If it hurts, should i still exercise?

If there is a question that we get asked often, this would be right up there. As much as we can all say that exercise is a virtuous or healthy practice, the most significant reason why people don’t is because of pain and discomfort. To add confusion and conflict to the matter, there persists a certain attitude that ranges from the sentiment of ‘toughen up’, to the cliché of ‘no pain, no gain’. Whilst it certainly is true that we can expect some discomfort with exercise – fatigue, in some degree, is a necessary part of effective exercise – the complexity of the experience of pain means that this sentiment is not particularly healthy and certainly not always true. To really understand why, there’s two things that warrant explaining: what pain actually is, and what is required to make exercise worth it. 

 To answer the first as simply as possible, pain is all about protection. Pain indicates that there may be some kind of threat against your body. By means of trying to provide a relevant example, if you were to put your hand under hot running water with the expectation of it being considerably cooler, there is a very good chance that the ‘scalding’ experience of contacting that water will cause you some pain and you’ll remove your hand from the water. In doing so you’ll likely have been prevented from being burnt and suffering actual damage to your skin. Pain drives us to protect our body from threat, and most of the time it works pretty well. If the threatening stimulus to which we are exposed is greater than what our body’s tissues are able to withstand then we will experience harm, but the onset of pain is usually a reliable enough experience to protect us from these harms. In the same way, the pain experienced in a knee or a back is not due to changes in these parts of our bodies, but rather the threat that our body perceives from stresses placed on these parts. There is one other additional complexity that’s worth explaining at this point also, our body’s threat detection system will likely become more sensitive as we continue to expose ourselves to repetitive threat.

Secondly, in order to make exercise actually worth the discomfort, exercise should be driving your body to adapt to a level of functioning that you actually want it to be capable of. Simply, if I want to lift 10kg and I can only lift 5kg, I need to find ways to push my ability steadily towards 10kg. Lifting 5kg endlessly will not help me reach my goal. However, lifting 10kg may very well result in my getting hurt. By making small incremental increases in how much I lift and how many times I lift, the body’s resources are expended and stimulate the delivery of more resources during the process of recovery so as to prepare the body for another exposure to that same stimulus. So it’s normal to experience fatigue, it’s normal to experience stiffness, and some discomfort may result. 

“But should it hurt?” The rationale goes like this: if our body’s pain response is about protecting us from threat, then it’s probably an important thing for us to consider. So stubbornly pushing ourselves into pain that is debilitating is not likely to be a strategy you’ll be able to implement successfully for very long, and as a result you’ll not likely get the benefits. Whilst there is reasonable evidence that exercise, even when painful, is actually beneficial, there should be reasonable care taken to understand the specific circumstances about your pain so that you can actually experience the benefits. One principle we use, to good success, is about ‘acceptable increases in pain’. If you experience pain during exercise, the increase in pain should only be such that it is acceptable to your willingness to endure it. If you considered your pain before exercise to be a 2 on a scale from 1-10, with 10 being the most intense pain, and after exercise it increased to 4 but readily reduced within a short period thereafter then this is likely to be an acceptable experience. If your pain increases to a 6 and remains that way for a day or two, however, and this prevents you from doing tasks in your daily life you would’ve otherwise been able to do, then this is likely not an acceptable exchange.

So, if you’re worried about the pain you experience from exercise then rest assured that it’s normal to feel worried about pain. The questions that you need to ask yourself are: is this pain acceptable, does it interfere with the other things I do, and am I exercising in a way that’s going to help me get my body to where I want it to be?