Is pain during exercise okay?

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It’s the last set but what started as shoulder stiffness has now turned to pain. “It’ll be fine, I’ll just push this out to complete the workout.”

Is that the right thing to do?

It’s a common question we get asked in a physio consultation. Is it okay to have pain during an exercise? Unfortunately, the answer to this might not be as straight forward as you hope. There’re a few factors to consider when pain is present during exercise.

Some pain or discomfort is normal and okay

We’re actually not designed to live pain free lives all the time. Pain is a useful system the body has developed to protect us against damage, to warn us when we’re pushing ourselves or stretching the limits.

If you’re doing an exercise to help you get stronger or go further you’re probably going to experience some pain – and that’s almost always okay.

Pain and tissue adaptation

Our bodies a wired to adapt. We as humans are really good at it. If you go to the gym and lift weights for long enough you will get stronger, if you commit to running regularly you will get more efficient, if you jump up and down for long enough over time your bones will adapt and become stronger.

So moving through safe pain and staying consistent almost always leads to the pain resolving as your body adapts to the load (there are some exceptions to this fairly broad statement at the end of the blog!)

Here are some useful indicators of whether the pain is something to go with or stop and reassess…

1. How long it lasts

Pain that comes and goes quickly (on/off like a light switch) is typically safe to continue with. If the pain starts as on/off but then begins to linger, you may be overloading your tissues. A good rule of thumb for safe pain in terms of timeframe is on and off pain that resolves within 10 minutes.

The pain is intermittent: it comes and goes and doesn’t linger longer that 10 minutes after finishing

2. The intensity (how painful it is)

The intensity of pain can be a good guide too.

Low grade tolerable (1-4/10) pain that doesn’t worsen with time or repetition is generally safe to persist with.

Pain that starts low but increases with time or repetition or pain that is moderate to high (6-10/10) intensity can be a sign to stop or slow down and reassess.

The pain is tolerable and doesn’t get worse with time or repetition.

3. Where you feel it

Pain shouldn’t grow in area with exercise. For example, pain that starts in your shoulder blade shouldn’t then move into the forearm. This is a sign that you should probably stop and give it a rest.

Pain that’s localised (in a small defined area) and remains relatively contained without worsening is typically safe to continue with.

The pain stays in the same location and doesn’t spread to other areas.

4. How you feel the next day

24 hours later after an exercise bout can give you some good information.

It needs to be noted that If you’ve done a harder workout, especially if you’ve not used a certain muscle group for a while then it’s normal to feel muscle soreness. This is called DOMS (Delayed Onset Muscle Soreness) – it’s a normal process of your body breaking down and rebuilding – it typically peaks 48hours after.

Worse localised pain 24 hours later can be a sign that you’re overloading a tissue. In particular certain tendon issues can feel okay when you’re exercising but be much more sore the next day. This increase in localised pain the next day is worth listening to and modifying your training loads.

Pain should be no worse the next day after a bout of exercise

Other considerations

The above factors are useful for most situations but there are some other considerations that are worth noting:

  • If you’re dealing with a particular injury the above guidelines may be a bit to generic. With certain injuries we can accept higher levels of pain during exercise as safe and sometimes we want to avoid exercise that produces pain altogether (usually only for very short periods of time). If you have an injury and are unsure about pain during movement your best bet is to get assessed by a physiotherapist and get information that’s relevant to you specifically.
  • Pain is influenced by a variety of factors and can’t always be relied on as an accurate measure of safe activity. Sometimes our bodies get good at producing pain (we become sensitised) and so our pain response can be greater to a normal exercise or load. This is common for people who’ve had longer bouts of persistent pain or have fibromyalgia and other similar conditions.
  • Sleep can effect your pain response. Just one night of poor sleep (less that6-7 hours) can influence our pain perception the next day.

Think of pain as your friend

Pain is not the enemy, despite it often being unpleasant, we don’t always need to avoid it or stop doing things that produce pain. It can be more useful to think of pain as a friend – giving you information about what’s happening in your body.

Pain can be an indicator of a few different things: It might be telling you that you’re just adapting to something new and you should continue on. Or perhaps it’s messaging to you that you’re starting to overload your tissues and need to stop or change what you’re doing. The above indicators can be a useful filter to use to determine what you should do if you’re experiencing pain with exercise.

 

Tim Cathers

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