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When to work through the pain, and when to sit it out

As a physiotherapist, my clients would be the first to tell you that I’m not afraid of asking them to work through pain if it’s helpful. The question is, when is it helpful?

When healing from an injury, we often expect discomfort during the recovery process. However, what about during a regular exercise routine?

Every year, I see clients in my physiotherapy practice who accidentally injured themselves during exercise. Often, in hindsight, they can see the warning signals their bodies were giving them. But while doing the exercises, they interpreted these symptoms to be a sign of hard work, not of impending injury.

The phrase, “No Pain, No Gain” was popularized in the 1980s by Jane Fonda, as she led high-intensity exercise workouts. Participants were encouraged to “feel the burn” to know they were doing the exercises correctly and with the right amount of effort.

Fonda’s references were related to the normal mild discomfort and perceived “heat” in a muscle that is felt when exercising at a high intensity. This discomfort is generally safe as long as it is short-lived, and the muscle recovers completely between workouts. It is also normal (and safe) to feel mild tightness in the muscles for one to two days after exercise. This tightness is typically relieved with light aerobic activity (a walk or bike ride) or gentle stretching.

There is a phenomenon called Delayed Onset Muscle Soreness (DOMS) that is worth mentioning. High-intensity exercise can result in severe muscle discomfort that begins 12 to 24 hours after exercise, and peaks between 48 to 72 hours afterward. Although the muscle will recover from DOMS spontaneously, it must not occur after every workout.

If the muscle comfort isn’t restored before the next session, additional exercise can contribute to muscle breakdown instead of muscle building.

It is also important to monitor how your joints are feeling. Typically, we do not expect joints to be painful during or after exercise. If there is pain in joints (such as the knees) during exercise, it is often associated with a technique problem. The technique should be corrected before continuing, as mild symptoms often escalate over time creating larger problems.

Pain, swelling or stiffness in a joint that develops following exercise is a significant warning sign. If you start to experience symptoms like this, discussing them with a physiotherapist can help identify the issue and determine which exercises suit your joints best and how quickly it is safe to return to them.

The exception to the rule of joint pain is if you have an underlying condition like osteoarthritis. In this case, the joint may be painful during exercise, but if you’ve had professional guidance regarding your exercises, a minimal amount of joint pain can be acceptable and safe.

Ultimately, exercise should help our bodies feel better, not worse. Mild discomfort may be acceptable during exercise, but it’s important to be monitoring both the muscles and joints for signs that our routine needs to be adjusted.

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