Fifty shades of pain

I know what you’re thinking. And no, I have not read the recent bestseller of a very similar name to my post. And no, this post won’t have anything to do with the novel. But this title just popped into my head as I was thinking about this post, and I just couldn’t get rid of it – it’s just right.

The reason this slightly questionable title is so much better than any other pain-related pop culture reference, is because I want to talk about different types of pain.

It was about 4 or 5 years ago that I first thought about how to describe “good” and “bad” pain to people. I was in the university gym with two of my housemates – one a rugby player who had been following standard hypertrophy workouts for years, and the other a complete newbie. And me, somewhere in between; the only female in the free weights area, having lifted before but not having done so in a while. Our novice housemate complained of a pain in his chest when chest pressing – the other and I laughed, which was perhaps unnecessary, and explained that the pain was just the result of his muscles working.

But as I’ve started training people professionally, some of whom are complete novices, it has become much more important to try and explain and understand pain. You have trainers barking clichés such as, “Push through the pain!” and t-shirts bearing slogans like “No pain, no gain“. Hell, my old gym where I performed my very first squats, deadlifts, and most other standard lifts was called Painworld! But then what do you do when your client falls off the treadmill as the result of a cramp or, worse, a serious injury?

I’ve had several phases of training where I actually forget what it’s like to not be in some sort of pain or discomfort at any time. When I was Thai boxing several nights a week, I was also covered in bruises which were obviously sore, but it’s only in the last year or so that I’ve experience the very unique pains of injury. Hopefully, I can help shed the light on some of these differences, to either reassure a fitness and training novice, or encourage someone to seek help for a growing niggle.

I generally don’t analyse my aches and pains too methodically – I usually suspect when something needs professional help or not (whether I choose to bother getting anything done about it or not, is another matter… and something I need to work on!). But I have tried my best to break it down into various questions you can ask yourself, to decide where you stand.

Does it still hurt when you are at rest?

This is normally the first warning sign to me. I am not moving, and yet something is throbbing, feeling warm, or experiencing shooting pains. If you are at rest, you are not putting tired tissues through stressful movements, so this could be a sign that something has been damaged and the body is trying to repair itself by sending extra blood to the area.

Does the pain persist throughout and after warming up?

This is a tricky one. Endorphins are powerful things, and warming up too hard can rapidly mask pain. If you are experiencing unnatural amounts of discomfort before training, warm up gently. Make sure to warm the sore area up – again, gently and progressively. If the pain doesn’t seem to subside, if stiff muscles still won’t stretch, this could be a soft tissue injury.

Did the pain come on suddenly?

I’m not talking about the rapid build-up of burn or dull ache from lactic acid, I’m talking about sharp sensations that feel like clicking or grinding or snapping or popping… you get the idea.

This could be the result of a sudden, explosive movement as you would experience in contact sports, or something more subtle – one of several thousand strides in a run, a sharp pain in a seemingly unrelated body part. In any case, stop what you are doing, identify where the pain is coming from, and seek help if possible. Even if you can’t tell why or how the pain happened, something clearly changed from one moment to the next, and without knowing what it is, you can’t be sure that continuing the activity won’t put you at further risk. It could be as simple as ice, anti-inflammatories, and a day’s rest, but you won’t know if you push on and risk putting other areas at risk if they need to compensate for a malfunctioning body part.

Is the pain changing? Is it getting better or worse?

Sometimes, something will click out and back into place, resulting in some pain but then a gradual subsiding of pain. In the case of delayed-onset muscle soreness (DOMS), the pain can sometimes be quite intense but will gradually evolve, often getting sharper for 2 or 3 days following exercise, but then gradually subsiding. I normally give pains that arise a few hours after training a couple of days of observation (as we saw above, anything that comes on suddenly is a cause for immediate concern). If it gets better, if I can work through it with a gentle warm-up and some static and dynamic stretching, I get on with it. If, however, it gets worse – if the pain gets sharper, if it is impeding my use of the area, impacting on my sleep or training, then I will normally get Ben to have a look, or at least take a day or two off training to see what happens.

Is the pain in an area that is currently being stressed?

Assuming, of course, that the pain has not come on suddenly and sharply, if my abs feel sore and tight during a set of abs, I’m not really going to start worrying. If, however, I am working on my upper body after a couple of days off, and after the session my right hamstring, say, feels really tight and sore, I am going to be a little concerned. It could be that one odd little random movement happened in the session, startling an unsuspecting muscle and maybe causing a minor injury. In contact sports, and anything else explosive and unpredictable, it becomes very hard to monitor what area what being used, so if possible revert to the previous criteria. In any case, may be one to watch.

I realise that all of this is very vague, and indeed I would prefer to keep it that way as I am not a doctor or physiotherapist, or anyone else with any authority to talk about specific issues affecting the human body.

Luckily, I have enlisted the help of Ben, who is a physiotherapist and therefore has some authority to talk about specific issues affecting the human body – in a few weeks, he’ll be dropping in to talk about pain in a little more detail, as well as some coping mechanisms for people experience pain and going through therapy. So stay tuned for that!

In the meantime, do feel free to ask any questions by emailing me at claire at greatexpectationsfitness dot co dot uk, or in the comments below. Or, if you have any concerns, please do seek out your nearest physiotherapist. Hopefully, though, you are all staying healthy, fit, and happy!