Hurts So Good: How Much Pain Your Exercise Should Really Involve

hurts so good

We know No Pain No Gain is BS. Pushing through injury is dangerous and downright foolish. But exercise isn’t supposed to be easy, either. When I gasped about how hard some uphill weighted walking lunges were to my trainer last week, he replied drily that he doesn’t mean for me to feel like I’m floating along. And when he sent me immediately into wall sits after I dropped the 40 pounds of dumbbells, I let the agonized shrieking echo off the walls along with the Linkin Park blasting on the stereo. If I were ever captured by hostile interrogators who needed information from me, they’d need only to force me into a wall sit. After enough time I’d give up any state secret they wanted. They’re that painful. But: when I stand up and walk it off, moments later I’m fine.

And that’s the key difference in the kernel of truth behind No Pain No Gain, and the misunderstood, overhyped notion of pushing yourself balls to the wall, all the time. Pain expert Eddie O’Connor, Ph.D., sport psychologist and director of the Pain Center at Mary Free Bed Rehabilitation Hospital, spoke with me about the realities of pain in the life of an athlete.

“You can’t be an athlete and not hurt,” he says, and then laughs: “How do you do it without pain? You play golf.” But seriously, “You cannot perform at a high level and not experience pain” he explains. “To improve you’ve got to hurt. The problem is people don’t know the difference in discomfort and training pain and injury pain. That’s where all the problems start.”

The simplest rule of thumb is that “training pain is diffuse … maybe a gradual onset; it will decrease or go away when effort is discontinued,” Dr Eddie says. “Injury-signaling pain won’t go away when the effort is done. It’s sharp as opposed to dull, it’s a specific location. It’s ‘that spot RIGHT THERE.’ If it gets progressively worse it is more likely an injury.”

Dr. Eddie further explains–in plain English–how to understand the difference in his article Pain Tolerance in Sport. In short, we start with fatigue and discomfort. “Athletes learn to be comfortable being uncomfortable.” This can progress to positive training pain, “muscle fatigue and sensations in the lungs and heart that can range from unpleasant to what is typically thought of as pain.” This is “a good sign of effort and improvement.” Past this we can move into negative training pain, which “goes beyond positive signs of training benefit. An example may be extreme soreness that lasts for days.”

Negative warning pain is similar to negative training pain, but could be a sign of injury occurring. It typically occurs gradually. Now’s the time to “evaluate potential training causes and respond appropriately.” In other words, your body is talking. Pay attention! Don’t follow your probable tendency to stick your head in the sand like an ostrich.

When you’re a dedicated athlete, “What’s wise and what you want to do are two completely different things,” acknowledges Dr. Eddie. “I see this all the time. You know rest is going to be required and you just don’t want to stop.” But, he explains, “If you at least go to the doctor you can make an informed choice. It’s still your choice but then you get to know what you’re risking and not just have it taken away.” He encourages athletes to specifically see a sports medical professional, since most typical physicians will just tell you to stop the activity. “You have to be open to the information but you are still in charge. For the most part the doctor can’t take you off the field. You have to.” If you don’t go to a doctor, “you’re putting yourself at risk,” he warns. “There’s no way it can turn out good if you don’t have information.”

I waited far too long to go to the doctor when my pain moved into that stage. I reached the negative acute pain stage, “an intense and specific pain that occurs suddenly, often a result of injury. It is often localized to a specific body part.” I lingered there for months. Only after numbness, “a rare but of very serious concern … sign of serious injury” set in did I see my sports doctor. By then it was too late. He took me off the field of powerlifting permanently and scheduled me for surgery.

If this scares you it should. Pain should not be taken lightly. But this doesn’t mean it should be avoided. I experience positive training pain every time I work out now. I don’t enjoy the pain – far from it! I make terrible faces, yell and swear. But, according to Dr. Eddie, although pain tolerance is not natural, “it is a learned skill,” one that “separates athletes from everybody else.”

He says we become comfortable with pain by building up to it. Eventually you “have to seek it out and be willing to live in that space. Get used to being uncomfortable. After you get used to it, set challenges; ‘I can go five minutes, next go six.’ You get a sense of accomplishment … learn the uncomfortable feeling means you’re making progress.” He explains that when the endorphins kick in exercisers’ minds can make the connection that with pain comes a good feeling. Although the idea seems crazy when you’re in the midst of, say, a horrific quad-burning wall-sit, he says “it’s important to push through and engage training pain, and celebrate it.”

Celebrate it? I’m not there yet, as I crush my trainer’s hand and scream along with Linkin Park in the wall-sit. But I feel damn fine afterward, and that I can celebrate.

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