One of the biggest mistakes people make when exercising is assuming that all pain means the same thing. It doesn’t.
Pain is information. It is your body’s way of telling you that something is happening, but the reason for the pain can be very different from one person to another. Understanding why something hurts can help determine whether you should modify your activity, stop exercising and allow an injury to heal, or begin strengthening an area that has simply become weak.
I like to think of pain as falling into three general categories: pain caused by a condition, pain caused by an injury, and pain caused by weakness.
Understanding the difference is extremely important, particularly as we get older and want to remain active.
- Pain Caused by a Condition
The first type of pain is associated with an underlying condition.
Examples might include spinal stenosis, arthritis, degenerative disc disease, a bulging or herniated disc, or nerve irritation such as sciatica.
This type of pain can be challenging because the underlying condition may not simply disappear. The goal, therefore, may not always be to “cure” the condition. Instead, the objective is often to manage symptoms, maintain function, improve strength and continue moving as safely as possible. Consider spinal stenosis. Someone with stenosis may experience discomfort in the lower back, buttocks or legs, particularly during standing or walking. Sitting down or changing position may reduce the symptoms. Completely avoiding activity because discomfort occurs isn’t necessarily the best long-term strategy. Instead, the individual needs to understand what movements aggravate the condition, what movements provide relief and what exercises can help support the surrounding structures.
The important distinction is that working with a chronic condition is not the same thing as training through an acute injury.
Someone with a diagnosed condition should work with their physician, physical therapist or other qualified healthcare professional to understand what activities are appropriate. Once those parameters are established, a knowledgeable personal trainer can help develop an exercise program that works within them.
The goal is simple: work with the condition rather than constantly fighting against it.
- Pain Caused by an Injury
The second type of pain needs to be treated very differently. This is pain associated with an actual injury—a muscle strain, ligament sprain, tendon injury, fracture or other acute tissue damage.
You should not try to prove your toughness by training through an injury.
The old expression “no pain, no gain” can be terribly misleading in this situation. Continuing to load an injured body part can aggravate the injury and potentially turn something relatively minor into a longer-term problem. If you experience sudden pain during exercise, significant swelling, bruising, loss of strength, loss of normal movement, inability to bear weight, or pain following a fall or other trauma, stop and have the problem appropriately evaluated. Once an injury has healed sufficiently and a healthcare professional has cleared you to resume activity when necessary, the rehabilitation process begins.
And rehabilitation requires patience. You don’t immediately return to the weight, distance, speed or intensity you were using before the injury. The injured area may have lost strength, mobility, stability and endurance during recovery. The progression might begin with gentle movement and appropriate rehabilitation exercises, followed by gradually increasing resistance and eventually returning to normal activity.
Healing comes first. Rehabilitation comes second. Performance comes later. Trying to skip those steps can put you right back where you started.
- Pain Caused by Weakness
The third type of pain is particularly important because sometimes people stop moving when movement—appropriately prescribed—is exactly what they need. Pain or discomfort can sometimes be related to weakness, poor muscular endurance or inadequate support around a joint.
When muscles become weak, other structures may be asked to do more work. Movement patterns can change. A person may become less stable, fatigue more quickly and begin avoiding activities that feel difficult. Unfortunately, this can create a cycle:
Weakness → discomfort → less activity → more weakness → more discomfort.
The solution isn’t necessarily more rest. It may be progressive strengthening. The key word is progressive. You don’t take a weak muscle or poorly conditioned joint and suddenly place a heavy load on it. You begin at a level the person can tolerate and gradually increase the challenge. That could mean beginning with body-weight movements, isometric exercises, resistance bands, light dumbbells or supported exercises. As strength and tolerance improve, resistance, repetitions, range of motion and exercise complexity can gradually increase.
This progressive approach helps strengthen not only muscles but also improves the capacity of the supporting connective tissues and the body’s ability to tolerate physical demands. For an older adult, this can be especially important. A weak hip can affect walking and balance. Weak quadriceps can make getting out of a chair more difficult. Weak glutes can affect stability. Weak upper-body muscles can make everyday activities increasingly challenging.
Rest alone doesn’t make a weak body stronger.
The appropriate response to weakness is progressive, intelligent resistance training.
Learn to Ask Why It Hurts
When someone tells me, “It hurts when I exercise,” my first thought isn’t simply that the person should stop exercising.
My question is:
Why does it hurt?
Is there an underlying condition? Is there an injury? Or has the body simply become weak and deconditioned? The answer matters because each situation requires a different approach. With a chronic condition, the goal may be to manage symptoms and maintain function. With an injury, the goal is to allow healing and then rehabilitate the area appropriately. With weakness, the goal is to progressively strengthen the body so it becomes better able to handle the demands of everyday life. There is also an important limitation to remember: you cannot reliably diagnose the source of pain based on symptoms alone. Persistent, worsening, severe or unexplained pain deserves medical evaluation before assuming that weakness is the cause.
Don’t Be Afraid of Movement—Be Smart About It
As we age, aches and pains can become part of life, but fear of movement can create its own problems. If every uncomfortable sensation causes us to stop exercising completely, eventually we can lose strength, mobility, confidence and independence. The answer isn’t to ignore pain.
The answer is to understand it.
Know when to modify an activity. Know when to stop. Know when professional medical evaluation is needed. And know when your body needs a carefully designed strengthening program. As a personal trainer, I believe exercise should meet people where they are. The objective isn’t to force someone through pain. It is to identify what they can safely do today and progressively build upon it.
Pain caused by a condition needs to be managed.
Pain caused by an injury needs to be healed and rehabilitated.
Pain associated with weakness needs to be addressed with progressive strengthening after more serious causes have been ruled out.
Knowing the difference can change the way you approach exercise—and may help you remain stronger, more confident and more independent for years to come.
Jim Burns
NASM Certified Personal Trainer
Be Simply Fit
besimplyfit23@gmail.com