How to Approach Exercise When You’re in Pain

There are endless benefits to physical exercise, and you should keep up with regular physical activity while you’re learning Clinical Somatics exercises—unless your workouts are making your pain worse or preventing you from making progress.

In this post, I’ll discuss:

  • The benefits of working out while learning Clinical Somatics exercises
  • What to do if your regular workout makes your pain worse or holds you back
  • What to do if all types of exercise make your pain worse
  • How to approach common types of exercise safely
  • The benefits of cross-training
  • How to incorporate Clinical Somatics into your workout routine
  • The importance of warming up

The benefits of working out while you’re learning Clinical Somatics exercises

Working out gives you an opportunity to put what you’ve learned from Clinical Somatics exercises into practice. It’s like taking what you learned in school and applying it in the real world. If you do it effectively, working out can enhance the progress you’re making in your Clinical Somatics practice.

You can do this by staying acutely aware of how you’re using your body during your workout. Slower, less intense workouts give you the opportunity to integrate muscular releases and postural shifts because you have the time to focus on how you’re moving.

So if you continue your regular workout routine while trying to get out of pain or retrain muscular patterns, I recommend either making the entire workout slower and less intense for a while, or taking time to warm up very slowly and gently.

Think about where in your body you typically hold excess muscle tension. Do those areas tense up even more when you work out? If so, slow down and dial down the intensity of your workout until you’re able to keep those areas relaxed.

When you’re working out, do you feel tension in any muscles that don’t really need to be used? This is called “recruiting.” Recruiting builds up excess muscle tension, creates inefficient movement patterns, and uses unnecessary energy. If you find yourself recruiting muscles that don’t need to be used to carry out the movement, slow down and try to keep them relaxed as you move.

If you’re trying to correct a postural imbalance or improve your form, a mirror can be extremely helpful when working out. The mirror gives you objective feedback about your alignment. You can then learn what correct form feels like in your body—just like doing the Somatics proprioceptive exercises.

If using a mirror during your workout isn’t possible, use a mirror at home beforehand to observe your posture. Bring yourself gently into proper alignment, and memorize how that posture feels internally. As you work out, continually remind yourself of what that correct posture feels like.

Always remember: The faster or more intense your workout is, the more likely it is that you’ll slip into old muscular habits. So take the time to warm up slowly, and slow down anytime you feel like you need to get back into proper form.

As you continue to practice Clinical Somatics exercises and improve your sensorimotor awareness, you’ll become increasingly aware of how you’re using your body when exercising. Maintaining proper form and using your body efficiently will continually become easier and more intuitive the longer you practice Clinical Somatics.

Other benefits of exercising while trying to get out of pain or tension are:

  • Improved circulation, which speeds healing of muscles and connective tissues
  • Decreased inflammation, which reduces pain
  • Improved flexibility of connective tissues as a result of regular movement
  • Improved mood and reduced stress, which help to lessen the experience of pain
  • Improved sleep, which is very important in the healing process

What to do if your regular workout makes your pain worse or holds you back

If you’re trying to get out of pain, you should pay close attention to what makes your pain worse as you move through your day. If you notice that your pain feels worse during or after your workout (including the day after), you need to consider changing up your workout routine while going through the healing process. You will probably not be able to make progress with Clinical Somatics exercises if your workouts are keeping you in pain.

It can be extremely difficult psychologically to take a break from your favorite type of workout—I understand this very well from personal experience. But I also know from personal experience that taking a temporary break from an activity that’s causing you pain is well worth it in the long run.

If you’re worried about losing endurance or strength, there may be other types of exercise that can help you retain your level of fitness while not putting you in pain. And even if you do lose a little bit of endurance or strength while you’re healing, you’ll gain it back more quickly than you think once you resume your regular routine. Plus, you’ll be out of pain and your muscular control will have improved significantly. You’ll be able to do your favorite activity with much better form, control, and awareness than you used to. You’ll likely feel that you are able to perform your exercise of choice better because you’ve taken the time to retrain your patterns of tension and improve your body use.

If you’re not in pain, you may find that your regular workouts are simply keeping you stuck in old habits of muscular tension. If you’re in this situation, it can be even harder to take a break from your workouts because you don’t have pain relief as a motivator. But again, I can tell you from personal experience that taking a temporary break is worth it in the long run. It can be difficult to impossible to fully retrain your muscular patterns if you keep reinforcing old patterns during your workouts. So, the same advice applies: Consider exploring other types of exercise if you’re trying to release tight muscles and change muscular patterns.

Below are some suggestions of types of exercise to try. Remember, something is better than nothing! If all you can do before you feel pain is five or ten minutes, that’s fine—just stick to very short workouts. If you’re someone who needs a challenge, then see how relaxed you can keep your body as you move.

