Growing without groaning: A brief guide to gardening when you have chronic pain

When I look at the economic news: the housing crunch, the high cost of groceries, or the possibility that AI will render my professional skills obsolete – I often come back to the same thought: I should start growing my own vegetables.

Financial savings and fresh produce aside, research shows gardening and spending time in nature has been shown to reduce stress, depression, and anxiety. For people like me who live in cities where community gardens are popular, there's evidence that gardening helps build a sense of community with neighbors.

And of course, the regular, moderate-intensity exercise of planting, weeding, and pruning can supports general health.

Sounds like a win all around. But there's a problem. Like about 20% of adults in the U.S., I live with chronic pain, including many with back pain. Mine is in my pelvis and legs, and it can make repetitive bending or crouching very uncomfortable.

Fortunately for me, this spring I've been seeing Rebecca Stephenson, a clinical specialist in physical therapy at Newton-Wellesley Hospital in Massachusetts. She has a passion for plants — in her own garden she grows flowers like sedum, coleus, peonies, as well as herbs — and has a lot of ideas about how to modify gardening activities to prevent pain.

She says gardening can benefit people with chronic pain. "You're exercising, breathing outside in nature and getting good lung expansion. You're also using your arms and legs in a coordinated way." Luckily she says, "there is a way to garden so that you don't hurt yourself and end up in pain afterwards."

Here are some of Stephenson's tips for getting your hands in the dirt, without the hurt.

Pace yourself

Like any physical activity, Stephenson says you can build endurance for gardening, step by step. Don't overdo it. "It's happened to me where I've gone out for four or five hours, and it's going to cost me for two weeks." But her professional training helps her stay grounded. "I come at it from underneath. Instead of going over your limit, I try to come under," she says.

"What I really recommend is to take your garden project and see how you could split it up into smaller pieces and be very reasonable about the amount of time that you're physically able to do it. So it might be a half an hour, it might be 15 minutes, it might be an hour, and then take a break, change your body position, do some stretches," she says.

Embrace 'functional bracing'

"Sometimes people wear a back brace just for gardening, and that gives them a little bit more of a reminder to be using their abdominal muscles," Stephenson says. It's worth a try, even if it seems awkward, she says. "It's not like your grandmother where you're wearing a girdle all day. You're just wearing it for an hour."

Take a seat, and get up gracefully

Stephenson suggests using a stadium chair, the kind that rests on the ground and provides back support, to work in a seated position. Spread your legs into a V shape, with knees straight or slightly bent, and work on the patch directly in front of you. You can also tuck one leg in with your foot resting against the inside of the opposite thigh.

And, when it's time to get up from a seated work position, follow these steps:

Twist your torso to one side and place both hands on the ground

Use your hands to push yourself into a table-top position, with both hands and both knees on the ground

Lift your torso until it's perpendicular to the ground, and plant one foot on the ground in front of you

Lift your other leg to stand upright.

Try 'the quadruped'

For a bit more range of movement, kneel with both knees on a foam pad. Then, placing both hands on the ground, come forward into a table top position, with your back straight and your arms and legs perpendicular to the ground. You can then work with your dominant hand while supporting your weight with your non-dominant hand on the ground.

Take a knee

Kneel with one knee on a pad and the foot of the opposite leg on the ground, (as if you're proposing marriage or protesting the National Anthem at a football game). Use your front leg to brace your elbow as you work. This is a good position for using a small shovel or trowel, and you can work with both hands on the tool.

Consider raised beds

Instead of getting down on the ground, you can bring the earth up to you with a raised bed that comes up to hip level. The bed should be about twice as wide as your arm length, Stephenson says. You engage your abdominal muscles while leaning forward against the bed wall, which provides support for your pelvis while your upper body does the gardening. You can even prop one foot up on a stool for more support.

Stephenson particularly recommends raised beds for senior citizens. "A senior could have one in their backyard, in their condo, on the back porch. That could have their lettuce, could have spinach, a lot of herbs that could change how they're cooking to make it a little bit more exciting," she says. Short of building a raised bed, veggies can also be grown in planters that hook over a railing.

Switch sides and dominant hands regularly

To minimize the harms of repetitive, unbalanced motions like digging or raking, Stephenson suggests switching arms regularly, say every five minutes, taking turns using your non-dominant hand on the top of the shovel or rake. With raking in particular, she suggests positioning the rake in front of you and drawing it towards you in a symmetrical fashion.

Have you got tips for gardening with chronic pain? Send them to us at shots@npr.org, and you could be featured in a future edition of the NPR Health newsletter.

Andrea Muraskin writes the NPR Health newsletter and is a freelance writer and audio producer based in Boston. [Copyright 2023 NPR]