Strength Training for Chronic Pain: Science, Strategy, and the Tide Theory Approach
DISCLAIMER: The information in this article is for educational purposes only and is not a substitute for medical advice. Always consult your physician before starting any exercise program, especially if you have chronic pain or a medical condition.
Strength Training for Chronic Pain: Science-Backed Benefits and Safe Exercise Modifications
If you live with chronic pain, whether it’s from arthritis, a hypermobility disorder, or general undiagnosed pain, the idea of lifting weights might sound impossible. We’ve all heard the warnings that “rest is best” or “exercise may increase the soreness and stiffness you’re feeling.” But what if strength training could actually help you feel better?
This week on Dark Matter & Deadlifts, we’re covering:
The Science behind why strength training can reduce chronic pain
Safe exercise modifications for those with chronic conditions
A beginner-friendly routine you can try today
How Tide Theory’s philosophy helps adapt fitness to chronic illness
At Tide Theory Fitness, we believe that strength can move in phases, just like the tides. Some days will be high-energy and some days will be low-energy - and that’s okay! Fitness should adapt to you, and we’ll help you learn how. Now, let’s get started!
Can Strength Training Reduce Chronic Pain? Science Says Yes!
The Myth: People with chronic pain were historically told to rest to not exacerbate their conditions. But now, research suggests otherwise.
What the Science Says: Strength training reduces pain and improves functional mobility in people with chronic pain conditions.
While we learned through trial and error that exercising and keeping our bodies moving actually reduced pain and stiffness, recent research does support the idea that exercise can be a powerful tool for chronic pain management.
Weightlifting can be intimidating to approach as someone who has pain or other chronic conditions that make movement difficult - but lifting weights doesn’t have to mean throwing 150 pounds on a barbell and trying to bench press for the first time! There are places to start that can help positively impact mobility and strength while avoiding being intimidated at the gym.
According to a study published by the Novus Spine & Pain Center, structured exercise programs—including resistance training—can improve pain levels and enhance mobility over time (Novus Spine & Pain Center, 2023).
By strengthening the muscles around a joint, if you suffer from joint instability such as from EDS, hEDS, or other hypermobility disorders, the muscles will help offload the pressure of those joints, thereby eliminating or reducing some of the associated pain and increasing circulation.
A real-life example of this can come from the sacroiliac (SI) joints. The SI joints are two small joints found at the junction of the sacrum (the triangular bone at the base of the spine) and the ilium (the two large bones of the pelvis). This joint can hurt for a plethora of reasons: pregnancy, injury, walking habits, posture, autoimmune disease, and more. But one commonly suggested fix for it is to walk slowly to increase circulation.
The Best Strength Training Exercises for Pain Management
How Strength Training Supports You:
Joint Health
Some of the best strength exercises for joint pain can start small. By using light dumbbells and low-impact movements, controlled motion, and progressively adjusting factors of your workout to increase strength, you can being to safely exercise even if you have chronic pain.
Strength training plays a crucial role in supporting and stabilizing joints, particularly for individuals dealing with chronic pain conditions like arthritis or Ehlers-Danlos Syndrome (EDS). When the muscles surrounding a joint are weak, it results in more stress being placed directly on the joint itself, which can lead to increased pain, discomfort, and instability. However, by engaging in progressive resistance training, you can begin strengthening these surrounding muscles. By doing so, it will effectively act as a natural brace to reduce excess movement and joint strain, and promoting greater overall stability.
A recent study from The Journal of Musculoskeletal and Neuronal Interactions found that strength training significantly improved joint stability and proprioception in hypermobile individuals, reducing the likelihood of joint dislocations and pain flares (Ehlers-Danlos Society, 2022). Check our resources below to read more on the topic!
