing
with musculoskeletal adaptation is just being aware
that it is slow to respond.
Give your body time to respond, let it adapt,
and then we'll massively reduce the risks
of you developing any aches and pains from exercise.
Will repeated bending and twisting lead to a problem?
We get a lot of these questions,
particularly when people come in with back pain,
and that myth of bending
and twisting can cause pain, so I mustn't do it.
The problem with that is those myths create a fear,
and that fear prevents people from moving.
And the best way
and the strongest research behind managing back pain
is exercise.
So if we avoid exercise
and we stop bending, we stop twisting, we stopping provide
that rehabilitation that gets our bodies better.
So there's no link between bending and twisting
and recurrent injuries.
Is joint/muscle pain hereditary?
There's no consensus on this, whether the joint
and muscle pain is hereditary.
Age-related changes like osteoarthritis aren't hereditary.
However, there are certain autoimmune inflammatory
conditions that can be so for example,
rheumatoid arthritis is one of those.
So if you are close family members, if your mother
or father has rheumatoid arthritis,
you do have an increased predisposition to developing this.
The older I get, the more likely I'll develop a condition, is this true?
It is not completely true.
What you tend to find is there are age-related conditions
like osteoarthritis, which typically we'll see
the prevalence increases, age increases.
However, there are studies to suggest
that actually back pain reduces in prevalence in later life,
perhaps as our judge start to stiffen a little bit more,
they move less, so less likelihood of overloading them.
However, what we do see as we get older is
that our body's condition and our body's ability to move
and function and balance certainly does deteriorate.
Now, it's important that we help provide the body
with enough stimulus to stop that from happening.
So in later life, as our muscle strength reduces,
keep providing that your body
with enough resistance training, enough strength training
to prevent that deterioration.
It's really important as well,
that in later life you work on regular exercise
to help improve flexibility, to help improve balance.
Because if you are mobile and if you are more strong
and flexible, you're going to have less likelihood of slips,
trips, and falls, which can easily occur in later life
and cause significant impact to your function.
Can I prevent conditions like Osteoarthritis?
Osteoarthritis is typically an age-related condition
and a degenerative condition.
So as our bodies get older on the outside,
they also get older on the inside.
So what we can see in a mirror is grey hair and wrinkles.
And what we see on the inside is that smooth,
slippery cartilage that we have over our joint surfaces
that when we're in our younger years, is sort of glass like
and smooth becomes a lot more roughened,
a bit like a sandpaper.
And it can go through that gradings
of sandpaper as we get older.
And that can have more and more impact on
how your joint moves
and how your body functions,
which ultimately can result in pain
and you needing support to manage that.
So we can slow the progression of arthritis
by keeping good nutrition to our joint, keeping healthy
with a good weight.
So we know that people who are overweight
and carry more load have extra stress
thrown through their joints.
And there's a strong relation between high weight
and incidence of arthritis.
And can we ensure that our joints are kept active?
So regular exercise is another really good way
to help prevent the deterioration of the joint surface
and keeping the joint healthy.
And probably the best take home message with
that is strength training.
The stronger we can get our muscles around the joint,
the more that can offload the work
that the actual joint surface does and reduce that overload
and that deterioration in the joint.
So keeping an eye on weight,
making sure we keep our joints strong.
Also thinking about our other lifestyle choices.
So smoking, we know that has a deteriorating impact
of joint surfaces, so stopping smoking
and also excessive alcohol intake.
So try and make those lifestyle changes earlier on in life
and then we'll be able to keep our joints healthier in later
life.
Can a physiotherapist advise me on avoiding pains and injuries?
Physiotherapists are perfectly placed
to advise you on avoiding and preventing injuries.
Their advanced knowledge on injury management
and rehabilitation helps give them enough ingredients
and enough knowledge to help guide you back.
I think the most important thing is making sure
that you grade your exposure to exercise,
build it up gradually allow the body to adapt.
The research suggests it takes between six
and twelve weeks for muscle tissue to adapt, for muscle fibres,
to become more numerous, numerous, and to become fatter.
And that's what generates strength
and that is what will help keep us healthy, happy,
and functional.
How long should I self-manage any aches and pains?
A lot of injuries can be successfully self-managed,
and as physiotherapists,
we don't see every injury everybody has.
What you'll typically see is small sprains
and strains will resolve quickly within a couple of weeks
as long as you modify your activity and are sensible
and listen to your body.
However, anything that lasts beyond two weeks
that isn't showing signs
of improvement is when you should start
to seek some more support and some more advice,
particularly if your symptoms are deteriorating.
I wouldn't leave symptoms that are getting worse
for longer than 10 days.
However, if there are signs
that you're getting significant changes in muscle power
and you're finding that you're extremely weak,
really quickly seek advice very promptly.
And if you're noticing any abnormal symptoms, pins
and needles, or numbness, you're having difficulty sleeping
because you're waking regularly through the night
because of your pain, then seek some
professional advice soon.
It may be that some early simple intervention can help
manage your condition really quickly
and get you back to activity.
And if you ever find yourself in that stage,
if you're a Bupa customer,
contact our MSK Direct Access service.
Or if you're not a Bupa customer, get into your NHS GP,
or perhaps you can access some self-referral
to physiotherapy.
Does applying hot or cold therapy to aches or pains work?
It's a good question and it's something
that we're asked a lot about.
There's no real significant research to say
that one is better than the other.
However, I do give advice about it,
and I think the easiest way
to look at it is if you've got an acute traumatic injury
where you can see swelling
or bruising, that's a sign
that there's significant inflammation in that tissue.
You'll often feel that it gets hot.
And what does your brain tell you?
Put some cold on it, and that's what I'd go with is listen
to your body, get some cold on it.
Swelling is healthy because it brings nutrients to heal,
but persistent swelling, swelling that stays
around the joint for longer periods can have a big impact on
your recovery and how you function.
So get some ice on it, manage it regularly,
try and get movement back to it.
But ice is great for acute injuries like that
where we can see that swelling.
I'd use heat when we tend to see maybe more muscle injuries.
So perhaps you've overloaded the tissue in the gym
or exercising and it's feeling tight.
Maybe you've got a cramp or a spasm in the muscle.
That's where heat's really good.
Can we relax the muscle to get it back
to its original length and can we calm it down?
So ice in the acute period for those first sort of seven
to 10 days, calm down that swelling, then heat on it
to help try and warm up the muscles around it,
help return those muscles back to their original length
and regain the flexibility and ultimately your function.
How can I stop pains returning?
So management of an injury is really important
to prevent pains from returning as you engage
with the rehabilitation exercise
and get yourself back to normal function.
There's definitely an aspect of maintenance that's required.
Unfortunately, with musculoskeletal adaptations,
if we don't keep stimulating the body with that need
to get strong to help keep flexibility, then we can lose it.
So we hear the phrase that use it or lose it,
and there's definitely a bit of theory behind that.
So making sure you keep exercising regularly.
There are a few studies that say to maintain strength,
you can exercise a couple of times a week to help make sure
that the body doesn't deteriorate further.
So I always recommend when people have resolved their
injury, that there's an ongoing maintenance thing.
Now, that doesn't have to be continued with your exercises
that you've been given by your physio.
It may be get into an activity,
get into a sport that you want to do.
It's really important that you enjoy what you're doing,
and if you don't enjoy the exercise, it's very unlikely
that you're going to maintain it.
So enjoy your exercise.
Find something that you want to do
because you'll keep to it.
And if it's new, build yourself up to it.
Let the body adapt. Let the body change.
Try to listen to your body and don't overload it.
Give that body time to adapt and keep it strong
and that'll avoid any recurrence in your injuries.
What's the difference between acute and chronic pain?
So acute pain is pain
that typically will resolve within healing timeframes.
So what I mean by that is tissues responding
to the body's natural progression
and natural laying down of new fibres.
So that may be anywhere between six and twelve weeks timeframe.
Chronic pain is something that's classified as pain
that lasts beyond that timeframe,
and that's where it can become a little bit more complex.
Chronic pain isn't always linked to just the amount
of tissue damage that has occurred,
and chronic pain can be influenced by a lot
of bio-psychosocial issues.
So it may be your beliefs about your injury,
what your initial thoughts are of how to manage it.
It may be your consequences at home, at life,
your mental health at the time,
and all these very complex aspects
of pain can feed into your pain becoming more persistent
or becoming more chronic.
How long can back pain last?
Recovery for back pain can be really varied,
and this may be due to sort
of the amount of tissue that's damaged.
So if we are looking at a small injury, a sprain
or strain where not many fibres have been involved,
we expect those to resolve reasonably quickly
with modification of activities,
perhaps some pain relief in order to help get you back
to moving and functioning well.
Or maybe if there's more tissue damage
that has a more significant impact on your function,
that you need to let your body have a little bit
more time to adapt.
And those will normally occur between six and 12 weeks.
Now, after that 12 week mark, pain isn't always linked
to the amount of tissue damage that can occur.
And we can find that tissues are actually healing on the
inside, but there is no influence to our pain.
And so the research in the last five
to 10 years has very much looked at persistent
and chronic pain to say that there is no correlation
between pain and tissue damage.
And so what does that mean to you in your recovery?
Basically, listen to your body,
but don't be fearful of pain.
If we're fearful of pain, we're not going to move well,
which means we're not going to recover.
A movement is the best way to recover from back pain.
Our national guidelines recommend exercise
as the premier sort of activity in order
to manage back pain.
So exercising regularly is really important.
Understanding and taking on board that pain
and tissue damage at that stage
of your recovery isn't always linked.
So listen to your pain, but work with it.
Try and focus a little bit more on function.
If you are able to walk for five minutes, day one,
see if we can start to look at progressing that gradually.
And that's the important thing
with our musculoskeletal system.
Give it time to adapt.
So what we'd look at is say five minutes, day one,
let's try seven minutes at day three
and 10 minutes at day 10.
Build it up gradually let your body adapt.
You'll find that your function will improve
and in time your pain will start to reduce.
How can I keep my muscles, bones, and joints healthy?
So keeping our muscles, bones, and joints healthy.
The take home messages, keep active,
that's the most important thing.
Sit less and move more.
There are loads of physical activity guidelines.
