If you’ve been training long enough you have probably encountered some sort of injury or nagging pain somewhere throughout the body. This pain could just be an annoyance or something that is debilitating. When most people encounter this situation, they are very unsure of what to do. Do I go see a doctor, do I just lift through the pain, do I take time off, etc? I think the best way to navigate this situation is simple. You just need a professional with the right experience to help navigate.
When dealing with an injury I think most people fear that it could get way worse down the line. Our initial reaction to pain is, “oh shit, what did I just do?” From a purely physiological perspective this is sort of what your body is trying to do. Pain is a defense mechanism. The specific area might not even be injured, but something novel might have occurred in which your brain responds with a pain signal to make sure we keep that area safe. This is easy to see when someone first begins their strength training journey. When they first start lifting, they might not only feel sore all the time, but their joints might ache, and they usually have a hard time hitting significant range of motion in many exercises. This is mostly due to their body not experiencing that before and being a bit hesitant in allowing it to achieve those things. After some practice and consistent stimulus, the body adapts, and those things become easier and more comfortable to perform.
So, how do we navigate in the gym if we are experiencing pain or we have injured a certain area? I think the best piece of advice is to simply avoid any more pain. We still don’t have a full scientific understanding of pain, but the pain is telling our bodies something, so it is appropriate to try to stay away from it as much as possible. This usually eases a client from a mental perspective and also gives the body some time to deal with the pain or injury inflicted area. As strength and conditioning professionals, I think it is very appropriate to acknowledge that most of the time we might not know what is causing the issue. Unless something happens acutely or we can make a well-educated guess, a lot of the times we simply don’t know. There are many variables at play, and we only see clients for a few hours a few times a week. In my opinion, it can be rather stupid to decide what caused the issue if 96% of that person’s life is NOT spent with you. I do think it is appropriate to give the client some exercises to perform that you might think will help based on your level of experience and education. This might mean picking different variations of squats, presses, deadlifts, etc. Or, limiting range of motion to where there is no pain, or the pain is greatly diminished. You might be surprised that choosing a swiss bar over a straight bar helps a person’s elbow or shoulder on the bench press. Or, putting the feet up on the bench for a bench press helps reduce lower back discomfort. Or, elevating the heels on a squat helps someone orient their pelvis in a way where their lower back or hips don’t hurt. There are many options out there, but it is important to always intervene and reevaluate to see if what you are doing is making progress.
On the flipside of staying away from pain, it is important to know that sometimes that might not be possible. If you are trying to stay away from any discomfort whatsoever than you might not actually be giving the body enough stress for the problematic area to adapt. In a good article, “Squatting with Patellar Tendinopathy,” Jason Eure says, “to force positive adaptations, we must find the sweet spot within the envelope of function where the total stress is enough to disrupt tissue homeostasis and create an impetus for change without diminishing structural integrity.” He also goes on to mention that he keeps clients at about a 3-4 out of 10 on a pain scale to ensure this is happening. All injuries and pain have their context so this might not be the optimal thing to do based on the situation, but I think it is a fairly good principle to follow in most. I think this can be good advice to let people know it is okay to work through mild amounts of pain, and it isn’t going to cause any harm, but probably some good.
An additional article could be written on identifying the potential causes of pain and what can be done to help, but that is not within the scope of this article. Dealing with injuries and pain in a training context can be mentally overwhelming. I have had the experience of training through pain and injury and it isn’t fun at all. I was constantly wondering when it was going to be better and if I was doing the right thing to help it. The unsettling answer is that it is hard to know if you are doing the right things. That is why I think the best principle to follow is to pick exercises that greatly reduce the pain associated to a given area, and never go above a 4/10 on the pain scale. The human body can be complicated and sometimes we have to admit we don’t know. However, most of us want to continue to train. We love it and that is why we hate injuries. They limit our training freedom. If you are someone who wants to continue to train around an injury it is important to pick things where that pain is greatly reduced. Most of the times this simple guideline does the trick.