Should you exercise through pain?

As a Sports Therapist this is a common question I get asked.

‘Should I exercise through pain?’

First of all if you have persistent pain whilst exercising, please get it checked out.

My response¬† to this question is usually ‘it depends, pain is complex’ clients are left frustrated by me leaving the answer open ended. It is important for the client to understand pain but it can take time to explain. I tend to stick to 3 short rules.

  • During your session use a pain scale 1-10 (1 no pain 10 pain as bad as it could be) do not go into or beyond 6/10.

0-2 Safe 2-5 Acceptable 5-10 high risk

  • Recovery, if you have 3/10 pain the next morning that is okay you can do your next session, if you have 3/10 pain in 1-2 days you can do your next session with caution reduce intensity or volume, if you still have pain above 3/10 3-5 days after, then you have done too much, rest, and cross train. Your next session should involve less volume or less intensity when pain has reduced to an acceptable level.
  • If you have to miss 2 weeks of exercise or pain is not reducing in fact is getting worse: rest, cross train and seek out an injury expert.

The above maybe all you want to know but here is some more in depth information:

Pain is a complex thing, I have done a lot of reading on it and here are my conclusions. It can really stop us in our tracks or it can just let us know we had a good training session. Peoples perception of pain varies greatly, what is sharp for one person may just be dull for another. Our bodies response to a pain stimulus is also not very accurate, using an example of making toast, it can not tell whether you have burnt the toast or burnt the whole house down. It just sends the signal and sometimes, over reacts. We can say pain and tissue damage are very poorly correlated. Just because you feel pain does not necessarily mean you have damaged something. An example would be a single episode of cramp.

Can you change your pain?

See if slowing down, reducing intensity, and/or changing type of exercise (high impact to low impact) eases your pain. Are there certain movements which ease your pain, performing these regularly but staying away from painful actions can off load the injury site and help it recover. Sometimes a change of footwear is needed. If trainers are getting old or have started to lose their support due to getting soaked through it can trigger many lower limb injuries. Check for technical errors or if you have implemented some changes intensity/volume/technique/equipment have these triggered the pain?

Sometimes when you can modify your pain it is good to test your limits. I have seen many clients where actual fear of injury recurrence can increase perception of pain. Test it out gradually on your next sessions, do not go straight back into the same volume or intensity, build it back up. Your injury site has to get back to a level of been able to cope with the impact, fitness and stress of your exercise. Exercise in itself can help stimulate healing. An injury specialist can help guide you, to help get you back fully into your chosen exercise.

Physiologically what signs can we see of a serious injury?

Look for swelling, redness, heat, severe pain, giving way or locking of a joint and bony tenderness. You should not exercise through pins and needles or numbness, which are your typical symptoms of referred pain from a disc/nerve been compromised. All of the above are symptoms you should not exercise through. These are symptoms to get checked out.

When should I definitely NOT exercise?

If there is any suggestion of a stress fracture, then exercise especially impact exercise (running, zumba, gymnastics ect.) should be avoided until advised it is safe to do so. You may be able to use swimming or cycling for very light exercise but only if they give the go ahead. Acute injuries or the acute stage of an injury (1-2 wks) active rest is recommended. If a tendon has become swollen and very painful (reactive) exercise will likely aggravate it further. If a tendon injury has been around for a while and you mainly get pain after or the next day but it goes away in a few days, exercise is okay. If you have been training really hard, you may have over trained and rest can be the best option for both recovery and injury. Do not push through chest pain or abdominal pain.

Try to follow the above information if you are having pain exercising and if ever in doubt get it checked out. Never put up with pain thinking it will go away, it may just get worse.

 The text above is for guidance purposes only. If you are in pain whilst exercising then seek out a specialist in this area.