Reducing Inflammation & Improving Circulation
Chronic pain is often linked to low-grade inflammation, which can cause nerves and joints to become more sensitive over time. By strength training and utilizing other forms of low-impact exercise, inflammatory markers can begin regulating to reduce overall pain levels. Walking is one of the simplest and most effective ways to start this process, reduce inflammation, and trigger the body to oxygenate and transport nutrients more effectively!
An example of this can be seen in the sacroiliac (SI) joint. This joint connects the base of your spine to your pelvis, and can often become inflamed from postural issues, an injury, osteoarthritis, pregnancy, or a muscle imbalance. When it does, it can feel difficult to walk on it. However, walking can increase your circulation to the lower back, hips, and pelvis, reducing the stiffness around the joint and helping the SI joint function more smoothly and with less discomfort.
Boosting Endorphins & Increasing Pain Tolerance
Lastly, strength training doesn’t just help physically - it can also have powerful impacts on brain chemistry. Resistance exercises often stimulate an endorphin release, the body’s natural painkillers, to reduce perceived pain and promote a good and healthy mood. If you’ve heard ore experienced a “runner’s high,” then youv’e felt the benefits of elevated endorphins! Over time, the more you’re exposed to discomfort in a controlled way (such as lifting weights), the better your brain is trained to handle pain more effectively. This is known as exercise-induced hypoalgesia or pain desensitization.
We can see this in a study from BMC Musculoskeletal Disorders found that consistent strength training increased pain tolerance in individuals with fibromyalgia by enhancing endrorphin release and decreasing the brain’s sensitivity to pain signals. (BMC, 2023).
How to Modify Strength Training for Chronic Pain & Joint Sensitivity
While many with chronic pain struggle with the idea of strength training, it can be highly beneficial to help moderate pain. It doesn’t have to be high-intensity or painful to be effective! By following some of the recommended foundational safety principles, you can reduce your risk of injury and get the best benefit from your workouts!
General Safety Tips for Exercising with Chronic Pain
First, it’s always important to start slow and listen to your body. While it’s tempting to want to push through discomfort — and many trainers and gym promotional will often encourage this as a strategy — pain is not a sign of progress. There’s a fine balance to ride between pushing through the discomfort of working out and pushing through the pain signals of your body telling you something’s off. Unlike muscle soreness, pain is a red flag. If a specific exercise aggravates your pain or causes a flare up, take a break from it or find an adaptive method to do the same thing differently.
Secondly, prioritize form over weight! When dealing with chronic pain, proper form is far more important than the weight of the dumbbells you lift. With an already-compromised system, it’s all the more important to make sure your movement patterns aren’t putting unnecessary stress on joints, tendons, and ligaments. If needed, watch videos on correct form, then watch yourself in the mirror or film yourselves to ensure the best posture and proper alignment!
Third, utilize isometric holds for stability! Isometric exercises — where you hold a position without moving, sometimes midway through a rep — are excellent for stabilizing joints without putting excess strain on them. This is especially helpful for hypermobility, arthritis, and generalized joint pain because it can strengthen the muscles without excessive movement that could irritate weak or unstable joints.
Lastly, adjust your range of movement (ROM). You don’t need to perform full-depth squats or extreme stretches to build strength! Instead, work within a comfortable range of motion and gradually increase as your strength and mobility improve. For example, if squats are too painful, try box squats - with these, you can sit back onto a chair or bench to limit joint stress and give yourself some support!
Strength Training Modifications for Common Chronic Pain Conditions
Not all exercises and modifications work for every condition; It's important to make adjustments and find what works best for you and tailor your strength training to your specific needs. Below are some condition-specific modifications that can help you train safely and effectively.
Arthritis, EDS, and Generalized Joint Pain:
Reduce impact by using machines, which have a very specific track of motion. This can be useful if you have weak stabilizer muscles, or you need extra reinforcement in the technique of the movement.
Utilize resistance bands and bodyweight exercises instead of heavier weights.
Limit hyperextension by keeping joints slightly bent at the end of each rep. Sometimes, this will look like you aren’t completing the rep - and that’s okay. Partial reps are better than zero reps.
