New Way to Exercise: Training to Eliminate Pain
by David Rubenstein, PT

Virtually all movement of the body is achieved through an almost magical symphony between the brain and muscles. Muscle tissue moves everything, not just the body parts such as arms, legs, torso and head but also the fluids in your body such as blood, lymph, water and waste. All muscles possess four basic characteristics: excitability which is the ability to receive and respond to the brain, contractility which is the ability to shorten and thicken or contract, extensibility which is the ability to lengthen or stretch and finally elasticity or an ability to return to its original shape after work.

Muscles cause motion from shortening. They simply close the distance between the points where the ends of the muscle connect or root into a bone. By pulling on the bone, movement is be generated. The cycle of movement refers to a four-part series of biological events that together define how the body gets the muscles to cause motion. Signal is the first event and is when the brain decides (consciously or unconsciously) to make movement and sends an electrical signal via nerves directly to a muscle. The second is called stimulation and is the initiation of a muscle contraction. The third part of the process is the action itself. The fourth is the recovery or rest phase when the muscle returns to its inactive state and original shape. By understanding these aspects of normal and abnormal muscle physiology and biomechanics, health care providers, exercise professionals and practitioners are able to dissect the nature of a problem in order to determine the right course of action of treatment or therapy.

But this presupposes the notion that exercise prescription actually takes into account abnormal muscle physiology and biomechanical effectiveness. It does not. Moreover, the body is continuously breaking down from the influences of entropy (aging) and therefore tends toward losing it's capacity to remain or become strong, flexible, and coordinated.

But there is a clue hidden inside this cycle. It is that the nature of the body is cyclic. By realizing all the body's processes and structures are based in a cyclic pattern, this permits a deeper understanding and therefore enhanced health and fitness choices can be made and are of a more informed sort. Normally, in exercise programming, an evaluation will indicate current status with respect to fitness ability and limitations. This usually results in the typical progressive resistance training program characterized by a selection or menu of exercises executed to treat the indicated results of the initial evaluation.

A cyclic approach allows for the different aspects of healthy body functioning to be addressed; they simply are too numerous to be worked simultaneously and, they can be counterproductive if combined in incorrect ways. For example, a common problem is chronic low back irritation. Attempting strength training at this point can further exacerbate this condition and usually results in a reduction of overall body performance. So a means that regularly checks and revisits the body's parts that are subjected to more erosive and destructive forces pays big dividends.

The use of an exercise cycle is essentially 'theme training'. The theme in the above example could be to specifically address the low back pain with exercises and stretches specific to the nature of the pain. At the same time, working or treating other related or unrelated body parts is efficient because a certain amount of reduced training intensity is appropriate due to the low back pain. So, it is an efficient use of time to work on other weak areas. For example, hamstring weakness or inflexibility nearly always accompanies low back irritation especially if it is chronic or semi-chronic. Other core training work may also appropriate in this case.

ProHab stands for proactive habilitation. Just as in the above example of treating low back pain this "weak point" training and pain elimination work is a key to sustaining the ability to move and exercise. The next theme is called power and coordination and puts a high demand on coordination, proprioception and whole body, non-isolating exercise. The third theme is endurance and is characterized by circuit training and heavier cardiovascular work. Finally, the forth theme is building strength and mass.

This new style of exercise training has an accent on completeness and the treatment of underlying causes to musculoskeletal pain. After all, it is usually the stuff you leave out of your exercise routine that shows up later as pain and limitation.

David Rubenstein is a Restorative Fitness Therapist and has authored three books with his most recent entitled "Fitness on Purpose" (EG Publishing; 2004) which focuses on the elimination of chronic pain through exercise. He is also a UCLA Certificated Fitness Instructor, ISSA Fitness Therapist logging in over 50,000 training sessions. For more info visit, or call 714-899-1449.