Footstep 5

Getting active

People with pain find it helps to be more active and build fitness even if it was not really part of their life before pain arrived.

This is because enjoyable, rewarding and regular activity builds confidence to do things and lessens the struggles with pain.

So let's take a look at what you can do to get fitter and stay active ...

How can I get fitter and more active?

Like many people with persistent pain, you may be avoiding physical activity because you are worried it will make your pain worse.

These fears are normal and understandable – when you live with pain, the last thing that you want to do is aggravate it further! So it may be encouraging for you to know that getting fit and staying active is actually good for your sleep and your pain.

The key to getting fitter is to keep it going every day. To help maintain regular activity levels, there are a number of things that you can do:

Do physical activities that you enjoy

Quite simply, if you enjoy what you’re doing then you’ll be more motivated to keep it up. This could be anything from taking a morning walk through to swimming, playing badminton or gentle Tai Chi or Yoga guided by an app (more ideas below).

Learn the skill of pacing

Pacing is a really useful skill as it guides you to do the level of activity that is right for your body. When you pace your activity, you take a break before pain, tiredness or exhaustion forces you to stop. You can learn more about the skill of pacing in footstep 3.

Try doing activities outside during the day

Being outside in the daylight helps your body clock to stay in balance with day and night time patterns. It can help with stressful feelings too.

Avoid energetic activities shortly before sleep

Exercising late in the day ‘wakes up’ your body and so it can lead to problems falling asleep or staying asleep. To help with sleep, the best time to exercise is late in the afternoon or early evening. Find out more about sleep in footstep 7.

Pete’s story

“Getting fitter and more active played a major factor in reducing my pain. At the start I was one of those people who thought that exercise equalled more pain. It did in the early days, as I tried too hard to do too much, too soon and too fast, I over paced it.

Many people with pain like me stop keeping active because when we move it hurts, but then our muscles become weak and unsteady and our joints get what I call “rusty”.

It’s true that when we start stretching and exercising pain levels can increase, but they soon drop off.

Look at it this way, if a door has not been opened for some time, the hinges may creak a bit. When we move the door backwards and forwards a few times… it stops creaking. It’s the same with our joints and body.

For me getting fitter means not having to take pain medication. I haven’t done so for the past few years. Stretching and exercising are my daily doses of medicine. The only side effects are less pain and feeling good about myself!”

Four ideas for getting – and staying – active

OK, so you'ce decided you're going to become more active. The tricky bit is deciding what to do, how to do it, and how much time and effort to put in. Here are four ideas that can help.

1. Choose something easy and fun

You're far more likely to keep it up if you choose a gentle activity you enjoy. Here are some ideas:

  • A gentle walk in a favourite place – pace the time and length
  • Stretching and listening to your favourite radio programme
  • Gentle yoga or Pilates, guided by a DVD, website or App (see Footstep resources)
  • Volunteering in a museum, public garden or library
  • Dancing to enjoyable music at home
  • Planting out bedding plants in tubs or in the garden

2. Explore local fitness and activity opportunities

Find out what's available in your local area. It could be a fitness group – but anything that involves moving and stretching, such as a pottery class or a singing group, is also fine.

3. Keeping motivated

This can be a tough one, so here are some tips:

  • If the activity you choose is too much effort, simply do something else. To understand more about getting the effort level right, check out the Effort Scale in Footstep 3 – Pacing.
  • Give yourself regular rewards for your successes. Find out ore about why rewards matter in Footstep 4 – Setting goals.
  • Tell other people what you've achieved so that they can see your progress and support you.
  • Find other people to do the activity with – fitness is more fun with friends, and that means you're more likely to keep it up.

4. Dealing with difficulties

Many people still use their pain as a guide as to when to start and stop an activity. This is the pain managing you – it’s not you managing pain!

The main thing to remember is that when you begin to stretch and exercise, it is normal for pain levels to increase.

The good news is, these pains soon go away if you grade your activities. Grading means gently increasing the amount of time you spend doing your stretches, exercises or fitness plan. For example:

Stretching: Day 1: hold the stretches for 5 seconds and do three repeats Day 2: hold a stretch for 6 seconds and do three repeats Day 3 hold a stretch for 7 seconds.... and so on Over the next few days slowly build up the repeats and time on stretching.

What kind of exercise do I need?

Whatever activities you decide to do, make sure they include:


Activities that involve stretching help loosen tight muscles, ligaments and joints and increases flexibility.

Strengthening exercises

Strengthening exercises are anything that build stronger muscles and joints so that you can stand, walk and play for longer. This help you to get out of chairs and use stairs and slopes more easily. Your balance improves and this reduces the chances of falls and pain setbacks.

Stamina activities

These will enable you to do things for longer without more pain or tiredness. This helps you enjoy a range of day to day activities, join in with family and friends and reduce our fear of more pain.

Mick’s story

Mick struggled to get fit, reduce weight and felt fed up. He avoided his local pool as sometimes it was too hot and made him very tired and sweaty. A friend, Frank told him about an adult swim and fitness group for people with health problems, saying “I am going next week, come with me, if you like”. Mick swallowed hard and felt nervous and then plucked up courage, “I’ll give it a go”. At the pool, Mick and Frank discovered that other people swimming had similar pain problems. He felt encouraged so swam two lengths of the pool and decided to go again the next week.

Resources for you to use

Getting started

These gentle exercises from the NHS will help improve your mobility and prevent falls, and can even be done at home.

Don't worry if you've not done much for a while – these exercises can be done sitting down and are easy to follow.

NHS Choices Fitness Studio

Needing more ways to being or staying active? Explore NHS Choices Fitness Studio online for exercise videos and learn Yoga, Tai Chi and Pilates at your own pace at home.

“Love activity hate exercise?”

According to the Chartered Society of Physiotherapy chronic pain affects at least 20% of people in the UK and many are able to carry on with daily activities. Their Love Activity Hate Exercise campaign explains how to get started without causing more pain, and includes people’s stories of being active despite chronic pain as well as how to start swimming, dance and cycling.

Keep Moving

Keep Moving is a booklet from Versus Arthritis providing information and answers to your questions about how to exercise if you have arthritis.

Pain Toolkit – exercising

Pain Toolkit website has 15 reasons why stretching and exercising is good for you...

Getting active: key ideas

  • People with pain find it helps to be more active even if it wasn't part of their life before pain
  • The key to getting fitter is to keep it going every day
  • Choose activities you enjoy, pace your activity – and reward yourself
  • Doing things with friends will help keep you motivated