  • Slow, gentle walking. It’s not a race! Walk slowly enough that you can keep your body fully relaxed. Enjoy being outdoors, breathing the fresh air, and taking some time for yourself. If you feel your pain or tension returning or getting worse, then that should be the end of your walk.

  • Swimming or water aerobics. These can be especially helpful for people with joint issues or any type of pain that gets worse with standing or impact activities. Be sure to still move slowly and consciously, and don’t do anything that makes your pain or tension worse.

  • Tai Chi or Qigong. Both of these involve slow, mindful movement, and offer great opportunity for you to improve your sensorimotor awareness and incorporate what you’ve learned about your body in your Clinical Somatics practice.

  • Chair exercises. If standing makes your pain worse, explore forms of chair exercise like chair yoga, aerobics, or strength training.

  • Mindful Strength Training to Failure (MSTF). This approach to strength training is very slow and mindful, and highly effective at building strength. It is typically safe for those in pain or with joint or bone issues. (I’ll discuss it again in the strength training section below.)

What to do if all types of exercise make your pain worse

If all types of workouts, including those listed above, make your pain worse, this is an indicator that you should take a break from working out until you start feeling a reduction in your pain. During this break from working out:

  • Continue your daily Clinical Somatics practice, but skip any exercises that make your pain worse.

  • Be sure to spend time outside, which will help to regulate your mood and sleep cycle—both of which can be negatively affected by not exercising.

  • Don’t be completely sedentary. Get up and move around gently as often as you can; this improves circulation, reduces inflammation, and warms up and loosens your muscles and connective tissues.

  • Stick to a healthy diet, and minimize your caffeine and alcohol intake.

  • With your doctor’s approval, you can use a sauna to get your heart rate up. Research shows that regular sauna bathing has similar physical benefits as moderate exercise, including improving cardiovascular function and lowering blood pressure.

How to approach running, strength training, and yoga safely

Running, strength training, and yoga are the types of exercise I get asked about most often. Here is my advice on how to approach them safely.


If you run more than three times per week, I strongly advise you to cross-train, which means incorporating other types of workouts into your weekly schedule (more on cross-training below). While walking and running are the most natural types of exercise for humans, we also need variety in our movement patterns—and if you’re sitting at a desk for most of the day and then going for a run, you’re not getting that variety. Alternating running with other types of workouts that use your body in different ways gives your leg muscles a break and allows your joints to rest and heal.

Run on dirt trails when you can. If you run on concrete, be sure to replace your running shoes frequently.

Keep your body relaxed while you run, and maintain natural, efficient running form. Notice if you’re holding unnecessary tension anywhere and consciously let go of it. I recommend reading ChiRunning and Slow Burn for advice on running form.

Warm up slowly and gently by first walking, and then jogging slowly. When you come into your full running pace, it should feel easy.

Strength training:

There are many approaches to strength training out there. Some of them put dangerous strain on the body, especially when practiced with improper form. Traditional approaches to strength training can also lead to unnecessary muscle tension building up over time.

When you strength train, warming up thoroughly is extremely important; please follow the advice in my warming up section below. It is also important to always maintain proper form, even when you’re lifting your heaviest weight. If you can’t maintain proper form, then you aren’t ready to lift that weight.

To anyone who wants to build strength, I highly recommend the book Deep Fitness by Philip Shepherd and Andrei Yakovenko. The book outlines an approach to strength training developed by Shepherd and Yakovenko, which they call Mindful Strength Training to Failure (MSTF). This is the first approach to strength training I’ve ever found that is in line with the principles of Clinical Somatics, so I can wholeheartedly recommend it to my students. MSTF is also the first type of strength workout I’ve ever enjoyed and looked forward to!

MSTF involves practicing resistance exercises extremely slowly, so that you bring your muscles to failure within about a minute and a half instead of 10 minutes or more. It is the safest, most effective, and most efficient method of strength training I’ve found. If you’re interested in learning how to practice it and why it works, I highly recommend reading the book.

Strength training is an important part of everyone’s workout routine, especially because it prevents muscle loss and weakening of bones as we age. If you tend to avoid strength training, MSTF is something you can easily incorporate into your routine because it doesn’t take much time and doesn’t require a trip to the gym. If you’re already hooked on strength training, MSTF will give you a new perspective and might just change the way you train!


Yoga is a wonderful way to build strength throughout the body and improve balance and control. Yoga lengthens muscles and connective tissues by moving slowly and consciously through ranges of motion. It also reduces stress because it involves deep, diaphragmatic breathing and intentional focus. Practicing yoga several times per week is an excellent way to make your cross-training regimen more well-rounded.