The World Health Organisation recommends
we exercise around 150 minutes a week.
So that's looking at 20 minutes at least a day
of cardiovascular exercise.
So that's exercise of moderate intensity, getting you
to a level where you're slightly breathless, still able
to hold a conversation, but maybe having to take a breath
to continue that conversation.
And that should be done regularly
to help improve cardiovascular health,
to help improve muscle and joint health as well.
And I think one thing that's often forgotten
with exercise is strength training.
As we get older in later life, we tend to lose muscle mass
and we tend to lose strength.
So keep in part of that strength programme during your week
and during your exercise is so important.
So keep active, move more, stay less,
and that's the best way to keep your bones
and joints healthy.
What are the key tips for healthy bones and joints?
So keeping healthy bones and joints is really important.
The early we start this, the better the impact.
So we know that keeping joints healthy comes about
by keeping the joint strong.
So we need to make sure that the muscles around
that joint are strong, making sure
that we don't excessively load that joint.
So monitoring
and keeping an eye on your weight is really important.
And also giving the joint enough nutrition, calcium,
and vitamin D are really important.
If we go to the strength training, it's important
and we recommend to people
that they're doing strength training at least twice a week
to overload that muscle in order to keep the joint supported
and keep the muscles strong.
With weight. We know that people
who are overweight put more stress
and more load through the joint surfaces.
So if we look for example at running
where we are massively increasing the load
and the research suggests that can be up
to five times our body weight through our lower limbs.
If you've got an extra kilogramme
or three of weight going through that joint,
you can imagine the stresses
and strains that are going to go through that
and the impact that diet might have,
and also diet and nutrition.
So calcium is really important to make sure that
that's in our diet to help lay down good healthy bones.
As we get older, our bone density reduces
and we see that also in post-menopausal women.
The hormonal support in order
to help keep bone density isn't there.
And so we need to make sure that we have enough calcium
to help support that.
Now calcium doesn't help to provide strong bones on its own
and it needs vitamin D and we absorb that from the sun.
So in the summer months in the uk, we're okay.
We might be covered if there's enough skin exposure.
However, in the winter months when we not have
as much skin exposure, it's important
to supplement your diet with vitamin D
to help reduce the risks of changes in bone density.
So to summarise, keep strong,
make sure you're not carrying excess weight.
Keep nutrition to the joints.
And I think the other things to keep in mind of is
not taking too much excessive alcohol and avoid smoking.
Where can I go for useful information about muscles and bones?
I always recommend people look for sources
that are ratified and that are trusted, so go to Bupa.
We know that the literature
that's published on our website has been ratified
by professionals, and it's been reviewed to make sure
that it's in line with good recent evidence-based practise.
Of course, we've got lots of research
and sources through the NHS as well that you could look at.
So look at reputable names that
provide good sound health advice.
When should I seek professional advice and treatment?
So I'd always encourage people
to seek urgent advice if they're finding
that their symptoms are deteriorating quickly.
If you're noticing that you've got any neurological
compromise, what I mean by that is if you're seeing signs
that you're getting any numbness in the body part,
if you notice any pins
and needles, if you find
that you're getting any deteriorating muscle power
or urgent weakness, seek urgent advice.
Any other abnormal systemic symptoms as well.
So if you're starting to develop a temperature, a fever
that might be causing night sweats,
or you're starting to see a significant weight loss,
always go and seek urgent medical advice.
And that may be if you're a Bupa customer,
contacting us at MSK direct access service,
or if you're not seeking advice
and support through your NHS GP
or maybe your self-referral physiotherapy.
How do I access support through Bupa?
If you're a Bupa customer, we can help you
through our MSK direct access,
or you can speak to a physiotherapist
through our digital GP app,
or you can access our Anytime Healthline nurses
who are available 24/7.
Muscle, bone and joint conditions
Information on conditions, as well as symptoms, causes and possible treatments.
Treatments for muscles, bones and joints
Information on how you can treat muscle, bone and joint conditions.
Do you need physiotherapy?
With or without insurance, we can help you
If you’re a Bupa health insurance customer
You can book physiotherapy appointments using the My Bupa app.
You can also call us on 0345 609 0111∧ to discuss your aches, pains or an injury. Depending on your symptoms and cover, we may arrange a telephone or video call appointment with a physiotherapist.
If you don’t have health insurance with us
No problem. We can still help you on a pay-as-you-go basis. Just pay for the treatment you need, when you need it.
Call 0345 850 8399∧∧ to find a physiotherapist near you.
Get physio support with our health subscriptions
Bupa Well+ Silver is our new subscription service. Pay £20 a month or £240 upfront for a 12 month subscription and get six remote appointments with a physio a year. As well as digital appointments with GPs and additional physio support.
Caring for your muscles, bones and joints
Ten morning stretches to help you start your day
Start your day, increase your flexibility and reduce back pain with these stretches.
Five ways to care for your back
Learn how to prevent back pain or stiffness and some top tips on avoiding a back injury.
Knee strengthening exercises
Explore different types of exercises that can help to strengthen your knees.
Is cold water therapy good for you?
What does cold water therapy involve and is there any evidence behind it?
Why is strength training important for menopause?
Why does strength training make such a difference to your health and wellbeing during the menopause and beyond?
What are the best exercises for older people?
Our experts share the benefits of exercise for older adults and which exercises are most appropriate.
A simple guide to getting stronger
Watch in 8 mins
Get tips on getting stronger through simple exercises suited to all ages from TV actor Adam Thomas and Bupa's Physioline Lead Therapist Sarah Griffiths.
Hi.
I'm Adam Thomas, and I'm here with Bupa’s physioline and lead therapist, Sarah Griffiths to get some tips on getting stronger through some simple exercises which anyone can do and build into our everyday lives really easily.
What's our first exercise?
Okay, let's start with a simple squat.
So I want you to come on to your mat.
You're going to bring your feet towards the outside and just turn your feet out to where feels comfortable.
So when we're doing a squat, we really want to think about our position.
So you want to put the weight to the back of your heels.
Imagine if you're going to sit down in a chair and avoid your knees coming forwards over your toes.
Okay.
For this demonstration we'll bring our arms out in front.
Let's go.
As you stand nice and tall, squeeze the muscles at the front and the back of the thighs.
Should we go again?
Yeah.
Perfect.
We can make this harder by adding a dumbbell.
So if you just want to pick one up for me.
You just want to hold it nice and close towards your chest.
Again, same posture.
Okay.
Off we go.
So adding the dumbbell is adding that increased resistance that we talked about to make it harder and bring more strength towards our joint.
Really feel the strain with the weight can’t you.
Yeah a little bit of weight makes a difference and you don't have to use a dumbbell.
You can use equipment from around the house such as a tin of beans.
Okay.
Let's make it easier.
So I'm going to bring in the chair, and I'll get you to demonstrate this one.
Just come to the front of your mat.
And if you can take a seat on the chair.
So this is a really nice adaptation to make it easier.
So I want you to start your feet hip distance apart.
Bring your heels towards the chair, arms across your chest, so a sit to stand without using your arms really works our lower limbs.
So technique here.
I want you to bend your weight forwards and then stand up.
Push through the heels, squeeze back of the thighs, front of the thighs and your glutes.
Lovely.
When you're sitting down, take it nice and steady.
Perfect.
Perfect.
Great.
Okay, next exercise have a stand up for it.
Okay.
So let's move on to a bicep curl.
So this is a really good exercise to strengthen our arms.
So let's grab a dumbbell.
In fact grab two.
Yeah.
Perfect.
So again you just want your feet hip distance apart.
Okay.
Try and think about balance across the full foot.
We're going to just relax our arms down by our side.
So a simple bicep curl.
We're going to bend the elbow.
Just bringing the weight towards the shoulder.
So yep, you can do a single bicep curl.
Or as Adam’s demonstrating you can do both arms at the same time.
Okay.
Or you can even do alternate.
Okay.
So we're looking at providing strength to both the elbow and the shoulder here.
Nice.
Perfect.
Okay let's try a tricep exercise.
So just place one dumbbell down onto the mat.
So again you can do this in a seated position to make it easier.
Okay.
But let's start in standing.
So I'm just going to get you to hold the dumbbell with both hands.
Bring it behind your head and gently lower behind.
You're going to extend your elbows up towards the ceiling.
And then slowly lower down.
Good.
Let's go again.
So extend up towards the ceiling, thinking about straightening the arm.
And gently lowering down.
Perfect.
I'll demonstrate how you can make this harder.
Okay.
So you can use two dumbbells.
Okay.
And this time bringing both arms behind the head.
Okay.
Gently extending the elbows and gently lowering down.
So using two weights at the time is increased resistance and makes things much harder.
Perfect.
Okay.
Thank you.
Let's move on to a heel raise.
Okay.
So I'll demonstrate using the chair, which is an adaptation, and I'll get you to do it unsupported.
Okay.
So I'm just going to place my hands onto the back of the chair.
Ideally you want something around the height of your pelvis.
Okay.
Bring your feet hip distance apart.
This time you're going to bring the weight to the front of the balls of the feet.
Okay.
I'm going to lift the heels for a count of three.
Off we go.
One, two, three.
Perfect.
And, three.
two.
one, as we lower.
Let's do another rep.
So here we're really looking around strength and stability around the ankle and the knee.
So to make the calf raise harder, we can simply use some dumbbells to increase the resistance.
Sarah, thank you so much.
They seem really easy to fit in every day, and I think the message is to stick with them.
And they could have a really big impact.
So to make the calf raise harder, simply pick up the dumbbells to increase the resistance.
Thanks for that, Sarah.
And now that you've had a taste for strength training and the benefits that it can bring, it's time to dive a little deeper.
Explore our series of the bite size strength training classes in this app that will help you reduce pain and build strength.
So to make the calf raise harder, simply pick up the dumbbells to increase the resistance.
Thanks for that, Sarah.
And now that you've had a taste for strength training and the benefits that it can bring, it's time to dive a little deeper.
Explore our series of the bite size strength training classes in this app that will help you reduce pain and build strength.
So to make the calf raise harder, we can simply use some dumbbells to increase the resistance.
Sarah, thank you so much.
They seem really easy to fit in every day, and I think the message is to stick with them.
And they could have a really big impact.
