With the new year around the corner and an expected rise in people exercising, we thought it would be a good idea to go over some tips for starting, returning to, or progressing your exercise routine without aggravating symptoms or creating new ones. It is common for people to perform excessive volume of exercise, causing an aggravation or onset of new symptoms that leads to discouragement and potential ceasing of exercise. Whether you have never exercised before or have not exercised in years or months, these tips should apply to all levels or types of exercise.

Most people understand DOMS (delayed onset muscle soreness), and that it is a normal response to muscles being worked. This is inevitable after exercising for the first time or from returning to exercise after a hiatus, and should not be feared/avoided or thought of as a negative symptom or “new pain.” Whether you have current symptoms, or have older symptoms like knee, back or shoulder pain that you have not experienced in a while, a goal with returning to or increasing exercise would be to avoid significantly aggravating your symptoms. It is also somewhat expected that you may “wake up” your symptoms to some extent, and this is not always indicative that you are making your symptoms or condition worse. An analogy that we often use in the clinic would be that you “shock the system” when you have a sudden increase in stimulus (activity) to your nervous system, much like when going from a hot tub to a cool pool. The goal for you should be to establish a “baseline” of volume of activity that you can tolerate and so that you can build off of that. A level of activity where after completing it, you can say, “That went well,” even if there was a minor increase in your symptoms.

Some tips/concepts to consider include:


This is the combination of overall duration, intensity/weight, and number of reps/sets of your activity within a routine or day. Regardless, you should always consider how much in total you are performing, especially if your priority is managing your symptoms. Mismanagement of volume tends to be a primary cause of aggravating symptoms. Again, the goal is to establish a baseline volume that you know you can tolerate, and build from there.

You do not always have to return to the level of activity that you performed before.

So you used to perform exercise 6 days a week, or your friend who gave you their routine performs it 5 days a week — there is nothing wrong with starting out at 3 days a week and gradually adding one day to the weekly routine after completing it successfully for 1-2 weeks.


A common method for regressing or initiating a walking or running program is utilizing interval training.

  • For walking, this may look like walking at a brisk pace for 1 minute and then walking at a comfortable pace for 5 minutes. You can cycle between the 1 to 5 minute intervals for a total of 20 minutes. Then, you can manipulate the variables by increasing brisk walking time, decreasing comfortable pace time or increasing overall duration.
  • The same can be done for running. Run for 1 minute, walk for 5 minutes and progress from there.

Strength/Weight Training

It is typically less of a “shock to the system” if you begin with lower weight/intensity and a higher number of repetitions, such as 15-20 reps. This also helps to encourage development of muscular endurance and motor control of the exercise before you begin loading up with heavier weights.


Seems simple and obvious, but it is often overlooked and it is always a good idea to get the blood flowing and let your neuromuscular system know that it is about to have to work and control the body and its various parts.

If you have any questions, are having any difficulty with your return to exercise or managing your symptoms with exercise, call your Therapeutic Associates clinic to consult with us.