How Much Pain Is Safe During Exercise?

“No pain, no gain,” says Benjamin Franklin, then Jane Fonda, and is now repeated by numerous personal trainers, bodybuilders, runners, and fitness enthusiasts, but how much pain is safe during exercise before it becomes too much? “Feel the burn” is another term used to refer to general discomfort during exercise and working out, however, when does pain change from a burn to an injury?

Pain during exercise can be from a variety of factors, including improper technique, poor body mechanics, injury, soreness, and general discomfort from exertion. 

Our internal sensations are subjective, so the amount of pain that is okay during exercise or working out will differ from person to person. A large amount of pain does not always indicate an injury but a small amount does not indicate an injury is not present. This means that muscle soreness can be a barrier to exercise for some and not for others. 

The amount of pain experienced during exercise which is safe if you are injured will also differ based on your injury status: what injury you have and what stage of recovery you are at. 

Little pain, small gain; Big pain, no gain

During exercise, either cardiovascular or weight-bearing, micro-tears of the muscles will occur. The “gain”, in this instance, occurs when the micro-tears heal, adapting to the stress and load put on the body and becoming stronger and more resilient. The “burn” occurs during exercise, especially high-intensity cardio and weightlifting, when the temperature of the muscles increases, waste products build up, micro-tears arise, and other physiological changes happen which induce fatigue in the active muscle areas, producing the “burn” sensation. 

This sensation can be uncomfortable to some, and enjoyable to others, but is relatively benign in the scheme of physical activity. Where “no pain, no gain” becomes problematic is injury. If exercising under the misguided notion that pain means you’re doing it right, you risk exacerbating an injury. Any “gains” in the meantime will be overshadowed by the recovery process of whatever injury arises or is worsened.

You may be able to blame the misinformation surrounding the fitness industry for this, but the real culprit is the body. Due to the subjective nature of pain, determining whether it stems from soreness or injury is a hard task.

There are different categories or “feelings” that pain falls under and differentiating between the types can usually be done through self-assessment. However, if you are still unsure after reading this blog, book an appointment with City Physiotherapy using the button below.

How can I differentiate between soreness and injury?

The types of pain

If it is manageable and you’d describe the feelings in your body as “tender,” “tired,” or “tight,” you’re probably just experiencing soreness.

However, if you’d describe the sensations as “stabbing,” “burning,” or “sharp,” or if these symptoms are accompanied by numbness or tingling, these could be further signs of injury and you should either slow down your activities or cease exercising until you have seen a professional.

Hear a snap, crackle, or pop, and 9/10 pain or above? Go immediately to your local urgent care or the ER.

It’s important you see a physiotherapist if it is unbearable or is restricting movement to the point of not being able to move the affected area. Even if you are not exactly sure if you are injured or not, it is important to get an official diagnosis from an experienced physiotherapist, and a treatment programme can be developed to get you back to doing what you love.

This is where everyone’s understanding of pain gets difficult: Everyone has a different pain tolerance. Some people with lower tolerances are prone to think soreness is an injury and those with higher tolerances are prone to overlook injury as soreness, which can be detrimental to the condition and worsen the injury.

Soreness will have a shorter life than injury, so waiting can be beneficial if you are unsure about whether the pain is an injury or just soreness. Soreness will usually last 2 to 3 days, and sometimes up to 7 if you are just starting exercise. 

Answering the question of how much pain is okay during exercise is a tough one, and is dependent on a few contextual factors:

• What situation are you in?
• Are you in the process of rehabilitating an injury?
• If you are injured, what is the severity of your condition?
• Personal factors 
• The behaviour of your symptoms during and after exercise.

What physical activity situation are you in?

Our evaluation and recommendations on the continuation of exercise will be different depending on the situation you’re in. Are you in the clinic being supervised by a physiotherapist while undergoing a rehabilitation programme for an injury? Are you in the last quarter of a football game chasing after the ball when you feel a sharp sensation in your hamstring with no history of injury in the affected area? Is it two days after you have lifted weights and your muscles are tender and sore?

Injury in winter sports is common, and it’s important to be mindful of this as we head into the colder months.

Are you in the process of rehabilitating an injury?

Pain during a rehabilitation programme is to be expected. The aim of a rehabilitation programme is to restore freedom of movement, working the muscles and joints to the edge of their movement restrictions while maintaining a manageable level of pain (and without causing additional damage). 

If you are injured, what is the severity of your condition?

Different conditions will be able to tolerate pushing into pain during exercise, some even respond positively to exercise within painful limits, but others won’t. A lot of musculoskeletal issues, for example, muscle strains and sprains, joint conditions or osteoarthritis respond well to exercise within painful limits. 

Conversely, bone stress injuries, particularly in the earlier stages of the injury, need to be healed exercise and pain-free. At the end of the day, the condition that is driving your pain will need to be assessed to determine what level of pain is to be allowed during rehabilitation.

What is the behaviour of your symptoms during and after exercise?

Sudden, severe pains during exercise were described above as “stabbing,” “burning,” or “sharp. These symptoms are usually accompanied during exercise by:

• An inability to place weight on a leg, knee, ankle, or foot
• An inability to move a joint normally
• The extreme weakness of an injured limb

After exercise, and sometimes immediately after the sensation, it can be accompanied by extreme swelling or bruising. Soreness does not share this quality with injury. Soreness can be accompanied by movement restrictions but these will not be so excessive as to restrict it entirely.

Pain that continues to worsen throughout exercise may indicate bone stress injuries. This injury will be worsened by pushing through it. If it stays ‘bearable’ throughout exercise, it may be okay. However, it is useful to consult with your physiotherapist if you have an injury to determine if it will be worsened by exercise.

If you are unable to sleep due to discomfort after exercising, it is advisable to reduce the intensity and duration of your workout or take a break for a short period. If the pain subsides to its normal level and does not disrupt your sleep or cause any further problems, then it is likely safe to continue exercising.

Personal factors relating to pain

Beliefs about pain, whether you find pain distressing, or your history with pain and injuries, can make you more or less willing to continue exercising through pain. As mentioned above, different pain tolerance levels can influence this as well. This does not mean that you have to ignore it and just exercise, if it’s reducing your ability to find joy in exercise, or is making the activity unenjoyable, reduce activity or see a physiotherapist to determine if there are underlying causes.

How can City Physio Help?

At City Physio Adelaide, we want to see you reach your fitness goals. If you are worried you have an injury from working out, book an appointment to see one of our physiotherapists who can commence a rehabilitation program for you, utilising our range of treatments.  

If you want a personalised workout plan to suit you and your lifestyle, so you can smash your workout goals, City Physiotherapy can also help! Contact us today and make a positive change.  

References

https://health.clevelandclinic.org/is-your-exercise-causing-good-or-bad-pain-how-to-tell/

https://www.houstonmethodist.org/blog/articles/2022/mar/should-you-still-work-out-when-youre-sore-or-in-pain/#:~:text=%22Muscle%20soreness%20occurs%20because%20both,little%20bit%20better%20each%20time.%22

https://www.thrivephysioplus.com.au/get-active/how-much-pain-is-okay-when-i-exercise/

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