Pain can be a tricky customer. One of the most common questions I get is “can I exercise if it still hurts?” Here I will explain the general guidlines I use to recommend how to proceed with activity in the presence of pain. The infographic below covers all the basics in an easy-to-read format (click here for the full size version) and the text underneath goes into a little more detail.
The Pain Scale
While every case is different, there are some general guidelines to work to. The first step is to grade your pain on a scale of 1-10, where 1 is slight discomfort/stiffness and 10 is agonising pain. Judging the extremes of this scale is quite easy (you barely feel anything at a 1, or you are on the floor screaming at a 10!). In the middle, at a 5 you may feel some constant aching pain, but it is not sharp and it is not enough to be disabling.
Using this scale, I advise my clients to train as they can according to the zone they are in….
1-3 – Safe zone: While it may be uncomfortable to exercise with this low level of pain, it is usually safe and is not going to cause more damage. Often it can actually be beneficial to be active when this level of pain persists, as the activity provides the stimulus for the body to heal itself.
4-5 – OK zone: This is the toughest zone to judge. In general a bit of 4-5 pain is fine. If you are experiencing a constant level of this pain while you are exercising, or spending a long time in this zone, then you will want to reduce the intensity and volume of your training until the pain lowers back down. Maybe also take some extra recovery time. As long as you are not spending long periods in this zone however it is not normally a reason to overly worry.
6-8 – Warning zone: If your pain levels are getting into this zone then you definitely want to cease activity and take some rest and recovery, as well as any other steps to reduce the pain. Wait for your pain to return to it’s baseline lower levels before restarting activity, and then be careful to return gradually, at a level where your pain stays in the acceptable zones. If you are regularly getting into this zone, then professional help may be necessary to diagnose and treat your injury.
9-10 – !!!!: If you are experiencing pain at this level and it does not quickly subside, then it is likely that you will need medical attention.
24 Hours After Activity
Certain kinds of injury may cause pain to flare up after the activity stops, or over the next 24 hours. This is normal, but you need to monitor the pain according to the same rules as before. Ideally the pain will not go above the ‘OK Zone’ levels of 4-5/10, and the pain will settle down to it’s baseline level within 24 hours.
If the pain is going up to a level of 6/10 or above then next time you exercise, think about reducing the volume and intensity. The same applies if the pain persists for longer than 24 hours.
Monitoring Pain Over Time
You should be monitoring your pain over time. It is normal for people to think that if they are still in some pain after 4 weeks, that they have not got any better. Usually with a little bit of questioning however, these same people will realise that their pain is at a lower level and they are doing more activity – both of which are an improvement!
Ideally pain levels should decline over a period of days, weeks or months depending on the initial severity of the injury, and the type of injury. At the same time, you should be striving to increase activity levels.
If your pain appears to be staying fairly constant, but you are managing more activity, then remember that this is also an improvement.
If your pain isn’t improving, or it is getting worse then consider speaking to a professional.
The Final Word
It is important to remember that these guidelines are only general guidelines. Pain is a subjective thing, and not all pain is the same. With this article I am hoping to try to put your pain into a bit more of an objective scale and help you to understand the implications, benefits and drawbacks to exercising with pain. The advice however is not a substitution for professional advice, and if you are worried at all about your pain then you should speak to a professional.