Woman stretching in the gym after a workout

Should you exercise with pain?

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Is exercising with pain ever okay, or is the old adage ‘no pain, no gain’ blurring the line between what’s good for you and what’s harmful when it comes to working out? Physiotherapist Brad McIntosh explains when to push and when to hold back.

No pain, no gain?

One of the most common things we get asked is how much pain is acceptable.

We watch images of pro athletes pushing it to the limit and we hear stories of people smashing themselves day in day out…but the question always remains…how do we know when to push and when to hold back.

The question is an interesting one and the answer (of course) is not a simple one. There are many contributing factors….I’ll try to explain the most common ones.
...pains that settle with more activity can often mean the tendons are struggling with the change in load.

You may have to reduce your training load if this is happening, identify what tendon is causing the trouble and treat it locally with ice and targeted exercises.

1. You're new, or returning to training

If you’ve gone from a relative couch potato to captain motivation overnight, you are highly likely to get injured. Sudden changes in exposure of our bodies to unfamiliar movements means that we are often poorly prepared to cope.

If this is you there are a few things you can do to combat this:
  • Engage in a progressive demands system
  • Start light and easy and progress your exercise demands slowly
If you are completely new to exercise it may even be worthwhile in the long run to be assessed by a physio or exercise physiologist for identification of biomechanical ‘risk factors’ (e.g. tight calfs, flat feet, poor lumbopelvic stability) and integrate some preventative training into your actual training.
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2. The pain disappears when you are exercising, only to stiffen up again after you’ve rested

Unfortunately pains that settle with more activity can often mean the tendons are struggling with the change in load.

You may have to reduce your training load if this is happening, identify what tendon is causing the trouble and treat it locally with ice and targeted exercises.

In extreme cases you should discuss other treatment options to reduce tendon pain with your  physio, GP or sports physician to find an approach that is right for you. 

3. The pain comes on with training and then just gets worse and worse until you physically have to stop

Stop

This pain is not okay. 

If the pain is in your legs it can be a compartment syndrome (where the muscles swell and are compressed within the fascial outer casing of the muscle) or it could even be a stress reaction in the bone. Either way you need to get this looked at by someone who knows their stuff.

4. Your muscles are sore for up to 3 days following activity, but then they feel fine

Well done you are experiencing delayed onset muscle soreness…this is the no pain no gain they talk about!

You have exercised just enough to cause damage to the muscles, but it will be repaired and new, improved sarcomeres (the building blocks of muscles) will be laid down.

It is however a good time to rest for a day or two while you are sore, or cross train by doing something different (go for a swim or hit a few tennis balls gently).

Overall some discomfort is acceptable with training, but if it is impacting your ability to perform regularly you must get it checked out.

~This article first appeared on Sydney Physio Solutions.~
Sydney Physio Solutions was established in 2007 with the aim to provide a high quality service in injury rehabilitation using state-of-the art technology in an innovative environment.

Their team of highly qualified and caring physios, led by founder and Managing Director Brad McIntosh, can do a running analysis and provide advice & assessment for the very best outcome.

Brad and the team are also our injury prevention experts for the Blackmores Sydney Running Festival so send them your questions at Ask a Physio and they’ll help you achieve your goals and get you over the finish line!