Should I exercise when I’m in pain?

By Coach E

I got a great question from Laurie in the VIP Lab about continuing to workout with painful muscles.

If you click through and read my responses, you’ll see that the first thing is to make a clear distinction between different types of pain because they need different care. And different areas where the pain can come from, such as the muscles, nerves and connective tissues in joints.

Here are a few general descriptions of the most common types of pain us active people experience and how we can deal with them:

MUSCLE SORENESS:

aka Delayed Onset Muscle Soreness (DOMS), it typically feels like a general soreness through the entire muscle, it’s a result of working the muscle at an intensity level sufficient to cause micro-damage, which is a precursor to building the muscle up stronger than before. You often only notice sore muscles when you activate or poke them and the soreness usually diminishes after 2-3 days at most, unless you went beast mode after a long layoff, in which case you should learn how to ease back into training.

Laurie asked about working out with muscle soreness and I responded, “Unless the soreness is a 9-10 / 10, I suggest working through muscle soreness but adjusting reps/sets based on how you feel, so if you’re at a 6-8 / 10, back off the reps or sets somewhat. If you’re at a 5 or below, follow your program as directed.

It’s important to keep moving because blood flow facilitates healing of any damaged tissue, we just don’t want to keep moving if it contributes to further damage. If you follow the guidelines above, you won’t cause further damage.”

She then asked about taking some ibuprofen (painkiller) and here’s my response, “Oh and I’d avoid the ibuprofen and go by the pain guidelines I gave above – pain is your body telling you something and popping a painkiller is like putting on noise-cancelling headphones when someone is talking to you – rude! If the pain is 9-10 / 10 then don’t do the movements that caused the pain, but still try to move/exercise in a way that doesn’t cause pain, even if it’s going for a walk, swimming or riding a bike.”

BURNING MUSCLES:

This is what it feels like when you’re working out and you get into the anaerobic glycolytic energy system, for example, after doing Squat Jumps for 30+ seconds straight. This is what most people call “lactic acid” in the muscles. It’s transient and goes away once you rest. I mention it here because it’s distinct from muscle soreness as described above.

TRIGGER POINTS:

Often the result of a muscle that’s compensating for a muscle or movement dysfunction, the soreness is more specific to a small (pointed) area vs. a sore muscle where the soreness is throughout; trigger point pain is typically pretty steady throughout the day whether you’re using the muscle or not. The solution is to address the compensation/dysfunction and I typically recommend ASMR or massage for a bit of relief in the short-term.

TINGLING:

Tingling is generally a nerve being stretched or pinched. If you feel this during exercise, back off and continue within a range that doesn’t cause it.

PINS AND NEEDLES:

The feeling of blood returning to an extremity after it’s been occluded for a period of time. I remember this happening to me often when I’d fall asleep on my

SHARP JOINT PAIN:

If you feel sharp pain during movement on the closing side of the joint – i.e. if you’re flexing your elbow like doing a bicep curl and the sharp pain is on the inside of the elbow – then you want to stop because it indicates a pinching or tearing of one of the cartilaginous joint connective tissues. If you’re feeling this you need to avoid the sharp pain as much as possible and get things working right, which will be different for every case but likely includes addressing tissue restrictions, ensuring muscles are active and strong and movement patterns are clean. [Sounds kinda like what we do here at Precision Movement, doesn’t it?]

ACHY JOINTS:

If your joints are achy throughout the day, it’s likely they’re inflamed. If it’s chronic it’s often referred to as osteoarthritis. In these cases you have to look at the important domains of physical health including daily activity, exercise, nutrition, sleep, stress and prescription medication. If it’s more transient, it’s usually a result of a high volume of loading on the joint. For example, I get it in the winters because when I play outdoor hockey I’ll stay out there for hours because I’m having so much fun (and in the back of my mind I still think I can make it to the NHL). For both cases, I like contrast showers, so when in the shower alternate 30 sec of hot/as cold as possible on the area 3-5 times.

Now you’ve got some new vocab around pain – the next time something hurts, see if you can describe it within one of these categories and it’ll give you better insight into what it is and what’s to be done.

I suggest you save this email somewhere to reference because by choosing to live an active life, you’ll encounter something on this list sooner or later. It’s all a part of the path.

Coach E

About the Author

Eric Wong (aka Coach E) is the founder of Precision Movement and has a degree in Kinesiology from the University of Waterloo. He's been a coach since 2005 and spent his early career training combat athletes including multiple UFC fighters and professional boxers. He now dedicates himself to helping active people eliminate pain and improve mobility. He lives in Toronto (Go Leafs Go!) with his wife and two kids and drinks black coffee at work and IPAs at play. Click here to learn more about Eric.