Pain - what is it trying to tell us?

Firstly, pain and what causes it, is as highly complex topic. It is not always a sign of actual physical damage it can also be caused by our brain without there beeing any physical source for it. So, our intention is not to cut any corners here, but instead just to talk about pain that is training related as that is what we know a thing or two about.

How we react to pain?

Different individuals react very differently to pain. When some of us stop doing something immediately as we experience even the mildest of pain, the other part of us just keep on grinding until we can no more. There is nothing wrong in neither, but getting to know how you react to pain is something worth getting to know.

THE OVER-ANALYZERS

Some of us are more sensitive to pain, nothing wrong with that. But if you start analyzing every single bit of even the mildests of pains, you will propably not be able to do much. A pain you felt on one step of your run, on one lift you did with a kettlebell, for the first 5 seconds of your swim….is not something to get stuck with. A pain you feel once, that is not something very sharp is not something you should start analyzing too much before it comes back and is related to something you do on a regular basis. If you do something once and feel mild pain that never comes back again don’t hold on to that. It was propably nothing serious!

THE SUPER MEN AND WOMEN

Then there is the other half of us, who almost brag about how we still keep going even when our body is about to blow up! We are the champions, because we can tolerate so much!

But to keep on going when our body is in clear pain is nothing but just stupid. If your body is trying to tell you something, but you choose to not listen, it is not a sign of your toughness, it is just a sign of stupid kind of stubborness that will not help you progress in training. It will only just stop you form training sooner or later.

When should I be concerned about pain and from who to ask help from?

Pain that you feel once which never comes back and that does not limit your movement in any ways is not something to be concerned about. On the other hand, pain that;

• Lasts for days after exercise is not normal

• Begins to affect your sports performance is not normal

• Pain that does not go away with rest is not normal

• Pain that begins to affect your function outside of sports, such as walking or sleeping, is not normal

• Pain that is constant or increasing over time and does not go away is not normal

• Pain that you need to numb down with regular pain medication is not normal

• Pain that begins to wake you up from your sleep is also a concern, especially if it increases over time.

• Pain that comes together with the development of tingling or numbness, is not normal and may indicate nerve problems.

• Pain that comes together with the development of weakness in a limb is something to get concerned about too.

Pain that occurs with an injury

In most cases where a joint becomes swollen, painful and incapable of movement after an injury with the symptoms only getting worse over time, should be checked out by having an X-ray or an MRI taken. Only that will tell if there are bone fractures or more severe tissue damage that will highly impact the way it should be treated.

The treatment after that will be directed by the doctor very often including resting the limb at the initital stage followed by physiotherapy.

What about the pain that occurs without a clear injury?

More often than having clear injuries, we experience pain from sources that are hard to localize. We are not sure what have caused them in the first place and what movements make them worse.

With this kind of pain we often see this kind of a “ignorance is a bliss” - type of mentality. We firstly try and just ignore it in case it just goes away. And sometimes it does, but more often than that it gets worse. It started as something mild, but then grows to something that disables us from performing some movements or even keeps us awake at night.

But then what do we do?

The most often; we keep a week or two rest from training with the hopes of it going away, and yes, it often does, but then it comes back as often as it goes away with rest. We have done well with resting it off, but we haven’t done well with not trying to figure out what was causing it in the first place.

Then we may go an see a doctor, who will tell us not to perform the movements that cause pain and they give us a pain medication order. So we treat the symptoms, not the cause for the pain. Can be effective, but not very productive in terms of figuring out the source for the pain or how to avoid it in the future. Doctors are specialized in treating diseases and actual physical damages, but are not the best in helping with training or movement related pain if they are not specialized in sport medicine and in treating that specific area that you are having pain in.

SO IF RESTING AND GOING TO SEE A DOCTOR IS NOT THE MOST EFFECTIVE RECEIPT FOR NON INJURY RELATED PAIN THEN WHAT IS?

Let’s take an example of Shoulder pain. The most often the cause for shoulder pain (that hasn’t been directly caused by an injury) that gets worse with movement, especially done overhead, is poor range of motion in the shoulder joint and muscle imbalancies. It often starts slowly, first it is a little irritated and swollen, we ignore that and it starts getting worse. Then we stop training and go and see a doctor. We keep 2 weeks of rest and get the swelling down by pain medication. We feel great and are eager to get back to training, but it starts again.

What we could have done instead is firstly; not making it any worse by just keeping on doing what we are doing. Pain is a signal of something that you should always listen to! If it goes away as soon as it came and never comes back after a day or two of resting, then keep on going. But if it conitinues as a nagging pain that is always there and seems to get worse with certain movements, then the first person you should see in a Physiotherapist specialized in treating athletes. A physiotherapist will then see if you have mobility restrictions, muscle imbalancies, instability, weakness, compensational movement patterns etc. and will give you exercises to work on improving those things. This way you will not be just treating the symptoms, but the actual cause for it.

In many cases this receipt above, could help many athletes in avoiding making any further damage to something that could have been treated a lot easier if it was started earlier on. It could save from a lot of frustration and sleepless nights. Save from feeling depressed becauase of not beeing able to train the sport you love. Save time from running from a doctor to an osteopath to another magician in the hopes of somebody fixing it.

HOW ABOUT PAIN THAT COMES EVERYTIME YOU PERFORM A CERTAIN MOVEMENT?

Sometimes we feel fine during a workout, but then the next day we feel pain in a certain area that does not feel like the normal kind of after training muscle soreness. One typical area is lower back, we feel fine doing the heavy deadlifts, but then feel sore the day after. Or we do a large amount of push ups, but then feel a little burning type of pain in the front of the shoulder that seems to be a little out from the normal.

In these cases, you should not start avoiding those movements, beacuse they are “bad for you” or just keep on grinding through. In many cases your technique might require a little check up or you need help in figuring out if you are actually using the right muscles for the job or are you compensating with others because some muscles may be too weak for it. Such compensations are not uncommon. Most of us have some movement restrictions or wrong movement patterns that means we will create movement in a way that puts stress on the the wrong structures. This can, if repeated, lead to pain sensation and if prolonged to strain injuries.

In these type of cases, it might be well enough to have a an individual session from a coach to work on your technique or to do some further testing to see if there are some accessory exercises you could do in terms of making things better.

AND THEN LASTLY, BUT NOT ANY LESS IMPORTANTLY;

What you do and don’t do outside the gym will highly impact your ability to perform in sports. If you are sitting at your desk for 8h a day, it may not be the Deadlifts that are causing your lower back pain, there might be a lot more to it. Or if you are rarely ever raising your arms overhead in your daily life, it might be a little too much expected that your body could know how to handle that at the gym. 

As much as that hour you spend at the gym will affect your life outside, your life outside will affect that hour you spend at the gym. Most often it is not about doing BIG changes, but doing small changes every day:

Performing 20 full arm circles every hour you spend sitting still at your desk.

Spending 10min of each of your working hours either standing/stretching/walking or performing other type of light movement. Saying that you don’t have time is not a good reson not to as improving the blood circulation to your brain by moving will improve your productivity the same amount.

Small things done on a daily basis will go along way! :)