Guidance is an imperative part of the journey in taking someone from painful to pain free. Answering the “how much pain is okay when I exercise?” is a vital part of the guidance process for all clients that involve us in their Physiotherapy journey.
This is an important question for a few reasons:
- For those clients who are very active, or involved in regular exercise or sporting training, obviously you’d like to continue where possible. Utilising guidelines can in some cases allow you to continue training without adversely affecting your recovery or rehabilitation, or making your injury worse.
- For those who aren’t so active, but are endeavouring on a rehab program to reduce pain and improve function, this is equally important. Ensuring you’re working to the ‘right pain’ level so as to get the therapeutic benefits we know exercise can give us can be paramount to getting a good outcome.
Unfortunately, answering this question is not always the easiest task, and is influenced by several factors:
- Which context (or scenario) you find yourself in
- The type of pain
- What is the nature and severity of your condition
- Person specific factors
- Behaviour of your symptoms during and after exercise
Each of these factors often need to be considered in conjunction with the others, rather than independently. Let’s go through them individually in a little more detail.
Context and type of exercise
This refers to the circumstances that you find yourself in whilst experiencing your pain with exercise. For example: are you in the gym rehabilitating a condition under the supervision of a physiotherapist? Are you mid football game chasing for a ball in the 4th quarter, with no history of pain in your affected area previously? The scenario you find yourself in will help guide whether pain is okay, or potentially detrimental.
2. The nature and severity of your injury
Different conditions may be able to tolerate pushing into some pain with exercise, whilst others won’t. A lot of musculoskeletal issues, for example management of joint conditions or osteoarthritis and tendons respond well to exercise within painful limits. Bone stress injuries on the other hand do not, and particularly in the earlier stages need to be completed pain free. Ultimately, this is one of the bigger factors taken into consideration to help us answer this question. What at a tissue level is driving your pain, and how much pain should we allow as a result?
3. Type of pain
- Unbearable or bearable
Often the type of pain impacts whether you should continue or not. The question we’re often asking (whilst also being affected by other factors here…) is, “is it bearable or tolerable to you?”.
4. Behaviour of pain during and after exercise
Perhaps one of the better guides in helping us deem whether exercising with pain is okay or not. How is your pain behaving over the course of exercise? We know that pain that continues to worsen over the course of exercise can sometimes point to bone stress injuries, an injury considered more serious with a more cautious approach to staying away from pain. Pain that potentially stays ‘bearable’ over the course of exercise may be okay however, depending on the type of condition or injury you’re managing.
Similarly, after noting how your pain behaves during exercise, how does it feel after? Does it keep you awake that night and cause you particular discomfort for an extended period after? If this is the case it’s likely you need to either exercise less intensely, in less duration, or cease for a short period. If pain returns back to ‘baseline levels’ afterwards and doesn’t affect your sleep or cause you any issues afterwards, it’s likely okay! (depending on the nature of your condition)
5. Person specific factors
This can include your beliefs about pain, whether you find being in pain distressing, and your previous experience with exercise and other things. A more tricky factor to consider without appropriate education and discussion with your physiotherapist first. Ultimately, if you’re given the guidance as to what is acceptable based on the above factors, but still find exercising to that pain level distressing or emotionally disturbing, wind it back a notch or do less.
Hopefully that gives you a rough idea of some of the factors that influence whether or not pain during exercise is okay. Keep in mind, it’s not a one size fits all approach and should take into consideration all of the factors (and others!) we’ve mentioned above.
Here’s our thoughts:
If your condition is one that responds well to load (exercise), the pain is bearable during and returns to baseline levels within 24 hours, and isn’t hindering the recovery of your condition in the timeframe we expect, then it SHOULD be okay.
Ultimately, the best way to get this question answered, and get yourself on the road to recovery in the shortest time frame possible is to consult an expert physiotherapist. You can book a time online here, or call the clinic on 8490 0777 to discuss further.