And don't forget, you can find more help with strength and exercises to stay well in your group.
It's up.
Brilliant.
And action.
So to make the calf raise harder, you can simply pick up some dumbbells to increase the resistance.
Sarah, thank you so much.
And don't forget, in this app, you'll find a series of bite size strength training classes designed to help reduce pain and build strength.
make it part of your weekly routine and feel the difference strength training can make.
nope.
Now in Germany.
In.
pretty good to die.
Hey, we don't, have the best rating.
Yeah, we just need to wait through this one super quickly.
I got this correctly.
Yeah.
Then you have.
Okay, here we go.
So, version two, intro read.
Done.
And in your own time.
hi, I'm Adam Thomas, and I'm here with Budapest physio line lead therapist.
sorry, sorry.
I used to be a part.
Oh, wow.
Spotted.
No messing about where we.
Grab you.
Just give it a bit.
Yeah?
Yeah.
Okay.
Here we go.
hi, I'm Adam Thomas, and I'm here with Budapest physio line lead therapist Sarah Griffiths to get some tips on getting stronger through some simple exercises which anyone can do and build into our everyday lives really easily.
you can find lots of exercises and guidance to help support healthy muscles, bones and joints in your might boot, but I wanted to start by exploring why strength training is so important.
Okay, yeah, we got it.
Yeah, yeah, I have time.
Okay.
So to make the calf race harder, we can simply add a dumbbell in either hand to increase the resistance.
Well, there you have it.
Thank you so much, Sarah.
They seem really easy to fit in every day, and I think the message is to stick with them.
And they could have a really big impact.
And don't forget, you can find more help with the strength and exercises to stay well.
And you might be put up for Okay.
So I'll get you to demonstrate.
using both arms together.
So what we call a bilateral bicep curl.
And I'll do a single one.
Okay.
Oh.
We get.
Hi.
I'm Adam Thomas, and I'm here with Bupa Physio online lead therapist Sarah Griffiths to get some tips on getting stronger through some simple exercises which anyone can do and build into our everyday lives really easily.
You can find lots of exercises and guidance to help support healthy muscles, bones and joints in your My Bupa app.
But I wanted to start by exploring why strength training is so important.
Hi, Sarah.
It's great to meet you.
So, is it fair to say that getting stronger is one of the best ways that we can help our bodies to cope with any issues affecting our muscles, bones and joints?
Absolutely.
So strength training is really important.
It allows us to feel better, do more, and stay active.
And most importantly, it allows us stay independent to do everyday activities such as going shopping, doing the gardening or walking the dog.
Yeah.
Hey.
You want to get.
Okay.
Quiet, please.
All right.
And action.
Hi, Sarah.
It's great to meet you.
So, is it fair to say that getting stronger is one of the best ways that we can help our bodies to cope with any issues affecting our muscles, bones and joints?
Absolutely.
So getting stronger and strength training allows us to feel better, do more, and stay active.
Most importantly, it allows us to carry out everyday activities independently, such as doing the shopping, getting dressed or walking the dog.
Okay, so give us a little bit of the science here.
Why does being stronger help?
So puts in place?
Strength training is anything that adds resistance to either our muscles or joints to allow them to increase joint stability.
Improve.
It's me and Sarah.
It's me again.
And.
It's been me the whole day, isn't it?
Is it work out?
Yeah, you got it.
This is what I think in terms.
As much as you get to just go, okay.
I think.
Everyone's so honest, like, so much talking.
So I feel like I just want to steady on the you for everyone.
Thank you.
action.
Okay, so give us a little bit of the science here.
Why does being stronger help?
So puts in place?
Strength training is anything that adds resistance to either our muscles or joints to improve the stability, improve our bone density and reduce stiffness or any inflammation around the area.
And is that the same whether you are 18 or 18 and whether you have a specific condition or just suffer with everyday niggles and pains?
So it's strength training is for everybody, no matter what your age is.
So oh, oh, it's because I thought you were telling me to stop, so I'm distracting you.
I'm just pressing.
Oh, sorry.
So sorry.
So.
I'm okay.
Bye, everyone.
Here we go.
And is that the same whether you are 18 or 18 and whether you are sorry.
Yeah.
So I'm going to try to do that.
We're going to get that.
Yeah, yeah.
Okay.
Quiet, everyone.
and so is that the same whether you were 18 or 18 and whether you have a specific condition or just suffer with everyday niggles and pains.
So strength training is for everybody, no matter what you are.
It may just be that you need to adapt it depending on your age or if you do have a long term condition.
Right now, I've just recently been diagnosed with psoriatic arthritis, so I'm looking for always ways that I can help myself.
Kind of some of what you're showing me today help ease pain and relieve the symptoms.
Absolutely.
So we know with, rheumatoid arthritis that we get joint pain, inflammation and swelling, specifically in wrists, ankles.
but it can be all around the body.
We know that strength training improves, joint stability and strength and can help reduce flare ups.
So it's never too late to get started, even after a diagnosis.
Absolutely.
So strength training is even more important after a diagnosis.
As I mentioned previously, it can reduce flare ups and associated risks such as falls.
Okay.
Right.
Shall we?
Shall we get started then?
what's our first exercise?
Okay, let's start with a simple squat.
So I want you to come on.
Time out.
You're going to bring your feet towards the outside and just turn your feet out to where feels comfortable.
So when we're doing a squat, we really want to think about our position.
So you want to put the weight to the back of your heels.
Imagine if you're going to sit down on a chair and avoid your knees coming forwards over your toes.
Okay.
For this demonstration we'll bring our arms out in front.
Let's go.
As you stand nice and tall, squeeze the muscles at the front and the back of the thighs.
Should we go again?
Yeah.
Perfect.
We can make this hard by adding a dumbbell.
So if you just want to pick one up for me, you just want to hold it nice and close towards your chest.
Again.
Same posture.
Okay.
Off we go.
So adding the dumbbell is adding that increased resistance that we talked about to make it harder and bring more strength towards our joint.
Perfect.
The strength with the weight.
Continental.
Yeah.
A little bit of weight makes a difference.
And you don't have to use a dumbbell.
You can use equipment from around the house, such as a tin of beans.
Okay.
Let's make it easier.
So I'm going to bring in the chair, and I'll get you to demonstrate this one.
So if you just come to the front of your mat and if you can take a seat on the chair.
So this is a really nice adaptation to make it easier.
So I want you to start with your feet hip distance apart.
Bring your heels towards the chair, palms across your chest, so as to stand without using your arms.
Really works on lower limbs.
So technique here.
I want you to bend your weight forwards and then stand up.
Push through the heels, squeeze back of the thighs, front of the thighs and your glutes.
Lovely.
When you're sitting down, take it nice and steady.
Perfect.
Okay, let's move on to the next exercise.
I'll just take the chair away from me.
So if you want to grab a dumbbell each, we're going to do a simple bicep curl.
Okay.
So I'll get you to demonstrate.
using both arms together.
So what we call a bilateral dumbbell curl and a bicep curl.
And I'll do a single one.
Okay.
Off we go.
So just going to bend the elbow to where feels comfortable and make sure you straighten it all the way down.
You can also use alternate method.
So doing one arm at a time.
You can also do this exercise and seated to make it easier.
Okay.
So we're looking at providing strength to both the elbow and the shoulder here.
Nice.
Perfect.
Okay let's try a tricep exercise.
So just place one dumbbell down onto the mat.
So again you can do this in a seated position to make it easier.
Okay.
But let's start in standing.
So I'm just going to hold the dumbbell with both hands.
Bring it behind your head and gently lower behind.
You're going to extend your elbows up towards the ceiling.
And then slowly lower down.
Good.
Let's go again.
So extend up towards the ceiling.
Thinking about straightening the arm and gently lowering down.
Perfect.
I'll demonstrate how you can make this harder.
Okay.
So you can use two dumbbells.
Okay.
And this time bringing both arms behind the head.
Okay.
Gently extending the elbows and gently lowering down.
So using two weights at the time is increased resistance makes things much harder.
Perfect.
Okay.
Thank you.
Let's move on to a heel raise.
Okay.
So I'll demonstrate using the chair, which is an adaptation, and I'll get you to do it unsupported.
Okay.
So I'm just going to place my hands onto the back of the chair.
Ideally you want something around the height of your pelvis.
Okay.
Bring your feet hip distance apart.
This time you're going to bring the weight to the front of the ball.
To the feet.
Okay, I'm going to lift the heels for a count of three.
Off we go.
One.
Two.
Three.
Perfect.
And 3 to 1 as we lower.
Let's do another rep.
So here we're really looking around.
Strength and stability around the ankle and the knee.
Perfect.
If you want to make it harder, you can hold a dumbbell in either hand to add the resistance.
So.
All right.
Breathe.
I feel like it's just me, so.
Okay.
issuer.
Yes.
How would you want to surround them?
Well, I think if we just, we just do the last half of the last exercise and then, that you can cut from one.
Yeah.
Okay.
Should we do that?
Several.
And.
Yeah.
yeah.
Just.
Pause the last couple of lines, you said Sarah.
so I said we could use a dumbbell to make the calf raise harder to add more resistance.
Like, because we've got different versions that people need to say that line, but all the different versions, they are Adams doing.
For the sake of this, Oh, good.
So full on action, you say, your last few lines about adding the dumbbells to add more resistance, and then you've got the, different versions of the actual screen.
Okay, perfect.
I had the chair in front of me just in front of me.
it's that's the last thing.
It was in front.
Yeah.
For continuity.
Yeah.
And what did you move the chair as you set the off?
No, I just set it.
I set it, as I said.
Sure.
Okay, cool.
So, Here we go.
This is fashion one.
what's my what kind of equipment?
Yes.
So, back to front, man.
Can you send it around?
Yeah.
Oh, sorry.
It's back.
Yeah, I thought you were.
Oh, that's the, really easy to fit in.
And I think the message is stick with them, and they could have a big impact.
And don't forget, you can find more help with strength and exercises to stay well in your my Bupa app.
Okay, so that's the things I mentioned.
Take my take a tough shot.
Okay.
Boop.
Touch.
Yeah.
This was three questions.
Oh, God.
Okay.
No pressure.
Yeah.
No.
Let me go up.
Go ahead.
