Men's Health: Cure Pain Through Exercise

May 4, 2001 -- There's a medical phenomenon doctors call "referred pain" that you can do something about with exercise.

The pain is pain is "referred" — or passed down the line — from another muscle or tendon.

"With referred pain, the area where the symptoms appear may not be the area that's injured or dysfunctional," says David Upton, an exercise physiologist in Fort Worth, Texas.

Here are seven common types of referred pains, and exercises and stretches that can fix them.

If these tips don't help within two weeks, however, see a doctor.

Upper Arm Ache

THE PAIN: The back of one (or both) of your upper arms frequently aches

FIX IT BY: Strengthening your rotator-cuff muscles.

Men with weak or injured rotator-cuff muscles — a common problem among inactive guys and those who exercise with sloppy form — often develop this pain as a result.

If your rotator-cuff muscles are weak, the more powerful deltoid (shoulder) muscles bear the brunt of stabilizing your upper arms, so your upper arms fatigue and ache.

THE EXERCISE: To train your problematic arm, grab a large can of soup (or a 3-pound dumbbell) and lie on the floor on your side, supporting your head on your other arm.

Keeping your elbow flush against your side, bend the sore arm at a 90-degree angle and, without straightening your elbow, rotate the upper arm outward to lift the soup can toward the ceiling. Lower the can to the starting position and repeat.

This external rotation strengthens your rotators — the infraspinatus and teres minor.

Do 15 repetitions per arm, every day.

Foot and Rear Aches

THE PAIN: Numbness in the top of your foot, and, literally, a pain in the butt.

FIX IT BY: Stretching your hip muscles.

These dual pains are a classic sign of piriformis syndrome, in which the piriformis muscle in the hip (which stabilizes your pelvis) is overdeveloped, usually from running.

This overstrong muscle starts straining the sciatic nerve (in your butt), which controls the majority of movement in your legs, says Dr. Jonathan Chang, an orthopedic surgeon and assistant clinical professor at the University of Southern California. The pain radiates to your foot.

THE EXERCISE: Stretch your piriformis muscle by doing a backward hurdler's stretch.

Sit on the floor with your left leg crooked in a "V" out to the side and your right leg fully extended forward (the classic hurdler's position).

Don't lean forward as you did in high school; lean backward slowly until you feel a comfortable stretch in your left hip. Hold for 15 seconds, then release. Do this five times for each leg, three times a week.

Knee Pain

THE PAIN: A nasty tugging sensation behind one or both knees.

FIX IT BY: Stretching and strengthening your hamstrings.

This pain often occurs in men who do activities that strengthen their quadriceps (the frontal thigh muscles) — like running or squats — but don't do anything to build up their hamstrings.

Soon, your powerful quadriceps exert too much force on your kneecaps, and the backs of your knees (where your hamstrings connect to your knees) begin to ache from the added strain, says Daniel Trone, a research physiologist for the U.S. Naval Health Research Center in San Diego.

THE EXERCISE: You need to stretch and strengthen your hamstrings while moving them through their whole range of motion.

On a stationary bike, warm up for 10 to 15 minutes.

Then disengage the toe of one foot from the toe clip and, using the other leg only, complete 10 revolutions of the pedal. Repeat with the other leg. This single-leg pedaling will stretch the hamstrings in the whole range of their use, says Trone.

THE PAIN: Excruciating misery in your lower back.

FIX IT BY: Hardening your stomach.

"Strong abs support your back and give you healthy posture," says Kevin R. Stone, an orthopedic surgeon at the Stone Clinic in San Francisco.

If your abs are weak, the strain — and the pain — will hit your lower back.

THE EXERCISE: Do crunches with your legs suspended. Lie on your back with your feet in the air and your legs bent at a 90-degree angle.

Keeping your lower back on the floor, lift your head and shoulders a few inches and hold the contraction for 1 second. Do three sets of 10 to 15 repetitions (working up to 40 repetitions), three times a week.

When this becomes easy, do the more advanced reverse crunch. Lift your butt (not your shoulders) off the floor so that your legs go up and toward you. Hold the position for a second, then let go.

Keep your back and your head on the floor. This is golden for your back and abdominals.

Kneecap Pain

THE PAIN: Your kneecap hurts.

FIX IT BY: Strengthening your inner-thigh muscle.

Your outer thigh muscle, the stronger vastus lateralis, is pulling your kneecap to the outer side of your leg with greater force than your weaker vastus medialis (the teardrop muscle) can oppose.

This causes your kneecap to track off center, which grates cartilage and bone. Cyclists often have this complaint, since years of pedaling can overdevelop the outer muscle.

THE EXERCISE: Do partial knee extensions.

Strap a 5-pound ankle weight to one ankle, sit on a chair or bench, and bend your knees 90 degrees.

Lift your weighted ankle until the calf is parallel to the floor, and then lower it only halfway, until your lower leg is at 45 degrees. Lift it back to parallel.

Do three sets of 15 of these partial extensions (going from 45 degrees to straight) with each leg, with a minute's rest between sets, says Dr. Robert Cantu of Emerson Hospital in Concord, Mass.

THE PAIN: Your lower back hurts again.

FIX IT BY: Stretching your thigh muscles.

Lower-back pain is a common result of leading a chair-bound life and then suddenly exercising without stretching your muscles first.

Being sedentary tends to tighten the hip-flexor muscles, which run from your femur to your pelvis.

Over time, the hip flexors tilt the pelvis, which places a strain on the lower back and leads to pain.

THE EXERCISE: Do a classic hip-flexor stretch every day, advises Upton.

Place your left hand on a wall, bend your right leg behind you, and grasp your right foot with your right hand.

Now, without leaning forward, push your foot away from your butt. (Don't try to pull the foot toward you.)

"You should feel a comfortable stretch right in the center of your thigh," says Upton.

Hold this stretch for 5 to 8 seconds, then release. Do 10 repetitions with each leg.

Don't Ignore Shinsplints

THE PAIN: Shinsplints, or white-hot burning in the center of your shin.

FIX IT BY: Beefing up your shin muscles.

Stairclimbing, squats, and most other common lower-body exercises strengthen only your calf muscles.

Over time, your calf muscles allow your legs to work harder during exercise — but your shin muscles aren't able to cushion the impact on your feet with the same efficiency, so they ache.

Don't ignore shinsplints; they're a warning sign that your lagging shin muscles may actually tear.

THE EXERCISE: Walk on your heels for a few minutes a day, advises David Potach, a physical therapist at the Alegent Health Physical Therapy Center in Omaha, Neb.

This is a good way to strengthen your anterior shin muscles. For a more dignified move, sit on a chair or bench with your feet flat on the floor, and balance a 5-pound weight plate or dumbbell on one foot.

Keeping your heels on the floor, lift the front of your weighted foot upward 3 inches.

Do this 15 times for each foot, every day. To ease shinsplints while running, run on grass or dirt. Pounding cement will only worsen the pain.