Even while experiencing joint pain, exercise stimulus is needed!

Pain, joint pain and discomfort. Should we exercise while experiencing “PAIN” ?

Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review.

Based in my own practice over the last 2 decades my answer is definitely YES, but is also great to back it up the practice with this recent study covering the phobia of individuals experiencing pain (joint pain) and how that is actually the element who will lead to the worst case scenario or simply stalk in progress, functional ability or even optimum levels of strength and HEALTH profile been really hard to be achieved.


What does it mean  kinesiophobia ?

“Kinesiophobia is the most extreme form of fear of movement, and is defined as an excessive, irrational and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or reinjury…”


This recent study has found the following:

“Sixty-three articles (mostly cross-sectional) (total sample=10 726) were included. We found strong evidence for an association between a greater degree of kinesiophobia and greater levels of pain intensity and disability and moderate evidence between a greater degree of kinesiophobia and higher levels of pain severity and low quality of life. A greater degree of kinesiophobia predicts the progression of disability overtime, with moderate evidence. A greater degree of kinesiophobia also predicts greater levels of pain severity and low levels of quality of life at 6 months, but with limited evidence. Kinesiophobia does not predict changes in pain intensity.”


“It is common that when there is pain it will be fear of any movement and exercise that can possibly aggravate the problem, experiencing the kinesiophobia (fear of movement). But in fact, exercise is extremely good for the pain relief and can be an essential part of the healing process, also can help reverse the problem to its core, which is the weakness and muscle imbalances around the body. So the fear of exercise can be stopping you from getting this great medicine dosage on the weekly basis.

The fear of movement leads to inactivity and a sedentary lifestyle which causes loss of function ability and strength and quality of life which will cause more pain. Consequentially more pain will cause more fear successively…” (Dr Paulo Gentil)


Over the years I have found in training general population carrying injuries or past injurers that the most important fact in execution would be staying away form the angles where the painful discomfort was present and utilising protocols of TSC (Time Static Contraction) and Isometrics to achieve the desired outcome of fatiguing the target muscles for stimulus of positive adaptations in strength and also oxygenate blood flow within the area and muscles in activation to be very important part of the process, consequentially and progressively evolving to a more dynamic (concentric/ eccentric) method after pain is alleviated.

It is quite incredible and understandable that the individual who has experienced lower back pain will be at some level afraid to execute any exercise for the lumbar musculature. Counterintuitive as it sounds it is exactly what it needs to happend for both stimulating the protective mechanism (skeletal muscle system) and the flow of oxygenate blood (where a lot of the healing components would concentrate).

Of course the tools a practitioner will use and how it will execute the exercise are both paramount for a positive outcome in rehabilitation and strengthening progress. The most effective tools I’ve ever come across would be the clinical line of medical MedX equipment, Nautilus and David Health Solutions rehab line of equipment, all incredibly effective in isolating the lumbar musculature not allowing any other muscle to interact.

I personally’ve used the roman chair bench in a very specific way (super slow cadence / peak contraction and statically) and experienced incredible progress and remission in many cases of pain and discomfort. Now in the training chamber of Intense Health Clinics in the last couple years I’ve been utilising the TSC protocol with motorised resistance equipment for rehab/strengthening and “working around pain, not on top of it” and I am both impressed and excited with the possibility of helping more individuals to work thru the fear of exercise due to the previous experience of injuries or joint pain, the exploration of new methods and execution it’s a never ending game where every six months evolve and morph into and based on results experienced, I am not a healer or make any empty promises in regards to getting clients to a pain free state but there one element I am comfortable with is saying that staying where you are, not trying, feeding the fear which will drive sedentary behaviour, sarcopenia (the loss of muscle mass), consequentially increase of body fat and the cascade of unhealthy events which will follow is definitely not the best option.


“Keep doing the same things over and over again and expect different results is the definition of… insanity.”


1st – Find the practitioner 

Yes, we need good practitioner and sensible professional execution and understanding of human physiology and anatomy to feel confident in progression not regression with pain experiences so search for the good ones out there, they do exist.

2nd – Get Stronger 

The fear of committing to exercise is definitely holding you back form experiencing the state of “pain free” you want and deserve to experience a full of energy day to day lifestyle, you need to strength train the muscles around the experienced issue, skeletal muscle system is the protective mechanism of you tendons, ligaments and joints. GET STRONGER!

3rd – Being Healthy Helps

The mechanical work with muscle being the primary focus in a effective strategy that will focus on the causation not symptoms (pain) but don’t ignore that this strategy will always work better in a healthy organism other than a nutrient deficient and imbalanced organism. Many Nutritional strategies out there to decrease a pro inflammatory state body, find also a guidance from a appropriate Dietitian who can instruct and guide you for a healthy eating lifestyle based in real food, health and longevity profile better outcomes.

4th – Positive Mind Set

Let the little wins keep the positive mind set flourish over the negativity of saying that you tried everything and nothing works because if you really had tried everything you would be out of pain and experiencing progress but maybe in fact admit to yourself that possibly you have tried one or two things over and over again and never give a good go in a sensible e strength training program.


When it comes to you HEALTH, don’t be soft, be INTENSE.

Marcelo Mesquita

Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review.









Marcelo is the co-founder and Director of Exercise Physiology at Intense Health, Perth's #1 Private Strength Training and Nutrition Clinics.

Marcelo is the co-founder and Director of Exercise Physiology at Intense Health, Perth's #1 Private Strength Training and Nutrition Clinics.