Okay.
Yeah.
It's, on action.
It's, something you need to know.
Okay.
Here we go.
We one.
Okay.
Five plays.
Okay.
To make the calf raise.
Oh, sorry.
Sorry.
Okay.
action.
Okay, so to make the calf a little.
Okay, so to make the calf raise harder, we can simply add a dumbbell in either hand to increase the resistance.
Well, there you have it.
Thank you so much, Sarah.
They seem to really easy.
As I say, they seem really easy to fit in every okay.
Sorry.
Okay, so on the top, actually.
So adding resistance to that rule or.
Sorry, I thought it was going to go.
So tonight.
Oh, God.
All right, so to make the calf raise harder, you can simply add some dumbbells to add resistance.
Well, there you have it.
Thank you so much, Sarah.
They seem really easy to fit in every day.
And I think the message is to stick with them.
And they could have a really big impact.
And don't forget, you can find more help with the strength and exercises to stay well.
And you might be put up, perhaps, not ready to the same place there.
There we go.
And action.
So to make the calf raise harder, we can simply add dumbbells to increase resistance.
Amazing.
Thank you so much, Sarah.
They seem to really ease this.
Why do they keep saying that?
They seem really sorry.
No.
No problem.
So at the top.
action.
So, to make the calf raise harder, we can simply use some dumbbells to increase the resistance.
Sarah, thank you so much.
They seem really easy to fit in every day.
And I think the message is to stick with them.
And they could have a really big impact.
And don't forget, you can find more help with strength and exercises to stay well in your group.
It's such app.
Anyone?
Here we go.
And action!
So to make the calf raise harder, you can simply pick up some dumbbells to increase the resistance.
Thanks, Sarah.
And don't forget in this app you'll find a series of bite sized strength training classes designed to help reduce pain and build strength.
Make it part of science, or make it part of your weekly routine and feel the different strength training.
Okay, so ignite from the top and so to make the heel.
Oh, God said he'll race.
All right.
Okay, so to make the calf race harder, simply pick up some dumbbells and that will increase the resistance.
And don't forget in this app you'll find a series of bite sized.
So you'll bite sized strength training.
for each time.
Oh, I'll do that.
Yeah.
Okay.
So, unless you just want to record that, that's all I think you can add.
Lift it back to you.
Yeah, yeah, yeah.
Okay.
here we go.
action.
So to make the calf race harder, you can simply pick up some dumbbells to increase the resistance.
Sarah, thank you so much.
And don't forget, in this app, you'll find a series of bite size strength training classes designed to help reduce pain and build strength.
make it part of your weekly routine and feel the difference strength training can make.
Both okay and the last benefit test and action.
So to make the calf race harder, simply pick up the dumbbells to increase the resistance.
Thank you Sarah, and don't forget in this app you'll find a series of bite sized strength training classes designed to help reduce pain and build strength.
Oh.
No, that's what should be done.
Now that you have a taste for strength training for physical 000.
yes we do.
Sorry.
I accidentally add something saying that you've had it.
Sorry.
Now that you've had to take the first test to bring it, it's time to go.
Okay?
Okay.
action.
So to make the calf race harder, simply pick up the dumbbells to increase the resistance.
Thanks for that, Sarah.
And now that you've had a taste for strength training and the benefits that it can bring, it's time to dive a little deeper.
Explore our series of the bite size strength training classes in this app that will help you reduce pain and build strength.
Yeah.
Okay, now.
We do good to die.
I.
Hey, we got, we just lose weight, and.
Yeah, we just need to whiz through this one quickly, I guess.
Correctly, yes.
Does anyone have.
Okay, here we go.
version two.
intro redone and in your own time.
Hi, I'm Adam Thomas, and I'm here with Bpas physio line lead therapist.
sorry, sorry.
you're right.
Oh.
Well spotted.
No messing about.
We.
Should just give it a bit.
Yeah, yeah.
Okay, here we go.
actually, hi, I'm Adam Thomas, and I'm here with group physio line lead therapist Sarah Griffiths to get some tips on getting stronger through some simple exercises which anyone can do and build into our everyday lives really easily.
you can find lots of exercises and guidance to help support healthy muscles, bones and joints in your My Bupa app.
But I wanted to start by exploring why strength training is so important.
Oh yeah we go okay.
Yeah yeah I have time okay.
Five muscle and joint pain questions you
need the answer to
Watch in 3 mins
Do certain types of footwear cause back pain? Does running cause damage to your knees? Dr Zoe Williams and Bupa's Caitlin McNicholas answer the questions on muscle and joint pain you need to know.
Welcome to Caitlin, who's a Bupa physiotherapist.
We're going to answer some of your quickfire questions on muscle and joint pain.
So quickfire it is, number one.
Is my footwear giving me back pain.
No.
Not necessarily.
For most people, back pain is made up of an accumulation of lots of different factors.
So your footwear might be one of them.
Wearing flat shoes for a run might give you a bad back, but wearing the same pair of shoes to the gym would be perfectly fine.
So it's just about picking the right footwear for the task.
Should people go to these, sort of running shops where they, if you’re getting problems, go to these running shops where they put you on a treadmill and assess you and guide you.
Yeah, data analysis is great because you can understand if you need a more supportive footwear or less supportive to the individual.
So yeah, go get checked out.
It's usually free.
Can too much screen time damage my neck.
Too much of anything is usually not very good for us.
So for a long time at the desk and looking at tech is no different.
Changing your position regularly is really the best way to overcome any posture related injuries.
And that tech neck it’s this isn't it?
Yeah.
Too much of this is it getting common.
It is.
But I think it's more about how enticing the activity on the tech is rather than the position itself.
Is running going to damage my knees.
The short answer is no, which is great.
There are lots of injuries that can occur with running, but they're usually because people have progressed their speed or their distance a bit quicker than their muscles, bones, joints have been able to adapt to the activity.
So follow a graded plan and do some strength training on the side to avoid any injuries.
Do you have to see a physio face to face for it to work?
No, this is a common misconception.
A lot of what physio is is listening to what the problem is, doing some screening over a virtual platform to then help determine, do you need that in person assessment and treatment, or are you okay to continue virtually?
A lot of our assessment is based on what you tell us.
And then we'll do some movement screens and tests to confirm or deny what we've been thinking and then get you set up on a treatment plan.
But there are definitely some scenarios where an in-person assessment and in-person treatment is needed, but your physio should be able to guide you on that.
So I guess the initial assessment, then can actually be done over the phone.
Telephone screening definitely.
If I have muscle and joint pain, rest is best or not really.
Not necessarily.
It's more about dialing things back, make it relative to the injury, and then gradually build up as you recover from a sprain or a strain.
For more chronic conditions like arthritis and low back pain, movement is key because our muscles and joints lubricate themselves as they move.
So it's all about working, maybe with a physio or a coach, to try and break the movement down into more manageable chunks to eventually progress into the full normal, whatever that means for you.
Okay, brilliant.
Well, Caitlin, thank you so much.
Five quick questions and quick answers that hopefully you took something away from.
Managing muscle conditions, joint pain and injuries
Common running injuries and how to prevent them
Running can have many benefits, but it's important to minimise risk factors to prevent injuries.
Common football injuries and how to manage them
Learn about some of the most common football injuries how to manage them and what can be done to prevent injury.
What are the treatment options for knee pain?
Discover what causes knee pain, who can provide treatment and how treatments can differ.
The link between back pain and your emotions
Find out how staying active and adopting a positive outlook can help you to manage your back pain.
How to deal with lower back pain after pregnancy
Our experts discuss what causes lower back pain during pregnancy and how it can be managed after you give birth.
Are muscle aches and joint pains linked to the menopause?
Hormonal changes can cause aches and pains but there are various ways these can be managed.
How to recover from injury
Watch in 6 mins
Understand how to treat injuries and ease back into exercise to avoid long term problems with Dr Zoe Williams and Bupa's Sarah Griffiths.
I'm here today with Bupa's physioline lead therapist, Sarah Griffiths, who is going to talk us through what to look out for when we notice pain after exercise.
What are the differences between niggles and injuries, and what we can do to ease ourselves back into exercise post injury.
So, Sarah, what are your top tips for people who are recovering from injury, trying to get back into exercise?
And how can we tell the difference between, you know, that muscle soreness because you've done a bit more than usual to something that's a bit minor to something that's more serious?
Sure.
So when I'm looking at whether this is a niggle or whether it's an injury, there are five things that I look out for.
So one is has there been a severe, sudden onset of pain that stopped you in your tracks and you can no longer exercise?
The second one is it doesn't improve with rest.
That's indicated that it may be an injury rather than a niggle where it tends to improve without any intervention.
Three is anything other.
So thinking about swelling, bruising, tenderness or heat to the area.
Again, an indication it could be an injury over a niggle.
The fourth thing is is it a recurrent symptom.
So is it happening at the beginning of exercise in the middle and after.
And is it happening all the time?
So niggles can turn into injury.
So it's important to look out to see if this has occurred before.
And finally, past medical history.
Are you aware that that person has injured their knee or hip previously it may be an indicator that it is a reoccurring injury.
For people who love moving their bodies, love exercising after injury, that natural reaction is to just want to get back to it straight away as soon as possible.
Do you see that?
All the time.
Treat patients all the time where as soon as their injuries are recovered, they want to jump straight back into the exercise.
So we really want to think about a gradual return to exercise and something that could help with this sort of short term and long term goals.
So setting small, gradual goals, tracking your process to a long term goal such as a 10k race.
Can we speed up our repair and recovery?
Yes.
There are certainly things we can do at home.
So self-help techniques.
So we follow sort of the POLICE and HARM principles.
So HARM is avoiding anything that may make the injury worse.
So avoiding heat, alcohol, running or high impact exercise and massage in those sort of first few days, and then things we can do to help are protecting the joints.
We may need a period of rest, but then we really want to get back to that optimal loading.
So getting back to weight bearing activities as soon as possible.
Ice can also help, compression and elevation.
I think people used to think you just have to rest, don’t you, completely, but now you know, initial rest.
But gradually starting to try and keep things moving because otherwise you get stiff all over, don't you, if you don't keep moving.
Yes that's right.
Movement is the key to recovery.
And then once finally, the injuries recovered.
