By Lisa Ziegel:
One of the major limiting factors that keep people from exercising, or a reason why people drop out, is because of pain. The perception that you have to exercise to the point of feeling pain (who hasn’t heard of the saying “no pain, no gain”?) is one that is hard to dispel. But then again, there are people who are already in pain due to conditions, such as arthritis, from injuries or other physical reasons. Should these people exercise? How do you know when to stop if exercise hurts? These are questions that are asked quite frequently by people considering starting an exercise program, and since it may affect people’s decisions as to whether or not they become or stay active, it would be useful to explore the possibilities.
First, we know that exercise benefits us in so many ways. All the reasons and mechanisms through which it accomplishes this cannot be handily summed up. Nearly anyone in any stage or condition of life can perform some type of activity. For example, even in the frailest and weakest conditions, elderly persons can perform activity, even if they can’t leave their bed. Doing so can improve their quality of life and functioning or at the very least slow the degenerative process. Others, such as people who suffer from osteoarthritis or fibromyalgia, can benefit even more, even though the thought of going through more pain makes it seem nearly impossible to many, hence, their hesitance.
Below is a guide to the kinds of pain one can expect to experience with exercise, along with instruction as to when it is OK to persevere through it or when to stop. Hopefully, this will help newcomers feel more assured that they are doing the right thing or help others re-think how they approach physical activity.
- Muscle Fatigue Pain – The first type of pain a newcomer to exercise will almost certainly experience is muscle fatigue. This usually comes in the form of a “burning” sensation. In an untrained person, this is due to several factors, including the lack of efficiency of blood flow to the working muscles, insufficient muscle power and even undeveloped motor skills (when learning a new movement skill). Although it is not a pleasant sensation, the good news is that it goes away as soon as the activity ceases. It also gets better when a person continually practices the activity because physiologically, the heart becomes better at pumping blood, the network of capillaries expand to deliver blood and nutrients to the working muscles and the number of energy-producing muscle-cell organs, the mitochondria, increase to improve function. And the mind-body connection improves with the mastery of the movement skill. So while this is a form of pain, tolerance of it can be learned, and the effects will diminish as the fitness level improves.It is not always necessary to experience this kind of pain if one really wants to avoid it. Depending on a person’s beginning level, starting slowly and trying short bouts of an activity, such as walking, can increase tolerance for exertion in an easily controlled manner and lead to adherence to a long-term activity plan.On the other side of the coin, there are those who enjoy “the burn” and who actively seek to push their limits, whether they are cycling, weight lifting, running, or participating in a sport. There is nothing wrong with this until it gets to be too much. Without taking adequate rest periods between days of vigorous exertion, the body can start to show signs of wear, such as a decrease in immune system function, fatigue, muscle soreness that won’t go away, depression, lack of motivation, and more. This is not a good type of pain to work through, and is known as “overtraining syndrome.” The remedy for this is to incorporate more variety into your exercise program with one or two days being “easy” days, one or two “moderate” days and maybe two or three “hard” days. Including one day of “active” rest that is a day when you are doing easier, recreational activities (or even nothing at all if you lead an overall active lifestyle). Choosing a variety of activities instead of overdoing one thing (i.e., if you’re a runner, intersperse running days with days of swimming or weight training to balance things out) can help too.
- Muscle soreness – This is a pain that comes after the activity, sometimes a full day later. This is known as “delayed onset muscle soreness” or “DOMS.” Although it is not pleasant, it is not dangerous and does not mean you are injured. However, you should NOT “work it out” or work the same muscles until the soreness has subsided. It is better to perform easy whole-body movement (such as light cycling, walking, swimming) to help increase blood flow, thus decrease any stiffness, and maybe it would be OK to work different muscle groups (although this is not as easy as it sounds, since muscles interact with each other, and do not function independently). Better to rest if you are unsure, than to be sorry and risk injury. The soreness should subside in two to three days. This is not something you want to strive for at every workout. Muscle soreness means you’ve stepped over the threshold of your body’s tolerance. A little pain means you’ve pushed, and the muscles should adapt to that and become stronger until the next time you increase their load tolerance. If the pain is so bad that you can’t function afterwards, then you’ve pushed too hard or have done too much all at once. You will need to be more careful next time.
- Joint pain – This is something that most people should be concerned with if it is experienced in conjunction with exercise. Common complaints include lower back, knee and shoulder joints. If pain is experienced during or after activity in any of these areas, it would be a good idea to stop the activity and consult with a professional. Getting a proper diagnosis, even if you think “it’s nothing” or it will go away by itself, can prevent a little problem from turning into an injury that can set you back. The same goes for muscle pulls or nagging pain that persists. However, if you are a person who suffers from diagnosed osteoarthritis, fibromyalgia, or other chronic issues, you can still exercise and derive great benefit from activity that may even help your condition. The key is to find the right activity and to seek the right guidance to help make sure you don’t aggravate or worsen your condition. Consulting with an experienced professional would be your first step. There are many inexpensive options, such as community support groups, for those who exercise with arthritis, etc.
The human body and common sense tell us to avoid pain. However, we know in the case of exercise that a little discomfort, maybe even a little pain, can make us stronger. Each individual is different in how much they can or choose to tolerate, and the level of exercise can easily be tailored to each individual’s goals in this respect. Since we know the benefits of exercise can make us feel better and improve our health in so many ways, changing our way of thinking about it can help us get over this obstacle.