Lets talk about Pain Part 2. Acute pain during exercise.

If you have not yet, I encourage you to read Part 1 of this pain blog series to understand some key concepts discussed here. 

So what do we do when we experience pain while training? To reiterate, I am not a doctor so I cannot diagnose my client's cause of pain. I can, however, perform an assessment to help identify what relieves or worsens the pain "alarm" going off. This also helps me understand if we need to escalate to another level of professional help. This could include seeing a physiotherapist, physician, or even a surgeon should that be necessary. For me as your trainer, I would follow up with their notes to help find what possible movements we could continue to practice safely. In the majority of cases, barring an extreme incident like dropping a weight on your head, pain felt from exercise can be worked with right away.  

If you were practicing an exercise, like the deadlift, and experience an acute pain then we  begin the assessment right away. Stop the movement and take a moment to read and interpret what you are feeling. Try to remove the thoughts of doubt and worse case scenarios as you read your body. This helps reduce over-stressing ourselves and keeps us calm to assess. Start with these questions.

Did the pain stop as soon as you stopped the movement or does it continue after? Is it a sharp or dull pain? Does the pain travel from one area to another? If the pain reduces or goes away after stopping the movement then we can continue with assessment. If it is so severe that nothing else can be given attention or if range of motion is greatly reduced then that would indicate further professional help is needed. 

If the pain is not too severe then we can continue the assessment. For the deadlift study, a variety of movements like bending forward or backwards, moving your hand down each thigh, and soft twisting are ways of using movement to assess what is causing your pain and the severity. If you are by yourself then the easiest thing to do would be asking yourself, can you do what you were just doing? For the deadlift example I would reduce the weight and attempt 1-3 repetitions. If pain comes back, worsens, or persists then decrease the weight further. This can go all the way to an empty barbell if needed. 

At any point if the movement can be done without pain, or without worsening the pain then we can practice at that load for the rest of the session or even start adding weight again if it does not cause the pain to return. This would also encourage healing as movement can help reduce catastrophizing, or babying, the injured area. This could cause stiffness and reduced range of motion in the short term and reduce the speed of recovery. We are using the alarm to guide what we CAN do rather than deter us from trying anything at all.  

To summarize, understanding our pain as an alarm means we can use it to find out what we can do for movement. This helps reduce catastrophizing in the mind, keeping us calm and in control. Depending on the severity of pain experienced, we can assess and potentially continue the training. If severity is too high or range of motion is impeded, then that can indicate further help may need to be sought for recovery. This could include additional rest, ice or assisted support, or medical intervention like medications or professional diagnosis. In most cases, being able to continue moving helps assist recovery when paired with proper sleep and recovery management.