It is common for gym-goers to be confronted with the phrase ‘ No Pain, no Gain ‘. Whilst it is true that effort and diligence are often proportionate to results, there is a fine line between doing it right and irreversibly injuring oneself. The bones and soft tissues of our musculoskeletal system typically work under a normal range of loading and stress. When we participate in endurance or strength training, we begin to deliberately push the muscle, tendons, ligaments, and even our bones to accommodate stresses beyond their resting tension. They gradually begin to get accustomed to this new load by stretching beyond their resting tension and getting stronger. During this acclimatization phase, good pain is quite normal but typically improves and eventually diminishes. Good pain is a hallmark of conditioning exercises and will not result in a permanent deformity or loss of function. Bad pain on the other hand is usually suggestive of underlying structural damage. The pain may be sudden and sometimes associated with a ‘popping sound’ or even visible deformity that persists. Whilst it may be OK to treat an initial and early bad pain with rest, icing, elevation, and gentle mobilization, pain that persists warrants an expert assessment. Typically, there are 3 types of bad pain :
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- Acute pain – sudden onset, associated with swelling/bruising or deformity. Typically implies a fracture or ligament/tendon rupture
- Acute on chronic pain – sometimes referred to as overuse injuries. This is due to underlying damage that recurrently flares up due to repetitive insults. Examples are tennis elbow or patella tendonitis
- Chronic pain – This is often due to the bad pains from above that is neglected. The underlying structural damage progressively worsens with activity and this results in irreversible damage
Whilst bad pain may sometimes result from sheer bad luck, it is more often due to poor training techniques, poor gear, or a pre-existing orthopedic issue.
So, how can one avoid Bad Pain?
- A sensible and well-planned conditioning exercise regime is critical. This should incorporate a graduated increase in strength and endurance levels whilst allowing for adequate rest in between. Typically, this would involve just a 10-15% rise in intensity every 10-14 days.
- Pre and post-work-out warm-ups are essential, even for the fittest and strongest! It allows the body to prepare itself for the work-out and start working beyond its ‘resting tension’.
- Use the correct gear. This helps enormously with activities where the stresses can change dramatically resulting in an injury, for example climbing, weight-lifting, or contact sports.
- The preferred activity of choice may continue to take center-stage but try to incorporate other exercise modalities to achieve a more multicentric approach. This enables overall body fitness and avoids repetitive and excessive stresses focusing on one body segment.
- Be wary of bad pain. Whilst good pain and muscle fatigue typically improve in 24-36 hours after a good rest and adequate hydration, bad pain does not. Bad pain, left unattended could progress to weakness, abnormal/adaptive walking patterns, and eventually, persistent pain. Consult with your orthopaedic doctor early to get a proper assessment and biomechanical advice on how to deal with bad pain.
