Working Out With Pain

By: Heather Rozen

As a physical therapist at a strength and conditioning center, I’ll sometimes get called over to the desk to speak to someone who wants to know if it’s OK to work out with an injury.  Sometimes the answer is clear (clear to the therapist or trainer that is).  If this person is limping and having difficulty walking then I think that it’s fairly certain that running and jumping is out of the question.  Or, they have been unable to lift one arm up over their heads for the past few days.  Or their neck pain is so bad that they can’t turn it in one direction (I’m sometimes not sure how they managed to park their cars let alone take a boxing class).  The answer that we give people that are in this kind of acute pain is an emphatic “NO!”  It’s not OK to work out with that kind of pain.  Please go home and heal.  Of course, we want people to have fitness goals, and we want people to gain strength.  But more than that, we want people to take care of themselves. That means allowing yourself rest, recovery, and healing.

The “Sneaky” Pain

What becomes less apparent is the “sneaky” pain.  The kind of pain that happens when you move a certain way or it only happens when you squat, or it happens only at the beginning of a workout but then goes away half way through. This is the type of pain that people try to downplay.  People typically try to talk in circles about this pain because they know that I will want them to change their workouts and address the problem.  Either it hurts, or it doesn’t.  If it doesn’t hurt then, you probably won’t take the time to ask me the question in the first place.  So most likely it hurts.  Which means, no, you shouldn’t do that exercise.  The exercises that you are given in any given class should be done pain-free and should be done in full motion.  If you are avoiding any part of that exercise, I can assure you that you will end up with a much bigger problem.  The way that we move is changed significantly in the presence of pain.  Most of the time we aren’t even conscious of how much our movements change when something hurts.  Most of us have found out the hard way that the pain gets bigger requiring an even longer rest period (or surgery).  I’ve been both a patient and a practitioner, and I can assure you that if you take care of that pesky minor injury when it’s minor instead of trying to plow through the exercises, you will save yourself time and money.   

What Can I Do About It?

“So what can I do about it?” you ask.  Well if it’s something like overdoing it with yard work or shoveling and you are sore all over most people are pretty good about taking it easy for a day or two (they either lower the intensity or take a recovery class).  Or maybe you just overdid it during and exercise and you need a day or 2 of rest.  Beyond

that, I advocate having a healthcare practitioner take a look at it (I am a physical therapist after all).  Sometimes it’s just a matter of improving a particular movement, getting some soft tissue work done, modifying some activities and a little bit of homework.  Sometimes it’s a bit more serious and requires a surgeon.  But here’s the good news. … most of the time there is still a lot that can be done for a workout during the recovery phase.  Personal trainers and physical therapists have been able to create some great workouts during the recovery process from an injury.  We’ve also been able to create some great workouts for people with chronic conditions. It truly is worth your time to train with a physical therapist or trainer, at least initially, to learn the modifications and then gradually transition back into your workouts.   For example, we will sometimes come across people who have knee pain and have decided to just perform squats and lunges with half the motion when they would be better served learning some different exercises that will not only avoid pain but can improve matters.  Ultimately we want you to get assessed and then let us help you modify your workout so that you can have a complete recovery and lower your chances of re-injury.

What about Ibuprofen?

Please think twice about masking your pain.  Technically, this is supposed to be between you and your doctor.  However, most of us in the fitness field do promote listening to your body.  Artificially reducing the inflammation and pain is not listening to your body.  Your body has it’s own processes to handle inflammation.  There are obviously times when you would want to take pain medications but to get through an exercise class?  Is it worth it?  Do we want to squash the alarms that are trying to tell us that something is wrong?

If you take the time to start listening to your body and start to allow yourself the time to recover (not just from an injury but more intense workouts) you would be surprised from the fitness gains that you can make.  I promise you, working out through pain just isn’t worth it.  It usually only gets bigger.  Rest, get assessed and then let us help you get back to training.