How can people ease back into their typical exercise regime?
Yeah.
So we touched on this earlier, but again, really thinking about setting those short term and long term goals, making sure that we don't do too much too soon and end up with further injury.
Fantastic.
Sarah, some really great information and advice there.
And don't forget you can get more support with exercise and wellbeing in your myBupa app.
Managing muscle, bone and joint pain
Watch in 45 mins
Dr Zoe Williams and guests TV actor, Adam Thomas and Bupa's Physioline Lead Therapist, Sarah Griffiths, discuss ways to manage pain, cope with it and reduce the impact it has on our lives.
(bright music) Hi, everyone, and welcome to the latest in our "Inside Health" series.
Today we're getting into the topic of managing pain and specifically pain that affects muscles, bones, and joints.
Unfortunately, living with pain is a really common reality for many people, whether it's caused by a specific long-term condition such as arthritis, a short-term issue caused by an injury, for example, or simply just wear and tear due to getting older.
And it can impact so many different aspects of our life, from our sleep and our mental health to our ability to be active and even just enjoy normal everyday activities.
So today we're gonna look at some ways to manage pain, cope with it, and reduce the impact that it has on our lives.
And I'm joined by some brilliant guests to help me do that.
First up is Adam Thomas, a recognisable face to so many of you, I'm sure, from his time on shows such as "Waterloo Road" and "Emmerdale", and of course, his recent appearance on "Strictly Come Dancing".
Adam was diagnosed with arthritis about 18 months ago and has been on his own journey of living with and managing the painful symptoms.
So we'll be speaking to Adam all about this very soon.
I'm also joined by Sarah Griffiths, who's a physio at Physioline.
She's the lead therapist there for Bupa.
And she's gonna give us her clinical expertise on ways to manage our pain and get ourselves stronger, as well as bust some myths about treatments and supplements.
And of course, we'll be spending time answering your questions, so please send in questions for our experts on the chat and stay tuned for that later.
So firstly then, over to you, Adam, thank you so much for joining us today.
Thank you for having me.
You're an actor, TV presenter, dancer.
Dancer?
I don't know about that.
Well, you certainly are.
Have you seen me in Strictly?
I did.
You are brilliant.
Absolutely brilliant.
And you're a dad of two as well, but as I mentioned just then, you were recently diagnosed with arthritis.
Yeah.
Specifically psoriatic arthritis in your case.
And that can affect the joints, make them stiff, swollen, and painful.
So let's talk a bit about your diagnosis.
How old were you when you got diagnosed?
I think I'd say about 34, nearly 36.
I know I don't look it.
You don't.
How old were you when you got osteoarthritis You look about 18.
Stop it.
But yeah, I was there.
I got diagnosed with psoriatic arthritis when I was 34.
And yeah, it's been a tough old journey from then onwards, but we're slowly, slowly getting there.
Okay, I think a lot of people think about arthritis as something that only affects older people.
Yeah.
And whilst osteoarthritis, the commonest type does get more common as we get older.
There are many types like psoriatic arthritis, rheumatoid arthritis that crop up in earlier life, don't they?
What symptoms did you start experiencing?
Symptoms of osteoarthritis Well, I was actually training for a CrossFit competition at the time.
Right.
And I got an injury in my knees.
And yeah, several months went by and they just never went back to normal.
And I went to the doctors, went to the hospital, and no one really was giving me any answers.
And then it was a couple of weeks after that, I literally went to bed one night, woke up and I felt like I'd been in a fight with Mike Tyson 'cause my hands, my wrists, my fingers, they were just so stiff and so painful.
I genuinely thought that I'd like fallen out of bed and broken my wrist.
So I went to hospital, had an X-ray, and they didn't pick anything up.
Everything was fine.
And it wasn't until someone mentioned that, well, I could potentially have arthritis.
And I thought, again, going back to what you said, was I thought this was something that you got later on in life.
Yeah.
And so I went to see a specialist, and then yeah, I finally got diagnosed.
It wasn't until like six or seven months that I finally got diagnosed with psoriatic arthritis.
And yeah, it's been a journey for- Been a journey since then.
How did you feel when you got that diagnosis?
A big relief, to be honest with you.
Yeah, because you had an answer.
Because I was in so much pain for so long and no one was really giving me any answers.
So to finally say you've got this, this is how we're gonna manage it now, it was like a breath of fresh air.
Just because I think, again, mentally when you're in so much pain and you don't know why, no one's really giving you any answers, it can be quite challenging.
Yeah.
So to finally get the news that I was.
.
.
Well, I had psoriatic arthritis, it was the step in the right direction.
But obviously there was a long journey ahead, like I say.
And you've mentioned it was the pain.
In your situation, it was the pain.
What was it like?
Where was it?
Which joints were affected and how did that impact your daily life?
I mean, massively.
It started off in my knees, like I said, and then it travelled to my wrists and my fingers.
And then it was in my ankles and in my toes, literally every joint possible.
And especially being so active and I was always going for runs and going to the gym and then that just stopped overnight, literally.
And so it was a huge impact on my life.
And again, not just physically, but mentally, it was the most challenging thing that I've ever had to go through because I've also got kids as well.
And as you can imagine, you've got to stay active and keep fit for them.
So yeah, it was tough.
But again, I had a really good family support network around me and they helped me get through it.
But yeah, the pain was unbearable at times.
Sometimes I couldn't really get out of bed.
I had to get my wife to help me get dressed in the morning.
Really?
My kids would sometimes help me down the stairs.
So yeah, it was challenging, but there is light at the end of the tunnel, thankfully.
Yeah, well I think that's perhaps what only people who experience this understand.
It's that I'm sure it must have impacted your ability to do your job.
But it's the relationships that you have with your family.
When you have children, you were not able.
.
.
We were chatting before we did this, and you were saying you wanted to get up and play football with your little boy, and you just couldn't.
It breaks your heart.
Son's like, "Come on dad, let's go and play football," I'm like, "I can't, sorry.
" It's tough, you know?
And you see it in your kids' eyes when you go to pick them up and you're in pain and they think that they're causing the pain and it's like, it's not like that.
It's nothing to do with you.
Yeah.
But they they were young, but then they got they learn how to deal with it just as much as I did.
And I'd sometimes pick up a cup and he'd get it for me or he'd open it up the jar of jam for me.
Just little things like that.
Yeah.
And he'd just really helped me out.
Especially my oldest son, Teddy, was an absolute gem from the start.
So again, it's just important to have a family around you, but also for them to understand what you're going through, because with arthritis as well, because it's not a physical condition, you can't see it, it's quite a lonely disease because you are in pain and no one can necessarily see the pain that you're going through.
And also you don't want to go out your way and tell everyone I'm not.
.
.
Like a sob story sort of thing.
So it's just you just got to keep it to yourself sometimes.
But what I have found later down the line is that the more that you talk about it is the most important thing.
And I feel like more people need to be aware about the condition and that it's not just young people that are going through it.
So 'cause you're in pain and you've had this period of being in pain, how have you managed to cope with it day to day?
And I guess what maybe tips and tricks might you have for other people?
What can they learn from you?
I mean with arthritis, everyone's different, but for me, I mean, I've got every wrist strap under the sun and what's so good about these wrist straps is you can.
.
.
I feel like heat helps with my joints quite a lot.
But also, you can put them in the freezer as well.
So I put them on quite often.
Just finding out what works for you and what doesn't.
And again, I've got a blanket that I put on when I get into bed, just heats the bed up just to warm the joints up.
And I just feel like little things like that just make it a big difference.
Can diet help as well?
Yeah, I suppose so.
I mean, there's all sorts of diets out there.
And again, being so outspoken about my journey, you can sometimes get inundated with information about you shouldn't do this, you shouldn't do that.
But again, you've got to do what's right for you.
and again, it's about trial and error, and trying different foods and what's causing flareups, what's not causing flareups, and just trying to do the best job that you can do.
Listen, it's not gonna happen overnight, but again, you've just got to try and do the best job that you can do.
And I think obviously there is so much information, 'cause there's information from healthcare professionals and there's loads of information online, and I'm sure many family members and friends will sort of chip in with their bits of advice, and then there's the social media.
Exactly.
Loads of things that are said to be cures.
And did you try anything or really invest in anything that didn't work?
That didn't work?
I mean, I tried pretty much everything.
Did you?
Yeah, I did.
But for me, the main important thing for me was exercise.
And I couldn't necessarily go to the gym.
I couldn't really run, I couldn't lift weights.
So and again, I wanted to try and involve my kids as much as possible by just doing activities with them.
And I think swimming for me was the key thing, 'cause I could go swimming, but also I could be there with the kids.
It was something that we could do as a family.
And so yeah, I really found it beneficial for my pain, but also just the quality time with my kids because you sometimes miss out on the activities of playing football and doing these fun things with them.
So we just try and went for swims as much as possible.
Yeah.
No, that's a great thing to do.
And how are you doing now then?
I'm really good.
You're sat here, you look great.
Oh, stop it.
Looking 18 years old.
Yeah.
You don't look like you are in pain.
No, listen, I'm in a little bit of pain, but as from where I was to where I am now, huge difference.
Right.
Huge difference.
And again, like I don't take anything for granted anymore because I know what it's like to not being able to go for a walk and being in pain or going for a bike ride.
So every time I go to the gym now and I'm getting a sweat on or I'm going for a bike ride or a walk, I just really embrace it now and just enjoy every minute of it, because yeah, you just never know when these things are gonna get taken away from you.
And it's the small things that we necessarily take for granted and I don't wanna take any of it for granted anymore.
So yeah, fingers crossed, we're okay for now.
Good, good.
Yeah.
Thank you, Adam.
Thank you so much for sharing your story and I'm sure that there are many of our viewers that will find that very relatable, and it's great to hear that you're feeling much better now.
Thank you.
We'll be putting some of your questions to Adam a bit later, so please do stay tuned for that.
Now, Adam, you mentioned that exercise is something you do to help you manage your condition and cope with pain.
And it's actually true that for most people, strengthening your muscles and becoming physically stronger, it's one of the best things you can do to help your body cope and manage muscle and joint pain and stiffness.
