Pain during exercise: When is it ok and when should I take it more seriously?
Updated: Apr 11, 2021
Dr Luke Perraton physiotherapist and physiotherapy educator/researcher
Welcome to the first Healthy Fit & Injury-Free blog from Perraton.Physio!
We started Perraton.Physio and the Healthy Fit & Injury-Free blog to help translate research findings and clinical practice knowledge to patients and provide physiotherapy-led fitness workouts and clinical services.
Our blog is for the people we work with as clinicians and in our fitness classes, but we are happy to share what we know with the rest of the world.
Zuzana and I run a physiotherapist-led online fitness class called CORE & FITNESS to help people build general fitness and movement control. A benefit of our fitness classes is that Zuzana and I are practicing sports physiotherapists and in addition to describing exercises to you we also explain why the exercises are important and how you can modify them to suit your needs. We also do the exercises with you in the class while monitoring you on the screen. Zuzana and I also participate in group fitness classes ourselves at Blackburn Karate Club - it's important to practice what you preach!
Now, let's answer the question above...
Most of us have experienced pain during exercise to varying degrees. In fact, if you haven't felt any pain during exercise you're probably not going hard enough! But how do you know when pain is ok and when it is not ok?
When you work your muscles hard it is normal to feel some degree of muscle soreness in the hours or days following the session. This soreness if often worse the day after exercise and is therefore called Delayed Onset Muscle Soreness, or DOMS for short. DOMS is a generalised soreness within the muscles when you stretch or contract them. If you go extra hard, or are unfit and push yourself very hard, particularly with a lot of jumping, landing and heavy weight, DOMS can be worse. DOMS can be quite uncomfortable and can reduce athletic performance (e.g. speed, power, strength, mobility) when it is at its worst. But this does not mean that it is harmful.
It is important to remember that pain does not necessarily equal tissue damage in the body. DOMS is a good example of this. In fact, pain actually helps to protect you from further damage. The trick is to listen to your body and think about why you have pain.
What should you do if you develop DOMS after returning to training in the new year? The answer is, keep going! Massage can provide some relief for DOMS, but ice, stretching and other therapies like acupuncture have been shown to have no effect on DOMS. In our experience, the best treatment for DOMS is to do a good 'warm down' after training and do light exercise the day after a heavy training session. Warm up thoroughly prior to your next hard training session and make sure you are adequately hydrated with boring old water. In other words, nothing fancy, just good old common sense.
When should you take pain during or after exercise more seriously?
As a general rule, if you have pain in your muscles as a result of training, the pain feels like a dull ache or stiffness, you have it on both sides of your body and it improves as you warm up, this is more likely to be a positive adaption to exercise rather than an injury.
On the other hand, if you develop pain in your joints, or tendons (the cords that connect muscles to bone, e.g. the Achilles tendon), if you develop pain rapidly and it is more severe, or if you have pain at rest or during the night, this is more likely to be a sign of overload or injury. Pain that wakes you up at night could indicate a more serious problem and you should see a health professional.
If you develop pain during exercise and it feels like it is more than muscle stiffness or soreness you should stop and modify what you are doing. If you are exercising in a class, report the issue to your instructor or therapist. Pain or other symptoms that does not resolve with rest is a sign that you need to take action. See your doctor, physiotherapist or other health professional.
Well that's enough for now! We need to leave some material for the next blog. If you want more, stay tuned for our podcast episode on this topic.
If you have any injuries or niggles that you want to discuss with us feel free to stay online after one of the classes, email us at email@example.com or make an appointment via our website. Remember to work your way into your exercise in the new year, particularly after taking a break from exercise over the holiday season.
See you in the new year and happy training!
Luke is a physiotherapy educator and researcher from Monash University, Australia. He teaches into the first year of the Bachelor of Physiotherapy course in the Department of Physiotherapy and is the co-director of the Monash Musculoskeletal Research unit. Luke is the co-founder of Perraton.Physio and he runs online CORE & FITNESS classes with Zuzana twice a week. Connect with Luke @LukePerraton.
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