Finding the right exercise dosage

The importance of balancing rest and exercise for repetitive strain injuries and overuse injuries

In repetitive strain injuries and overuse injuries (such as patellofemoral pain syndrome, ITBS, shin splints, tendinopathies, etc...), finding the right balance between rest and exercise is in a lot of cases the most important method to improve symptoms. There is a fair amount of evidence backing this claim in the scientific literature. Paul Ingraham from PainScience.com has dedicated a whole article to this topic. This is also something which we have observed from our research at MyAIGuide, as shown in our latest article. Jill Cook, a tendinopathy world expert, has also emphasized the importance of correct exercise loading, for example during the speech shown in this video.

How should rest and exercise be balanced?

We don't know yet exactly how rest and exercise should be balanced. That's in large part why we created this website! By collecting data from people around the world, we hope to gain a better understanding regarding the best ways of balancing rest and exercise.
However, even though we don't exactly know what the right exercise dosage is, the general consensus is that regular, slowly increasing exercise over time, all while keeping the pain intensity either stagnant (or ideally slowly decreasing) is most likely a good method to get better over time.

How can MyAIGuide help me find the right balance between rest and exercise?

Once again, importantly, we do not know yet how exactly to find the right exercise dosage. Also, finding the right balance between rest and exercise is not always the best way for people to get better: sometimes, symptoms have little or even nothing to do with exercise!
However, if exercise dosage is important for you, then MyAIGuide will allow you to visualize how your symptoms and exercise levels are changing over time, as shown in the video below.

Visualizing your data might help you achieve the regular, slowly increasing exercise levels objective mentioned previously.

Will visualizing my symptoms bias the scientific research performed with data collected from MyAIGuide?

With and only with your consent, we use the data you collect using MyAIGuide for scientific research, to try to better understand how rest, exercise and other factors are impacting your symptoms. The results presented in the 2023 article were made possible using data for which patients did not have the ability to visualize their data (the visualization feature had not yet been created), therefore that bias was not present at that time.
However, as of 2023, we have now introduced this visualization feature, which may indeed bias the results. Thankfully, we keep track in our database of when exactly you used the visualization feature, which means that we will know if the results might be biased or not, and interpret the data accordingly. If you want to help our research in a completely unbiased way, you can thus choose to never look at the visualization graph. If you want to look at the visualization graph to try to optimize the amount of physical exercise you do, please do so: your data will most likely still be useful for our research!

What exactly does it mean to aim for regular, slowly increasing exercise levels?

“Regular” means that your physical activity over time should look more like the graph on the right, and less like the graph on the left.

"Slowly increasing" means that your physical activity should look something like the graph in the middle.

At the same time, you should most often also aim for either stagnant or if possible slowly decreasing pain levels (if your pain can decrease faster, then that's obviously even better; however, that's often not possible once the pain has become chronic).

To summarize, your graph should most often look something like this:

However, as you may have noticed on the graphs above, the scale of the axes have not been specified. Furthermore, we haven't specified the window of the filter we chose. This is because we currently do not know how fast your physical exercise can increase and how much regularity is necessary to achieve good results. Also, this will most likely vary from one person to the other. With the research being conducted through MyAIGuide, we hope to someday be able to answer these questions. For now, it will be up to you to figure out through trial and error what works for you: with MyAIGuide, you now have the ability to quantify and visualize the choices you make, and potentially make better (or at least more informed) decisions.

Is the quantification of physical exercise proposed by MyAIGuide accurate enough?

Currently, the quantification of physical exercise proposed by MyAIGuide relies on the data provided by fitness trackers, either the distance walked provided by Fitbit or the number of steps taken by Google Fit. The paper we recently published provides some support for both of those measurements being useful measurements of physical activity that should already be useful in trying to achieve the regular, slowly increasing exercise levels previously mentioned.
However, we do not believe that either of those measurements are perfect. Indeed it is likely that more factors come into play when trying to accurately quantify physical strain. For example, the denivelation / number of steps climbed, the number of calories spent or how spread out throughout the day physical strain was should also be important factors to take into account. As shown in our recently published paper, we have already started experimenting with those more complex measurements and we will integrate those in this web app going forward.

How much should I base my decisions on the visualization proposed by MyAIGuide?

It appears like finding the right balance between rest and exercise is often the most important method to improve symptoms for repetitive strain injuries and overuse injuries. It also appears like aiming for regular slowly increasing physical exercise and stagnant or slowly decreasing symptoms is often the best strategy. Finally, it also appears like the data visualization proposed by MyAIGuide is an accurate enough first quantification of physical exercise. Therefore, it makes logical sense that the visualization proposed by MyAIGuide should be a useful way to guide you in figuring out how to balance rest and exercise.
However, it is also very important to be transparent about potential limitations of MyAIGuide's visualization: balancing rest and exercise may not always be the most important thing to focus on for all patients, the quantification of physical exercise proposed by MyAIGuide may not always be precise enough and it is unclear which filters with which windows should be used. Therefore, the visualization proposed on this website should definitely not be blindly followed, at least not at this point. It may however be used as an approximate tool, all while keeping in mind the associated potential limitations. Alternatively, it can also be used simply as a way to help gather information to be used for MyAIGuide's scientific research. Importantly it is also important to specify once again the disclaimer: MyAIGuide is intended for informational purposes only and does not provide medical or any other health care advice, diagnosis or treatment. Overall, we recommend adopting an open yet critical mindset towards everything (including this website), reading painscience.com and sciencebasedmedicine.org are good ways to familiarize yourself with such ways of thinking.