Now that might sound a bit intimidating and even sound counterintuitive when you're experiencing pain, but Adam and Sarah actually met up yesterday to show us a few simple ways we can all work on our strength.
So let's have a look at what they got up to.
(upbeat music) Exercise What's our first exercise?
Okay, let's start with a simple squat.
So I want you to come onto your mat, you are gonna bring your feet towards the outside and just turn your feet out to where it feels comfortable.
So when we're doing a squat, we really want to think about our position.
So you want to put the weight to the back of your heels.
Imagine if you're gonna sit down on a chair and avoid your knees coming forwards over your toes, okay?
Okay.
For this demonstration, we'll bring our arms out in front.
Let's go.
As you stand nice and tall, squeeze the muscles at the front and the back of the thighs.
Should we go again?
Yeah.
Perfect.
We can make this harder by adding a dumbbell.
So if you just want to pick one up for me and you just want to hold it nice and close towards your chest, again, same posture.
Okay, off we go.
So adding the dumbbell is adding that increased resistance that we talked about to make it harder and bring more strength towards our joint.
Perfect.
You really feel the strain with the weight, can't you?
Yeah, a little bit of weight makes a difference and you don't have to use a dumbbell.
You can use equipment from around the house, such as a tin of beans.
Okay.
Let's make it easier.
So I'm gonna bring in the chair and I'll get you to demonstrate this one.
So if you just come to the front of your mat and if you can take a seat on the chair.
So this is a really nice adaptation to make it easier.
So I want you to start with your feet hip distance apart.
Bring your heels towards the chair, arms across your chest.
So a sit to stand without using your arms really works our lower limbs.
So technique here, I want you to bend your weight forwards and then stand up, push through the heels, squeeze back of the thighs, front of the thighs and your glutes.
Lovely.
When you're sitting down, take it nice and steady.
Perfect.
Perfect.
Great.
I love that.
Okay, next exercise.
Have a standup for me.
Okay.
So let's move on to a bicep curl.
This is a really good exercise to strengthen our arms.
So let's grab a dumbbell.
In fact, grab two.
Yeah.
Perfect.
So again, you just want your feet hip distance apart, okay?
Try and think about balance across the full foot.
We're gonna just relax our arms down by our side.
So a simple bicep curl, we're gonna bend the elbow just bringing the weight towards the shoulder.
So yep, you can do a single bicep curl as Adam is demonstrating.
You can do both arms at the same time, okay?
Or you can even do alternate, okay?
So we're looking at providing strength to both the elbow and the shoulder here.
Nice.
Perfect.
Okay, let's try a tricep exercise.
So just place one dumbbell down onto that.
So again, you can do this in a seated position to make it easier, okay?
But let's start in standing.
So I'm just gonna get you to hold the dumbbell with both hands.
Bring it behind your head and gently lower behind.
You're gonna extend your elbows up towards the ceiling and then slowly lower down.
Good.
Let's go again.
So extend up towards the ceiling, thinking about straightening the arm and gently lowering down.
Perfect.
I'll demonstrate how you can make this harder.
Okay.
So you can use two dumbbells, okay?
And this time bring in both arms behind the head, okay?
Gently extending the elbows and gently lowering down.
So using two weights at a time is increased resistance, makes things much harder.
Perfect.
Okay.
Amazing.
Thank you.
Let's move on to a heel raise.
Okay, so I'll demonstrate using the chair, which is an adaptation, and I'll get you to do it unsupported, okay?
So I'm just gonna place my hands onto the back of the chair.
Ideally you want something around the height of your pelvis.
Okay, bring your feet hip distance apart.
This time, you're gonna bring the weight to the front of the both of the feet.
Okay.
I'm gonna lift the heels for a count of three.
Off we go.
One, two, three.
Perfect.
And three, two, one as we are lower.
Let's do another rep.
So here we're really looking around strength and stability around the ankle and the knee.
So to make the calf raise harder, we can simply use some dumbbells to increase the resistance.
Sarah, thank you so much.
They seem really easy to fit in every day, and I think the message is to stick with them and they could have a really big impact.
That was great, guys.
And it just goes to show how simple it can be to work on our strength and support our bodies, and that you don't need tonnes of equipment or to be in a gym.
Okay, so now it's time to chat to Sarah, Bupa's Physioline lead therapist and we're gonna look at some of the common ways many of us might try to manage our pain and get Sarah's expert view on them, and maybe do a bit of mythbusting as well to help separate fact from fiction.
So Sarah, I think let's start with supplements.
There are so many products out there that claim to help alleviate pain, keep joint supple, help us build strength.
And I think if you're in pain suffering with an illness, then if anything is gonna work, you maybe wanna give it a go.
But a lot of these products are very expensive as well, and in lots of cases, they might not actually be needed.
So I think the first question, are there any supplements that we should be taking that are really proven to help with things like joint pain, joint mobility, and building strength?
Yes, so as a physiotherapist, we don't always specialise in supplements, Supplements but I do have end up having conversations with patients around sort of four key things, which are vitamin D, glucosamine, turmeric and protein or protein shakes.
So what about vitamin D then?
We all should be supplementing with vitamin D, especially in the winter months, shouldn't we?
What's your view on that one?
Yeah, absolutely agree.
I think we know that vitamin D helps us to absorb calcium which keeps our bones strong as we get older, so our bone density can reduce.
So making sure we have the correct amounts of vitamin D helps us to keep strong.
And if your patients have things like arthritis then, do you recommend they take more than the standard 10 micrograms, or do you recommend they take it all year round?
Generally take it all all year round.
And if you do need any more, it really is speak to your GP.
We know that conditions such as rheumatoid arthritis, they can be more deficient in vitamin D.
But again, a medical professional will guide you on that.
And then you said glucosamine, which is an interesting one, 'cause I remember when I was first a GP, we used to be allowed to prescribe that on the NHS for joint pain, but then a point came where we weren't able to anymore.
So what's your view on glucosamine?
Yeah, so it was really mixed.
So like you've just said, originally they thought there were some benefits and now there's not as many.
However, one in five people in the UK still take glucosamine.
Do they?
Gosh.
Yeah, it's still something that patients will regularly speak to me about.
And I think I often get asked about this as well and it will work for some people, won't it?
Because the evidence doesn't tell you how it will impact you as an individual.
So is it something you've tried, Adam?
Yeah, I think I've tried pretty much everything that I can do, but again, it's been about being consistent with it.
But again, I don't really do that much research into it.
I just know that people tell me to take it and so I'll take it.
I mean, what actually does glucosamine do exactly?
Yeah, so as we get older and natural with age or long-term conditions, we can have a breakdown of the cartilage in between our joints, which can reduce our mobility and strength and flexibility.
So there was some research that said glucosamine could kind of help that process slow down and provide more sort of joint ability.
However, like Dr.
Zoe was explaining, the evidence base isn't always there.
But then some people do benefits.
It's a tricky one.
What I end up often saying to patients is, look, if this is something that is potentially affordable to you and you want to try it, give it a go.
Buy it, but be regimented, take it properly, and keep a diary of your symptoms.
So after a couple of months, you can really make an accurate judgement as to whether it's benefited you or not.
If it has, great.
If it hasn't, don't waste your money.
Move on to the next.
Yeah, which is turmeric.
Yes.
So what about turmeric then?
Yeah, so it's a natural anti-inflammatory.
So something that you can just incorporate really easily into diet.
You can see sort of turmeric shots or drinks.
Again, it's something that try see if it works, but it's relatively easy to get and relatively cheap if you did want to try it.
They don't taste the best though, do they?
That's why they do them in shots.
And then the last one.
.
.
Protein.
Protein.
Oh yes, protein.
Protein and protein shakes.
Yeah.
Very popular definitely amongst people who are trying to build muscle in the gym just for gain.
But what about for people who are trying to build strength to help them combat a chronic condition?
Yeah, I think somebody, sort of like you said, who isn't a sports person or an little athlete or regularly training in the gym for muscle strength and gains, you can actually get enough protein from a really balanced diet.
So eating balance of meat, fish, tofu, nuts, a portion around the size of your hand.
We need about sort of 0.
75 milligrammes per kilogramme.
So about 0.
45 for women and about 0.
55 for men.
So you can get that from a balanced diet.
So would that be like a chicken breast?
Yeah, so- Roughly per day.
Yeah and other things.
So like we said, you want nuts in there, fish, and if you don't eat that, tofu as well.
But yeah, roughly the size of the palm of your hand.
Okay.
All right.
Okay, great.
So supplements then.
So vitamin D?
Yes.
Yes.
Glucosamine, maybe give it a try.
Turmeric, no harm in whacking a bit in.
And then protein, probably for the typical person, if you're eating a well-balanced diet- You don't always need it.
You may not need it.
Okay, that's really helpful.
Hot vs cold therapy Sarah, what about hot versus cold therapy?
You hear people say put ice packs on, put heat packs on.
Which is best or is it a bit of both?
So just like you said, that it is a bit of both, and it's not really about one being better than the other and it can often come down to preference.
We just need to consider with an acute injury in the first sort of three days, we don't want to be adding heat to the area.
If it's already inflamed, that can increase inflammation so we want to avoid that.
But then going on from there, there's evidence for both.
So it's really about trial and error, see what works for you.
I know you mentioned earlier that sort of heat was beneficial for you before you got into bed and- Just feels better as well.
It just feels so much better, but again, it depends how you're feeling on the day I suppose, doesn't it?
Yeah, definitely.
And some people use what we call contrast therapy, which is a mixture of both, and again, there's evidence for that as well.
So kind of doing 10 minutes of heat, 10 minutes of ice.
So again, it really is about what you find improves your pain and joint stiffness.
So something about that intuition, isn't it then?
If it feels like even though you might've been recommended to put an ice pack on it, if you think, oh, actually I just don't want to, it doesn't feel right, but heat would feel lovely, and be guided by what feels right at that time.
Definitely.
Might be a bit of both.
Can we discuss ice baths please?
We can indeed, yes.
They're everywhere.
Everyone's talking about the benefits of them.
I don't know if you've done them, Adam.
Have you've done ice baths?
I got one, yeah.
But again, it's about being consistent with it.
Yeah.
I was like, "I'm gonna do this every day," but I've only done it once.
Well, there's loads of different benefits potentially of them.
