Couch DOMS: The pain of inactivity

Hello. I haven’t been around for a while. I didn’t quit, but life got a little difficult. By “a little difficult” I mean that my post concussion symptoms stuck around and a major mental health crisis landed me in inpatient psych care a couple of times over the past few months. It wasn’t exactly fun, and it was serious enough that I’m not sure I’d be here without intervention by some very good friends and NHS crisis services. I’m not fully better, either. Recovery from a serious breakdown like this is not fast. There is ongoing treatment and I’m limited in various ways.

There are, however, opportunities and things to learn in this situation. I’m not glad I’ve gone through this, but it has taught and is still teaching me a lot. This is one of the more painful lessons.

I’ve never understood why people experience aging differently from me. At 34, I felt better than I ever had in my life. Sure I wasn’t the fastest or the strongest in the world, but I was strong and able. While my coworkers were talking about sore knees, I was squatting more than my bodyweight, jumping from height and running on a daily basis. I ached plenty, but it was not the depressing degeneration other people my age described. I had the pain of well used muscles that would peak around 48 hours after training and then dissipate. They talked about waking up with throbbing joints and stiff backs that gradually worsened over time, reducing their ability to exercise. They were “too old” to jump. This pain, they comfortably assured me, was inevitable and permanent. Soon I too would be unable to run and lift because of my knees realising I was no longer 20. It was amazing that I was still able to jump at all.

I had very strong suspicions that my training was exactly what was keeping me from this. A few minutes on google will give you an idea why – regular exercise is well known to keep your joints healthy and supple. Not only that, but I could see parkour practitioners, runners, skaters and lifters much older than me casually demonstrate their fitness every day. It seemed far more likely to me that the majority of my “too old” coworkers and acquaintances were feeling the long term effects of sedentary lifestyles and poor diets than waking up on their 30th birthday too old to move.

One of the interesting things about being in the middle of a mental health crisis is that physical activity is pretty hard. It’s not just a matter of willpower to get off the couch – your cognitive capacity drops like a crossfitter after a Grace workout. How does exercise even work? you need shoes. How do those go on? Outside is too hard. You can’t go out there. Maybe you could do some stretching but suddenly you’ve forgotten why you’re standing here.

That’s if you’re safe enough to be outside without supervision and aware enough to be able to leave the room without major concentration. It’s hard, guys. It’s really, really hard.

And so I became sedentary. I’m okay with that. I lost a lot of fitness, but when you have been a danger to yourself and unable to carry out basic self care like knowing when to shower and understanding you can’t go and live in the park, that’s not really a priority. When a neighbour calls the police on you hiding in the bushes outside your house because you are so afraid to go inside in case someone in your building sees you, your lifting schedule kind of falls by the wayside a bit. There’s also the small matter of medication. In mental health crisis care, you’re quite often given strong anti anxiety and sedative drugs for a brief period. Being stoned out of your brain is not a healthy long term strategy, but can make you a lot more comfortable while you are in a very bad state. It does, however, make exercise a bit awkward. Ever tried rail precisions on valium? No, me neither. I’d suggest not.

Over the next few months, I began to feel the things my coworkers described. I had trouble getting comfortable at night because my right hip and knee ached. My hip flexor was so tight that I got used to regular twinges. My left ankle hurt where it had been sprained badly in skating and this led to pain further up the leg. My shoulders and thoracic spine ached and ached. I was degenerating. I could feel it, and it hurt. I couldn’t run like this. I couldn’t jump. I couldn’t trust my joints. What if a sharp pain hit while I was out training? What if something tore? It felt uncontrollable and unfixable. I couldn’t get stronger in this state.

This is the DOMS you feel after spending too long on the couch. I don’t recommend it if you can avoid it.

Weight change is also a thing. While in crisis, I dropped kilograms. I wasn’t really going to eat unless someone fed me (which friends and crisis staff did. I’m forever grateful for waking up confused to find the friends looking after me while waiting for the NHS to place me somewhere had left a bowl out with granola and milk right next to it, a cup with a teabag and instructions on how to eat breakfast).

In the months that followed, however, I gained fat. This is okay. Remember that impaired cognition? That doesn’t go away immediately following a crisis. You can only handle so much thinking and planning before you dissolve into a puddle of tears and stress. It was far more important that I keep my hormones in a happy state by eating regularly and as nutritiously as possible than I start considering body composition and food tracking. Weight can be lost later – I had done it before, after all. A few kilos are not going to kill me.

As I recovered enough to start taking tentative steps towards exercise, though, the effects of that extra weight became pretty clear. Running is harder – there’s more of me to move (we’re talking a maximum gain of 6kg here, but that’s a fair amount for someone my height). Jumping? Yeah. There’s some extra baggage dragging me back down there. General cardio? I can actually feel how abdominal fat affects my ability to catch my breath.

So that degeneration is my life now, right? I got mentally broken, am not fully healthy yet and won’t be for a very long time. Time to accept it.

Nah.

You can’t just get off the couch and go outside for a run while in crisis. You can’t cope with a busy, fast-paced parkour class when you’re mentally vulnerable and unable to deal with stress. But it gets better, and there are things you can do.

I attempted various things off and on during the past few months. Between periods of psych care, I managed to get in some parkour classes (I couldn’t even keep up when they were running, just like when I started, but that’s never been a reason to quit). I did a bit of lifting, but not regularly enough to help me. But I also worked a lot more on lighter, gentler activities. First, I was able to go for a walk even just to a coffee shop. Then I could go to bagua class (more on this another time – for now, think of it as tai chi while walking in circles). A while later, I could swim once a week or so – no stress if I wasn’t up to it, but when I could, I did. And with just these gentle activities once or twice a week, those pains – the aching back, the bad hip, the dodgy knee – they stopped. Those seemingly incurable pains that had kept me awake and stopped me from feeling comfortable and told me I was weak now – they melted away. I barely noticed. I would suddenly remember that I hadn’t felt a stabbing in my hip for a few days, then I kind of forgot that it had ever happened. I started to sleep better. I found myself running without thinking about that sore knee.

And now I’m sitting here, writing after almost a year of feeling incapable of it, and aching again – but this time with good old post-lifting DOMS. My lower back is tender. My shoulders ache after doing overhead press with small dumbells. My legs are wobbly. But this doesn’t feel like degeneration. I can rest in this ache knowing that I’m getting stronger as I recover from it. It isn’t a pain that makes me feel helpless – it hurts because I worked those muscles hard on purpose and with purpose. It’s a strengthening ache, not a weakening one. It’s predictable and makes sense. It doesn’t make me afraid of running in case a sharp pain stabs me out of nowhere. It’s the most welcome pain I have ever felt in my life.

People say exercise hurts, but after trying both, I don’t think any training aches will ever compare to the uncontrollable, senseless, constant pain of living on the couch.