How to Form a New Habit: 5 Simple Steps to Conquer Chronic Pain

November 17th, 2020  by  Michael Craigen – Health Coach at Hinge Health, NBC-HWC

Forming a new health habit is often the hardest part. We all know what it’s like to stand at the foot of the mountain. Our goal is to make the ascent with our newfound motivation as fuel. We use this momentary inspiration to start climbing as fast as we can toward the peak, only to slip and fall or run out of steam. While setbacks are an inevitable part of striving for any long-term objective, it’s the ones caused by burnout from charging too hard out of the gate that are the hardest to quickly bounce back from. The old adage “slow and steady wins the race” rings true here to an extent, but I like to rephrase it as “small and simple” to emphasize making it more doable.

Cracking the habit formation code

For years, researchers have been working to crack the habit formation code. We don’t know everything, but we know that simplicity goes a long way. At Hinge Health, we keep this fact front and center, and in doing so have helped participants build an exercise therapy habit that significantly reduces persistent joint and back pain for four out of five people. I’ve coached many participants in our Hinge Health programs, and the most common epiphany I’ve heard is “I can’t believe it only takes 10 minutes.”

Small, but consistent steps go a long way

Sound too good to be true? I used to think that long exercise sessions are always necessary, but contrary to what mainstream fitness might indicate, getting your work in doesn’t always have to be a monumental undertaking. It certainly doesn’t need to start there, as there are benefits even the smallest efforts. For example, working at a higher heart rate for periods as short as 30 seconds releases feel-good chemicals in the body that can reduce pain. But the real bang-for-the-buck benefits come from long-term consistency, and research indicates that an effective way to both start and maintain a habit is to take it one small, consistent step at a time. This is because our brains physically change by rewiring neural pathways when we frequently repeat the same behaviors. By breaking a habit down to its simplest form, we can help ourselves get those necessary reps in.

For the past four months, I’ve been working with Sandra in our hip program at Hinge Health. After she wasn’t able to get started for the first few weeks, we talked on the phone. “This is what I always seem to run into,” she said. “Between the kids and work, I just never have the time.” She was referring to her efforts to build a habit of riding an elliptical for 45 minutes before work; fluctuating hip pain and family commitments usually kept that from happening consistently. We talked about how shorter workouts are still beneficial and came up with a plan to tackle the hip pain by first implementing a few five-to-ten-minute sessions with the Hinge Health app during the week. Since then, she hasn’t looked back, and she’s now building on her plan gradually. Of course, it wasn’t always easy, especially in the first few weeks as her body adapted to the new movements, but by starting small and simple she was able to keep herself going through challenges. In our last conversation, we discussed taking the next steps in her fitness journey using the same approach. Now she’s able to channel the momentum she built up from her exercise therapy habit.

So just how does starting small help?

  • Time: On top of work, we might have four to eight waking hours to fit everything else into a typical day. Depending on our other commitments, sometimes it’s just not possible to find a full hour to dedicate to exercise.
  • Motivation: Should we always have to muster a bunch of motivation before we take action? Keeping our goals in mind is important, and every so often a pep talk might be the extra fuel we need, but ultimately we can’t rely on motivation to be constant. Small efforts help us get through those challenging times when inspiration dwindles by making it easier to keep going.
  • Momentum: Success breeds success in the world of habits. Research indicates that we’re much more likely to stick with a routine when we can actually follow through and feel good about it. Using small goals as the catalyst sets us up for quick and frequent wins that make our brain want to come back the next day.

Nearly all health habits can benefit from a bite-sized approach, and these same concepts apply to pain management, too:

5 tactics to help you form new habits

Here are five tactics I implement with my participants to help them form new health habits and an exercise therapy routine.

1. Specificity is the secret sauce: It’s not enough to just say it’s going to happen in the midst of a busy day. Building a habit requires being specific about when and where it will happen. One way to do this is to map out the habits you already have and choose one as a cue for your new habit. For extra accountability, try setting up what psychologists called an implementation intention. Grab a piece of paper or sticky note and write down the sequence of events. An example: “I will do a Hinge Health playlist after I brew coffee in the morning.” You might try keeping this on the coffee maker in the morning as an extra reminder.

2. Your environment is your ally: Set up your space to influence success. James Clear, author of Atomic Habits, urges us to stop seeing our spaces as filled with things and start seeing them in terms of relationships. Make it as convenient as possible. If your exercise clothes are buried in the bottom of the closet, it’s going to take a minute or two plus some energy to dig them out. Keep them right where you need them, such as at the front door where you’ll see them when you walk in from work.

3. Track it: Set up a chart and mark each day you complete your habit. I recommend taking it week by week to further break it down, but some people like having the full calendar view to see the whole month or year. Having this at-a-glance view can help keep perspective when we fall off, and also provide something fun to aim for by being able to see your streaks develop. When it comes to pain management, we typically see significant results in just 3 months with ten-to-fifteen minutes of exercise therapy at least 3 times per week!

If you’re looking to build up the duration of your workouts, try setting a goal at the beginning of each week and writing down how much time you spent each day. Base the next week’s goal off of how you performed and what you feel is a realistic next step.

4. Celebrate it: Now that you’re through your exercises, you get to have a reward! Maybe it’s reaching for that fresh brewed cup of coffee, but it doesn’t even have to be something tangible. Stanford behavioral researcher BJ Fogg says celebrations are just as effective and can be something as subtle as making sure to say “good job” out loud or to yourself after following through. The key is to make sure it happens right after, as immediate celebrations act as that kind of positive reinforcement our brains love. If you’re using a tracker, I recommend taking an extra moment to really see your success on paper. Our brains also love anticipation, so you can also try setting milestone celebrations, like calling a friend to report that you haven’t missed a day in a month, or putting a dollar in a jar each day you’re active to use for a fun experience.

5. Social support: There’s a reason social support is one of the pillars of our approach at Hinge Health. Having other people along for the ride helps us stay active and work through challenges that come up. Ask a family member or friend to hold you accountable or even to join in the fun. Be clear about what your goals are and how you’d like their support. If you’re in a Hinge Health program, reach out to your coach or share your ambitions in Groups.

No matter the strategies we choose to implement, a willingness to experiment and adjust will always be important in dialing in our health habits. Even when we start small, it’s very likely we won’t have all the bases covered to begin with, so don’t be afraid to make changes to your plan. As long as we’re aware of when we need to go back to the drawing board, we’ll be on the path to sustaining the small efforts that compound to big changes over time.

Hinge Health’s virtual clinical model combines virtual 1-on-1 physical therapists & clinicians, health coaches, and technology to more effectively reduce chronic back and joint pain at lower spend. To find out how Hinge Health can help you and your members improve outcomes at lower spend, request a demo below.

Michael Craigen

About the Author

Michael Craigen is a Health Coach at Hinge Health. He is a Board Certified Health Coach with a Master’s degree in Integrative Health. As a Hinge Health Coach of 2 years, he has helped over 1000 people navigate and conquer the challenges of persistent pain, using exercise therapy as the cornerstone. After hours, you can find him on stage in a local theatre production or playing guitar too loudly in his bandmate’s garage.

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