The only downside of yoga is that most forms of it involve some type of static stretching. If you practice yoga and are feeling any negative effects from it, please read this article: Combining your Clinical Somatics and Yoga Practices.

The benefits of cross-training

The best way to keep up with regular exercise while reducing your risk of pain and recurring injuries is by cross-training: practicing different types of exercise on a regular basis. You should incorporate a lot of moderate aerobic exercise, and some strength training and high intensity interval training into your weekly workout schedule.

Humans evolved doing a lot of moderate aerobic exercise (mainly in the form of walking), with shorter bouts of high intensity exercise and strength-building movements. Since that’s what the systems of our body evolved to thrive on, that’s what I personally recommend and practice myself. If you’re interested in learning about how much and what type of movement is ideal for humans, I recommend reading Exercised by Daniel Lieberman, which I wrote about in a recent post.

A well-rounded cross-training regimen should incorporate several forms of exercise that use your muscles in different ways. For example, if you love weight-lifting, do a short yoga routine a few times a week to elongate your muscles and improve your balance. If you’re an avid runner, try swimming so that you can keep up your cardio fitness while taking strain off your legs and giving all the muscles in your body a gentle resistance workout. My personal recommendation is to incorporate at least three different types of exercise that use your body in different ways into your weekly routine.

How to incorporate Clinical Somatics into your workout routine

Many people ask what time of day is best to practice Clinical Somatics, and whether to practice the exercises before or after their workout. I find it most beneficial:

  • To do a few exercises before my workout if I’m feeling particularly tight in a certain area of my body. If I’m not feeling tight anywhere, then I don’t do any Somatics, and just do my normal warm-up.

  • To do my full Clinical Somatics practice (30 minutes) either right after my workout or in the evening when I’m done moving for the day. If you’re planning to be fairly sedentary after your workout, then it’s best to do your Somatics practice right after your workout, before you sit down and your muscles tighten up. If you’re going to continue to move around after your workout, then you can wait to do your Somatics practice until later in the day.

If you wake up feeling tight, sore, and achy, and if you find it beneficial to practice Clinical Somatics exercises in the morning, you certainly can. Just be aware that we all build up some muscle tension as we go through our daily activities—that’s why it can be more beneficial to practice Somatics later in the day. If you currently practice Somatics only in the morning and aren’t experiencing results, try practicing later in the day (either in addition to or instead of your morning practice) and see how you feel.

The importance of warming up

Warming up is a critical element of your workout routine, so don’t skip it! Warming up allows you to prepare both your body and mind for your workout. Moving slowly gives you time to focus on your form. It prevents injuries and sets the stage for a more effective workout. It can even help you burn more fat!

An effective way to warm up is to do slow, gentle versions of the movements you’ll be doing in your workout. Gradually increase the intensity, and don’t rush it. So, for example:

If you’re going running, start by slowly walking, then briskly walking, then slowly jogging. You should feel like your respiratory rate is warming up along with the muscles of your body. So, breathing should feel easy during all of these warm-up phases. Slowly jog for as long as you need to in order to feel that your breathing is easy and your body is warm and relaxed. Most likely, you will naturally pick up the pace as you warm up; you may not even realize you’re doing it! Note to the Type A folks out there who are trying to get out of pain: If you like to run fast and tend to push yourself hard, I recommend reading Slow Burn.

When you strength train, you should start by doing a very slow version of each exercise that you’ll be doing in your workout, but without weight. Slowly, consciously perform each movement without any resistance, taking the time to practice proper form from the beginning to the end of the movement.

When you feel that you’re able to practice the movement with proper form, add a small amount of resistance or weight. Again, take the time to practice the exercise with this small amount of resistance, making sure you maintain proper form from beginning to end. Only continue to add resistance if you are able to maintain proper form. It may feel slow and tedious, but it is worth it in the long run. Soon, you’ll be doing more reps and lifting heavier weights more easily because you took the time to train your nervous system to do it right!

Note: This advice applies mainly to traditional methods of strength training. I highly recommend MSTF as a safer alternative, especially if you have pain, recurring injuries, or chronic muscle tension.

In conclusion, here are some things to remember:

  • Moving a little is better than not at all. If you start feeling pain midway through your workout, try breaking up your workout into two or three short sessions throughout the day.
  • If it causes pain, don’t do it!
  • Always take the time to warm up slowly and focus on your form.
  • Trust what you’re feeling in your body and be willing to try things – like trying a new type of workout or taking a break from exercise altogether if needed. Always remind yourself that the top priority is getting out of pain.