Use isometric holds, as discussed earlier (e.g. wall sits, glute bridges, planks, hollow holds, etc.) instead of dynamic movements when experiencing a pain flare caused by motion through a movement.
Strength Training for Joint Hypermobility (Ehlers-Danlos Society, 2022)
For Dysautonomia & POTS:
Start with seated or floor-based exercises before progressing to standing movements to reduce presyncope or dizziness.
Prioritize resistance over endurance - lifting heavier for fewer reps is often easier on the cardiovascular system than prolonged sets.
Incorporate breathing techniques to help stabilize heart rate during movement.
For heavy lifters with POTS, while the Valsalva maneuver is taught to help stabilize your spine and lift heavier, it can also cause you to temporarily lose consciousness. As a heavy lifter with POTS, I recommend against it.
Exercise Guidelines for POTS (POTS UK, 2023)
For Chronic Lower Back Pain:
Avoid high-impact movements like jumping or deadlifts with poor form.
Focus on core engagement - exercises like glute bridges, bird-dogs, and plans can help stabilize the spine.
Use unilateral (single-sided) exercises like split squats and single-arm rows to improve balance and reduce compensations.
Strength Training for Chronic Low Back Pain (BMC, 2023)
And remember: everyone’s body responds differently to exercises, so trial and error is a key part of learning. The goal isn’t to force a movement - but adapt exercises to fit your abilities!
A Beginner-Friendly Strength Routine
Beginner-Friendly Warm Up (5 min.)
Seated Marching: sit tall in a chair, lift knees up and down, alternating for 1 minute
Standing Heel Raises: slowly lift heals on the ground & lower for 10 reps
Wall Angels: stand with your back to a wall, raise arms up and down like your making a snow angel for 10 reps
Beginner-Friendly Strength Circuit (15-20 minutes):
Seated or Standing Resistance Band or Dumbbell Rows: 3 x 8-10
Sit in a chair, loop a resistance band around your feet, pull elbows backwards
Great for back pain, posture support, and POTS (if seated)
Seated or STanding Leg Lifts: 2 x 8 per leg
Sit tall, slowly lift one leg straight out and then lower
Great for joint pain, knee weakness, SI joint dysfunction
Wall Sit or Supported Squat (Box Squat Option): 2 x 5
Stand against a wall and slowly lower into a squat. Hold 10-20 sec.
Or, sit on a chair by hinging backwards and lowering, then stand back up.
Great for knee pain, EDS, back pain
Seated Shoulder Press (Light Weights, Resistance Bands): 2 x 8
Sit tall, press weights/bands overhead
Great for dysautonomia (seated)
Glute Bridge or Pelvic Tilt: 2 x 8
Lie on your back, bend your knees until your fingertips can touch your heels, lift hips to “bridge” and hold for 5 sec.
Great for SI joint pain, core weakness, back pain
Isometric Core Hold (modified plank): 2 x 10 seconds
Lean against a wall, hold an engaged core position for 10 seconds
Great for core strength, spinal stability, avoiding high stain
We hope this gave you some insight on how to begin your journey. If you have any questions, leave a comment or contact us with any topics you’d like covered in the future! Check out our resources below to see where the science backs up the facts!
Resources
Isometric Strength Training for Chronic Pain (PMC, 2020) – Found that isometric exercises reduce pain without aggravating joints.
Strength Training and Joint Hypermobility (Ehlers-Danlos Society, 2022) – Highlights the importance of joint stability exercises for hypermobile individuals.
The Importance of Exercise in Chronic Pain Management (Novus Spine & Pain Center, 2023) – Resistance training is as effective as medication for some types of chronic pain.
Exercise Guidelines for POTS (POTS UK, 2023) – Seated exercises can help with dizziness and blood pressure issues.
Exercise as a Non-Pharmacological Treatment for Chronic Pain (PMC, 2020)