But thinking about coping with pain, what's the evidence there, Sarah?
Yeah so again, there's been lots of research, and again, it can be mixed, but generally to improve overall wellbeing, perceived pain levels, joint stiffness, and muscle pain.
But again, it's what works for you and incorporating it into a daily routine can be difficult.
Ice baths are usually around sort of 10 to 15 degrees and some people add additional ice to make it even cooler.
So it can be a big shock to the system.
It's really important to speak to your GP before you start cold water submersion just in case you do have sort of a heart condition or any other pre sort of medical conditions, and to see if that's the right thing for you.
Again, as we've discussed previously, sometimes heat is better, but it really can depend.
Cold shower And can you get the same benefits by just simply having a cold shower if you don't wanna invest in all the stuff?
So when people ask or patients ask about a cold water submersion, I'll have to say if you've never done it before, look, starting with a cold shower is a really nice way to introduce it gradually.
You can lower your shower to around sort of 15 degrees anyway and you can start gradually sort of 30 seconds and build it up.
So you really don't need to buy a big fancy ice bath that you see on social media.
Okay.
And I think, yeah, really important advice there.
If you do have a preexisting heart condition, Preexisting heart condition then do just get checked out by your GP first of all.
Or do it just very, very gradually, bring it down gradually towards that 10 to 15 degrees.
And finally, Sarah, probably all of our favourite topic here, medicine, movement as medicine.
Is exercise really genuinely the best thing that we can all be doing for our joints, whether we have painful conditions or not?
Absolutely.
So I'm a Pilates instructor and a physiotherapist, so that is absolutely my mantra.
I often.
.
.
Joseph Pilates was the founder of Pilates and he said change happens through movement and movement heals.
And I absolutely believe it.
Movement, keeping our joints supple, keeping them strong is the best way to sort of cope with short or longer term conditions.
And I think the word movement is really helpful, isn't it actually?
Movement 'Cause exercise puts a lot of people off, even I think sport puts people off.
Exercise puts people off, but movement just feels a bit more achievable.
Absolutely.
And The Chartered Society of Physiotherapy actually did a recent campaign called "Love Activity, Hate Exercise", and it was really looking at reframing, just like you've said, that word exercise into thinking about movement or activity, and as you mentioned previously, incorporating it with.
.
.
Incorporating it into everyday activities that you enjoy.
Bad and good days But some people who, I mean let's use Adam as an example, on the days when the pain is really bad or if people are having a flare up, is it better to avoid movement or do less movement on those days and do more on the good days?
How do people balance it?
Yeah, I mean as physiotherapist and when I speak to patients, we really talk about pacing, which is exactly what you've just said there.
So if you are having a bad day, don't feel guilty.
You need to listen to your body and take that downtime.
When you do have more energy and you're having a good day, you want to, yes, do more exercise.
But again, it's about gradually increasing it.
You don't want to do too much on your good days that can then cause a flare up.
So it really is finding that balance.
Something that can really help is kind of keeping a diary of what works for you, how much exercise or activity you can cope with.
Keeping a diary And it is really individualised as well, isn't it?
Everybody's different in what works for them.
Like you say, you just don't want to over overdo it.
On good days, I'd love to go for a run so I'd do five to 10K, and then the next day, they'd just swell up and then I wouldn't be able to do anything for like two weeks.
So it's just about, again, listening to your body and doing what's right.
Absolutely.
And does it depend to some extent what's causing your pain as well?
So would it be the same Longterm vs shortterm pain or different advice for somebody with a long term more chronic condition versus somebody with short term pain 'cause of an injury?
Yeah, definitely.
I think when we're talking about sort of acute or short term injuries, we tend to follow the principals, POLICE and HARM.
So HARM are the things we want to sort of try and avoid, which is heat, alcohol, running, or high impact exercise, and massage, and then things that we can do to help, it's POLICE.
So thinking about protecting the joint, maybe a bit of short term rest, optimal loading.
So try and get back to activity as soon as possible.
Ice, compression, and elevation.
When we're looking at sort of a long-term condition such as what you've got yourself, we're thinking about pacing as we spoke about earlier, but then I've kind of got sort of top three tips that can kind of help introduce that.
So really finding an activity that you enjoy that doesn't have to be at a gym, as you spoke about earlier.
It can be home workouts in the garden or just you don't need any fancy equipment either.
You can use things from around the home, which leads me into the environment.
That was my second top tip.
And then finally, trying to find somebody, if you can, a workout buddy that'll help you keep motivated.
A lot of people with long-term conditions struggle to keep going with exercise and have kind of highs and lows, which I'm sure you can relate to.
So it's really about finding somebody as well that you can go and enjoy that activity or movement with.
So you spoke about the importance of rest, Resting too much and sometimes rest is necessary.
But if people rest too much, are there harms in not moving?
Can that actually make some types of pain worse?
So we want to do as much as we can and keep moving, and like you spoke about, pacing.
But yes, we know that if you've been sat in a chair with that long-term condition, you can feel stiff or getting up first thing in the morning as we're getting older.
So movement really is the key to sort of reducing joint pain, stiffness, and muscle soreness.
Sarah, is it ever too late to start exercising?
Is it ever too late to start exercising I think sometimes people start receiving advice about moving more when they're a little bit older and maybe they've developed a condition or they've got, whether it's arthritis or another painful condition, but they've never been sporty, they've never been active.
Is it ever too late to start?
Absolutely not.
So as a physiotherapist, exercise is our main thing in our toolkit, and it's really safe for all ages.
There are benefits of exercising from an early age and throughout your life.
As you know, when we get older, we have natural changes to our joints, we can actually get stiffness, et cetera.
But it really is safe for everybody.
It can feel daunting though.
So when you're starting a new exercise or returning from injury, it's really about setting some short and long-term goals, and gradually increasing your exercise until you feel confident and maybe getting a routine.
People who do very little exercise Same is true for people who do very little exercise or movement as well, isn't it?
It's almost the less you do, the more you have to gain from just increasing those levels a little bit, whether it's walking around the block or just doing some seated exercise can really give benefit, can't it?
Absolutely.
Yes.
Thanks so much for that, Sarah.
Your questions Some brilliant advice there and a few myths busted as well, and hopefully you feel reassured that some of the best ways to manage pain is actually getting moving and it is almost always safe to do so.
Okay, so now it's time to hand the floor over to your questions which have been flying in on the chat and we'll get through as many as we can in the next 20 minutes or so.
So let's get started.
Sarah, the first question is for you.
I've been advised to build up my strength to support my back pain, and I'm contemplating yoga or Pilates, but I'm a bit confused which is the better one to do?
Well, I'm glad this question came to me 'cause I'm a Pilates instructor.
Pilates vs Yoga Doesn't that make you biassed though?
Well, I always say this to patients as well, but essentially there's benefits of both, and again, it can come down to preference.
So just a bit about them both.
They're both forms of low impact exercise that look to improve strength, flexibility, and overall wellbeing.
So with Pilates, we're looking at strengthening our deep core and specific muscle joints using our arms and legs as levers.
The really good thing about Pilates is there's different levels to the exercises.
So that means if you're new to exercise or you're pacing yourself or returning from an injury, that you can go up or down through the levels, which is really good.
You may have seen there's lots of fancy equipment in studios.
You don't need that.
You can do Pilates at home.
You can just use a mat or a towel and equipment from around your house, things like a water bottle or tin of beans, which is really good.
So on the flip side, there's yoga.
Okay, so yoga is more of a spiritual practise, however it kind of moves through movement and flow and holding positions.
They do a lot of focus on deep breathing and there's often relaxation at the end of the class, and there are lots of different types of yoga.
But one I would recommend for sort of a beginner or somebody with lower back pain is the hatha yoga, which is a slower paced form of yoga.
Okay.
I think, yeah, the preference thing is huge, isn't it?
Give them both a go.
Yeah, absolutely.
It's what works for you, And just a reminder to our viewers as well that there are loads of Pilates and yoga classes in the wellbeing section on the myBupa app.
So perfect opportunity to give them a go, and if you haven't downloaded it yet, do so.
Next question is actually for me.
It says my doctor has recommended some medication which includes steroids to support my pain, but I'm nervous about side effects.
Should I be worried?
And I think with steroids, I don't know if you had any steroids at any point, Adam?
Yeah, I had a couple of steroid injections, yeah.
Yeah.
And they definitely helped massively.
It was when I was doing Strictly, the pain was just unbearable at times and I spoke to them and they gave me a steroid injection, and it just, yeah, overnight changed my symptoms completely.
But again, it's not something that you can have long term.
That's right.
And there's kind of like two different types.
So there's the steroid injections which you referred to, Side effects which can be injected into a specific joint and can alleviate the inflammation and pain there.
But there is a limit to how many you can have, and sometimes for inflammatory conditions, people might be recommended oral steroids as well, of course, of all steroids.
And whilst it is deemed for that to be safe, if it's short term and not too many times, there is a really interesting and quite frightening side effect profile to long-term steroids, which include all sorts of things like increasing your risk of certain types of illnesses like diabetes and glaucoma in the eyes, weight gain, depositing fat in different areas of the body.
They can be very disruptive to sleep, but actually, often when people are unwell and they do have a short cause of steroids, they make you feel amazing.
Yeah.
They make people feel like they're superheroes.
So sometimes it's like anything medicine.
It's the doctors along with the patient should be weighing up what are the benefits and what are the risks at this particular time.
Yeah.
But generally, medicines like methotrexate, like you take, these disease modifying drugs, one of the aims for them is to reduce the amounts of steroids that people need.
So I think to whoever asked that question, Risk vs benefits you're right to be interested in the side effects and make sure you do know what those side effects are.
But have a chat with your doctors about the risks versus benefits.
And likely, if they're recommending a short cause of steroids, you will benefit from them.
The next question is for Adam.
How to get motivated How do you get motivated?
This is a really good one.
How do you get motivated to exercise?
I struggle with motivation and I don't have sore joints.
Everybody struggles with motivation.
If you know the answer, please let me know.
So how do you get motivated?
This person says, "I know it would be good for my pain and I need to do more, but I struggle.
" I mean for me, I get motivated just by.
.
.
Listen, no one ever regrets a good workout, do they?
