Exercising With Pain
Greg Stemkowski MS, PT, CSCS, PES
Bela Costa SPT - Dominican College Physical Therapy Program
Procore Physical Therapy P.C.
I believe society as a whole looks upon people who work through pain as dedicated individuals willing to sacrifice themselves to accomplish their goals or society puts them on a pedestal and labels them heroic. Otherwise, the statements no pain, no gain! or work through the pain! Would have little meaning. These two statements are innoxiously dangerous because they carry a false sense of security in that if you tolerate the pain, especially when exercising, the pain will go away. These statements only apply to healthy individuals who are working above and beyond to achieve their goals and have no preexisting musculoskeletal injury or condition. When exercising with musculoskeletal pain the risk for a more serious injury rises dramatically. This could lead to a loss of function at home and/or at work, lost time in the gym or in competition, and even surgery. So if you are exercising with pain it is recommended that you see an orthopedist for a consultation before you continue your exercises. This could help in preventing serious injury. Those of you who are willing to take on the risk of potential injury, here is some advice to follow when exercising with pain.
As a Physical Therapist, part of my profession is dealing with people who have musculoskeletal pain and prescribing exercises and modalities to help them overcome their condition. Over time I have developed an understanding of how to exercise my patients when they have pain. The first priory is reducing the intensity and range of motion (ROM) of the injured body part until it is pain free. This means changing your exercise variables to higher repetitions, lower sets, and less weight. Work through a ROM that is pain free! This will allow you to continue strengthening with less of a risk of further injury. Second, listen to what your pain is saying. If you have tolerable pain while exercising and the pain does not get worse and stops when you stop exercising, proceed with caution. If you have pain while exercising and the pain is progressive, meaning getting worse, stop exercising! If the pain is lingering, not going away quickly, call it a day and go on to something else. Third, you must keep in mind that the very exercise you are completing is the very reason you have pain. So, if that exercise is causing pain change the exercise all together. Try strengthening in another plane of motion or use a more controlled exercise machine instead of using dumb bells.
Finally, after exercising with pain use modalities such as cold or heat to help keep your pain under control. I generally use cold in the form of ice after my patients are done exercising. This is a more conservative modality than heat because if an inflammatory condition is present, heat will make it worse. I use heat when my patients have complaints of tightness after exercising. This will help circulate fluids and relax muscles.
I cannot stress enough the importance of seeing an orthopedist prior to exercising with musculoskeletal pain. Placing an injured body part under resistive stress has a high risk of causing greater pain and damage to that body part. If the musculoskeletal pain does not get better or gets worse, do yourself a favor, do not work through the pain, and go see your doctor.