No Pain, No Gain? - When should you stop because of pain?

What is Pain?

Pain is like the blinking red light in our cars telling us the oil is low. Sometimes it’s just a bad sensor and we can ignore it. Other times we need to actually replace the oil or wait until the engine blows and deal with the stressful consequences.

When Do We Feel Pain?

Many of us who engage in sports or activities have experienced that random red light or pain during a workout that we ignore because it just disappeared the next day. Other times we feel that nagging pain that will not go away until we decide to pay attention or the escalating injury will finally make us pay attention. The scope and duration of this experience is dependent upon many variables: degree of tissue insult, prior injury, underlying inflammatory disorders, exercise habits and access to medical care. However, one variable that can mitigate injury is our attitude or how we perceive and process what we are experiencing. Can simply thinking positive or negative thoughts affect our outcomes? Denial, personality traits, social influences, negative thoughts and view of one’s self can all play a role in whether we respond to pain and injury in a healthy manner. Science and the field of psychology have combined over the years to reveal the complicated interaction between the mind and body.

How Can I Control Pain?

Our ability to cope with injury is mitigated by complicated processes: physically through rehabilitation, emotionally through our experiences, developmentally through our thought processes, spiritually through our belief system and socially through our support system. Anyone who has participated in athletic activities or organized sports understands the concept of playing through pain. Some of us respond to the blinking light quickly and others wait until the engine blows. Pain tolerance, our personal identity and sometimes-downright stubbornness and drive can push us to make unhealthy decisions. But what is considered healthy can be very subjective and situational. A 20-year old quarterback playing Division 1 sports has been performing through pain since he started football age the young age of 8. A certain amount of pain is expected with athletics and in some cases teammates, coaches and fans applaud this behavior. So, as a college athlete the young man will deal with pain on a weekly basis due to conditioning demands, contact trauma and the occasional injury. It is accepted, expected, and for many athletes of this caliber, the price paid for love of the game. His viewpoint is affected by personal goals, social support, the emotional toughness developed through training, expectations from those around him and possibly the potential for a future paycheck. However, after multiple injuries and surgeries, what makes him decide to push through the rehab, the physical and mental pain and return to football ... all of the factors that have pushed this young man to become a high achiever in the first place. Are his choices healthy or unhealthy? No one can judge but him and unless we have experienced the pressure of a potential career in professional sports we will never understand ... it is outside the life experience for most of us. Did he feel anger, frustration, fear, or sadness ... possibly as these are very human responses to pain and injury. Anger can be motiving and provide mental energy to push through the pain and anxiety associated with injury and rehabilitation. However, if anger and frustration linger, motivation may become destructive, prompting early return to an activity level before the body is ready. If that same injury now becomes chronic, fear of movement can become a very real outcome, creating biomechanical compensation and poor tissue response to exercise. Other relatable factors such as social support and self-esteem are very powerful factors in our decision process. The “team” environment and our view of how others perceive us can heavily influence behavior. Many of us are much more inclined to run that extra mile or perform another round of lifts if we are in a group ... social influence can very motivating and supportive. That’s what makes group workouts so great. However, those of us who are stubborn or maybe afraid to NOT be like everyone else can succumb to social pressure and push through an activity. If we crave social interaction, attending group exercise classes or mingling at the gym helps keep feelings of isolation and loneliness at bay. Exercise becomes a secondary benefit to the social life support we feel. This is not a positive or negative issue unless the need becomes so great, pushing through chronic pain and injury becomes problematic.

Should I Work Through Pain?

So, with all that said ... should the middle-aged housewife who lost 100lbs participating in Cross-Fit continue lifting while enduring chronic back pain? The answer can be quite complex. First, chronic pain in any area of the body should be diagnosed and when possible, eliminated. Secondly, does she feel social pressure in the group environment to continue or does anger at the body’s betrayal override the flashing red pain signal that is telling her to stop? Is she fearful that giving in to the pain means stopping Cross-Fit and gaining weight? Would her peers encourage her to slow down and address the problem, or do personal expectations prevent her from listening? It could be one or all of them. In both situations...the athlete, the mom...choices had to be made. For those of us who remain active, adjusting or stopping the sports or workouts we love can be quite challenging and many times, we decide to endure, cope, and push through until the pain forces us to stop. So, the purpose of this blog is not to judge or make anyone fearful of activity but rather to shed light on the issues I have personally struggled through as an ex-athlete and through observations made over the years as a trainer. At the end of the day, there is no “perfect” response to injury. Pain and tolerance levels are subject to who we are and affected by the many facets of life experiences. If we all remain active, there will be aches and pains and for some, injuries. However, next time you feel that pain you know is not a ‘good pain” and you decide to keep pushing through, just ask yourself why ... is this a healthy choice for me ... and is it worth the price?

Traci Brown,