That feeling when you go to the gym and you're walking out of that, there's no better feeling.
So that's the feeling that I'm constantly trying to chase constantly because I know as soon as I get in the gym, that I'm gonna feel amazing after it.
But also for my kids as well.
There's no point being at a home feeling sorry for yourself.
And I look at my kids and I want them to see their dad getting out and being happy again.
And so yeah, my motivation is my kids and my family, to make sure that I'm getting out there and doing something for myself.
And by doing so, you make your kids happy and they got a big smile on their face, so that's all that matters at the end of the day.
And what a great role model you're being for them as well.
Role model Showing that despite it being difficult and the adversity, you're getting up and going and doing it anyway.
And doing something for yourself, I think as parents we often feel really guilty, don't we?
That we're doing something for ourselves, but we're setting a great example to our children that it's important to do stuff for yourself.
Great answer.
What about with your patients?
What tips do you have for people getting motivated, Sarah?
Yeah, I think short and long term goals are really good.
So if you are, say for example, a runner, you're wanting to get back to sort of a 10K race, setting those short term goals, tracking it as well so you can look back, see where you started and where you are now and see that progress.
I think that's really important.
Sometimes it's hard to see that progress.
Another thing I mentioned earlier is kind of finding the exercise or the activity that works for you and finding your workout buddy, somebody that can help to motivate you.
Yeah, okay, great tips.
Sarah, you tell us which is the best Exercise for osteoporosis or safest exercise to do for somebody with osteoporosis?
So osteoporosis is thinning of the bones essentially.
Yes, the Osteoporosis Society suggests three principles, so strong, steady, and straight, which are really easy for everybody to follow.
So when we're talking about being strong, we're looking about our bone strength, our muscle strength, so anything that essentially we're weight bearing through the joints.
So a Zumba class or walking or jogging perhaps.
Then looking at our steady principles, so really thinking about improving our balance, reducing things like risk of falls, so again, yoga, Pilates, tai chi, or just some simple balance exercises at home.
And then the last principle is straight, so looking at our spinal posture and looking after our spine.
So thinking about strengthening our core muscles, our back muscles, making sure we're lifting properly.
And with somebody with osteoporosis, we want to kind of avoid sort of loading in a flexed position with the spine.
So making sure we've got pent knees when we're lifting shopping bags or maybe avoiding things like sort of a deadlift in the gym.
Okay, all right, that's really helpful.
Adam, you mentioned you struggle with wrist pain.
Wrist pain What helps you most with that?
I mean going back to what I said earlier, wrist straps, hot and cold, but also I feel like a good massage helps a lot.
So I try and get in as many massages as I can and literally just get them just to work on my fingers and my wrist just to try and ease the pain as much as possible.
But again, the wrist straps and just trying to give them as much support as possible, and yeah, I suppose exercises, Well, just little exercises that you can do, just stretching them out in the mornings and at night, I feel really is beneficial and really helps with the pain.
Sarah, have you got any advice for someone with sciatica?
Absolutely.
So sciatica is a really common condition.
I see it all the time.
The main thing people struggle with sciatica is the pain.
It can be really uncomfortable and really debilitating.
And again, the best thing to do is really do as much as you still can manage.
However, sort of three top tips would be around sort of pain relief if you are struggling with that.
So speak to your GP or pharmacist.
We really need to get that pain under control to allow us to move to work on strengthening our core and our spine.
And sometimes the pain stops us from doing that.
A lot of people are nervous around taking pain medication and they don't want to come off it, but for a short period, it really helps us getting moving.
Other thing is adapting sort of daily routines.
So a lot of people, like Adam was saying, will struggle first thing in the morning or last thing at night.
So things like when you're putting your shoes and socks on, use a shoe horn, really simple.
If you're at work, using sort of regular breaks.
Every 20 minutes, get up, have a walk around the office, do some simple stretches or even something like a sit to stand desk can help.
And the other thing I talk about is sleep.
Sciatica can often disturb your sleep.
Again, pain medication can help with that.
But doing some specific and simple exercises before you go to bed.
If you wake up in the night as well, try and move and then first thing in the morning.
Medication Okay, great.
The next one's for me.
It says, "I've recently started a course of medication for my arthritis but will I need to be on this forever.
I'm worried about long-term reliance on medication," which I totally get because many people, the thought of being on medication for the rest of your life, to some people, they don't like the idea of that.
And that might be something you have thought about as well.
I think the thing with, depending on what type of arthritis it is, but something like psoriatic arthritis or rheumatoid arthritis, it's not completely 100% inevitable you'll be on medicine for the rest of your life, because nothing is.
You never know, there might be a cure one day that we'll find for these conditions, but for most people, it does mean it's likely to require medicine.
That medicine may change to a different one.
And sometimes people do feel that they really get their disease under control with lifestyle and feel that they can reduce down or even take a break from medication to see what happens.
It's not inevitable, but most people do stay on medication.
How did you get your head around that one?
I mean, I'm on methotrexate at the minute.
I started off with the tablet form and then there's loads of different side effects for that.
But so then I went over to the injection and I feel like it's, yeah, done worlds apart from the tablet form which I was taking, but again, still a few side effects.
Yeah.
I do worry, again, am I going to be on this for the rest of my life?
And I think now that I've sort of got my life back, I can go back now and make those little changes to try and help myself later down the line so I don't have to be on it as much as I am now, which is not where I want to be.
Planta Fasciitis Yeah, I think that risk benefit that determines medication, it will constantly change throughout your life, and I guess nothing is inevitable in medicine.
Right, next one's for Sarah.
I've developed really painful plantar fasciitis in my foot.
What's the best way to relieve it and will it ever go away?
So to explain what that is, that's the fascist, it's the tissue on the bottom of the foot inside the sole of the foot that connects the heel to the big toe, and if it gets inflamed, it can be really painful, can't it?
Really, really painful.
And I think.
.
.
This is something I treat all the time.
I think with plantar fasciitis, it can be something that takes a little bit longer, up to a year.
But the good news is that with self-help techniques, that can often be a lot sooner.
Some people when they are taking advice and following those things, it can heal sort of within weeks or even months.
But yeah, it can take up to a year to heal fully.
Things we can do to help those, so plantar fasciitis tends to be an overloading injury.
So what I mean by that is you've increased your exercise or changed your exercise, so may that be the frequency or the intensity or even the distance of running, and it just inflames the plantar fascia itself.
So for a period of time, we do need to rest and avoid those triggers.
So that might just be adapting how far you are walking or running potentially.
And then other things are strength and conditioning.
So this is where the evidence base is, is around mobility around the ankle and knee, strengthening around the ankle and foot and knee and also stretching.
Pros and cons, some people find it beneficial, some people find it aggravates it.
So again, trial and error there.
Getting a bottle of water, putting it in the freezer, rolling underneath the foot can really help with pain management.
Acupuncture Okay, this is a good question.
Have any of the panel tried any alternative therapies for pain management?
Can something like acupuncture work?
I guess over to you first, Adam.
Have you tried anything?
What's the other one?
The cups on the back and all?
What's the- Oh, cupping.
Cupping, yeah.
So I've had that done, but did I reap any rewards from it?
I'm not too sure.
Again, we keep using the word trial and error and just finding what works for you and what doesn't.
Acupuncture I believe is a really good one for inflammation.
Yeah, so lots of physiotherapists use acupuncture as an adjunct to sort of physiotherapeutic techniques.
I do it myself, used it with lots of different patients.
So the way acupuncture works is sort of the needles aim to stimulate the natural chemicals that are healing our body and aid to help that recover.
So it's something we're really using in adjunct alongside strength and conditioning where I keep going back to, but that is where the evidence base is.
It can help in sort of the early days as well.
So when people really are struggling with pain, they might not want to take pain medications.
Some people want to try alternative therapies and they benefit.
Again, some people have a more positive effect than others.
So again, it can be around sort of trial and error and using it with other techniques really.
And I think something I find really interesting is there are different levels at which you can intervene with pain.
So we think about what is pain, well, there's usually a stimulus, there are chemicals that release the nerves signal to the brain and all pain is actually created in the brain.
So focusing at the level of the brain, you might not be able to get rid of the inflammation in the joint by doing this, but things like meditation, cognitive behavioural therapy, and other forms of psychological therapy can really help people at the level of the brain.
'Cause your nervous system as well, if you're in pain, it's upsetting, it's annoying.
And as we've spoken about, it can be heartbreaking.
Especially you've got young children and what have you.
So sometimes those psychological techniques maybe don't get rid of the source of the pain, but help how you're able to cope and manage with the pain.
So it's another thing for people to consider.
Thanks, guys.
I'm afraid that's all we have time for today.
So thank you for joining us and I hope you learnt something that you can take away that will help on your pain journey, whatever the cause.
A recording of today's event will be sent out to you on email as well.
So do look out for that.
And finally, a huge thanks to Adam and Sarah for joining us today, and I'll see you next time.
(bright music)
Can Bupa help you take control of your health?
Legal disclaimer
This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals and deemed accurate on the date of review. Photos are only for illustrative purposes and do not reflect every presentation of a condition.
Any information about a treatment or procedure is generic, and does not necessarily describe that treatment or procedure as delivered by Bupa or its associated providers.
The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.
^ Lines are open Monday to Friday 8am to 8pm, Saturday 8am to 4pm. We may record or monitor our calls. Direct Access telephone services are available as long as the symptoms are covered under your policy. If your cover excludes conditions you had before your policy started, we'll ask you to provide evidence from your GP that your symptoms are not pre-existing for a period of up to two years from policy start date (or five years in the case of mental health) before we can refer you to a consultant through the Direct Access service. Always call us first to check your eligibility.
^^ We may record or monitor our calls.
Digital GP Services are not regulated by the Financial Conduct Authority or the Prudential Regulation Authority.
The My Bupa App is provided by Bupa Insurance Services Limited which is authorised and regulated by the Financial Conduct Authority (FCA). Registered in England and Wales at 1 Angel Court, London, EC2R 7HJ. Its company number is 3829851. VAT Registration Number: 239731641.
Bupa Digital GP services are provided by Bupa Occupational Health Limited. Registered in England and Wales with registration number 631336. Registered office: 1 Angel Court, London EC2R 7HJ.
