Is it true that if you are out of shape and hurt yourself, it takes longer to recover? Do people who are couch potatoes hurt more when they get hurt?

As a general rule, therapists and specialists working with athletes who sustain major injuries notice that recovery may be faster compared with inactive people (couch potatoes). Nurses in hospitals often comment on the fact that certain highly competitive athletes survive injuries others might not have lived through. Whether or not this is true has never been formally tested.

Researchers studying back pain are trying to determine any predictive factors for chronic pain and disability. Physical fitness and activity level always comes up as a possible predisposing factor.

Disuse or decreased activity level in daily life has been proposed as a key factor in failed recovery among low back pain sufferers. It is proposed that injury leading to a decline in activity will result in chronic low back pain.

A recent study from the Netherlands tested out this theory but couldn't prove it true. They followed a group of back pain patients for a year. There was no evidence that pain lead to activity decline. The general belief that people with chronic back pain are deconditioned just didn't stand up in this study.

Depressed mood, negative outlook on life, and fear of re-injury may be more predictive of chronic pain than a decrease in physical fitness. A person's perception may be far more powerful than their reality. Some people with chronic back pain think they are disabled. Yet their physical activity level is no less than someone without chronic pain.

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