Is pain during workout good or bad?

Y.You are running your morning run and suddenly you are feeling the pain of discomfort in your calf. Immediately your mind says “No pain, no gain!” Includes turning to an old rugged T-shirt stuffed in the back of your closet. The slogan plastered across it. However, what you are told in your Facebook running group mediates that thought: “If you feel pain, stop!”

So which side of the argument is correct? Well, as a physical therapist, I can tell you it’s none of that.

Although the pain may seem like a linear, passive A to B sequence – I slapped your hand and you felt the pain – it was actually a much more dynamic, active process. My slap in your hand creates an input that enters the nervous system and is then filtered by the brain based on past experience, current mood, attention and much more.

An interdisciplinary review paper from 2013 Somajati is also a science The journal described pain as “a personal, thematic experience influenced by cultural learning, situation meaning, attention and other psychological variables”.

Such complications make pain an unreliable indicator of what is happening in the body. Chronic pain often exists in the face of any observable structural or mechanical changes. This is why it is not legal to apply a simple model of “no pain, no gain” or “stop if you feel pain”. There is significant gray, and to deal with gray, we need a more subtle approach.

“We try to educate [athletes] No pain versus pain – the idea of ​​whether exercise provides discomfort Only When doing this vs. if the area still creates pain Later You do it, “said Gary Defilippo, a strength and sports performance coach who owns Challenger Strength in Wayne, NJ. “If a baseball athlete presents with pain in a normal arm that is annoying all day and not during direct throwing, then the throwing indicates something other than the main problem.”

Tom Gum, a physiotherapist and running specialist at Body Rehab Studios and creator of running-fizio.com, drilled the process further down. “I would often say that mild pain during activity (up to three in 10) is okay if it subsides within 24 hours and the patient continues to improve over time,” he said. “Of course there are times when this message will change, for example if I suspect a bone pressure injury or when there are other signs and symptoms such as swelling or giving way.”

Gum uses a traffic light presentation to help his patients understand this spectrum of discomfort: if it is an excruciating pain that is six or more in 10, it gets a red light and signals you should stop. Four or five are acceptable and get a yellow light, while three or less get a green light to continue the activity.

“The reality is that, like everything else in medicine, the answer to the question of what to do with pain or discomfort is: it depends,” said Shaunak Patel, DO, FAAPMR, a non-surgical pain therapist at Patel Center for effective regeneration in Arcadia, CA. . “If patients, despite the pain, stiffen their normal activities, they may continue to perform the actions that injured them in the first place. And sooner or later, even normal movement can become painful. “

In other words, fear of movement can lead to compensatory pain and injury, even movement that was not painful before now hurts, reinforcing a vicious cycle.

Keeping in mind the advice of these three experts, combined with my own experience as a physical therapist and the basic principles of the science of pain and movement, I have created a four-question list to help you navigate pain and understand when it is safe. Keep going and when you want to go backwards.

1. Is the pain five or more out of 10?

The visual analog scale used by healthcare practitioners has been shown to be a reliable and valid tool for measuring acute (new) pain: on a scale of zero to 10, a patient rates their pain level, with zero no pain, five moderate, and 10 worst pain. Being. I think of five as a level of pain that publicly changes your mood.

2. Is the type of pain radiative and / or electrical in nature? Is there constant sharp pain?

Radiating pain is when you feel pain or discomfort that it is traveling from one area of ​​the body to another, almost as if it is shooting in a different area. Electric pain feels like a stabbing and burning sensation and is quite limited, almost as you can find its outline with a pencil if you ask.

If one of these terms is familiar, or if it is constant and sharp, the pain may indicate something more serious that needs to be addressed immediately by a medical provider.

3. Has the pain lasted more than 36 hours?

If the remaining pain or discomfort from your activity lasts for more than a day and a half, then you have probably done too much and the body needs more recovery time before returning to strenuous activity. Even if you are only 24 hours after the activity and feel pain, give it another 12 hours and see what happens; Strict activity can sometimes exceed that one-day mark.

If you have pain that did not come from somewhere (i.e. it did not occur due to any special activity) and it lasts 36 hours or more, it is a significant red flag that needs to be addressed immediately.

4. Does the pain increase with time?

Be careful about the trendline: is the pain slowly rising from two to three to four, is it decreasing, or is it becoming a plateau? If it continues to increase over time, it is a major symptom of continued overuse and overload without adequate recovery.

What your answer might mean

Answering “no” to all four questions means you are on the right track with your activity level. Keep going, but keep remembering these questions.

But if you answer Any One of these questions is “yes,” then you need to adjust your training load. I would recommend lowering the level of your activity and see how it changes the answers to your questions. If you have that sharp or radiating / electric pain, or ramping down does not cause any change, now is the time to see a medical provider.

Remember, pain is a signal, but it is not a binary one. Be aware of the clues and listen to them.

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