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Is it ok to exercise when I am in pain? How should I exercise when in pain?

Blog produced by Jason Dodd Clinic Manager, Sports Therapist and member of the Physiotherapy and Musculo-Skeletal Team at Bodylogics The Sports Therapy Clinic.

We see many athletes and clients who are carrying injuries, whether that be the common lower back pain presentation all the way through to the runner who has Achilles Tendinopathy or the gym goer who is suffering from tennis/golfers elbow. One question we are ALWAYS asked is ‘when can I start playing sport again?’.

The answer to this question is not quite so simple though. There is no ‘recipe’ to injury recovery. There is certainly best practice and methods which will increase healing times, such as a structured Injury Rehabilitation programme and regular Sports Massage to improve circulation and the laying of collagen fibres. BUT what is important to realise too is that pain does not always mean damage is taking place. Pain is such a complex issue and one which scientists are still trying to understand and come up with a credible theory (which they will do soon I am sure!). Now if you are sitting there wondering what I mean by this, I will try and use an example. Let’s take two 70 year old females, one heavily involved in sport and the other not. One of them has arthritis of the knee and constant pain, the other has imaging which shows arthritis of the knee but no symptoms. Yet the one in pain is the inactive person. People often think it would be the active one, but it’s not always the case. The point here, is how can one person with similar knee presentation on a scan have pain and the other not. Surely if a knee has arthritis in then it should hurt? ………. It’s just not true.

Our Osteopath Team recently had a case where a client arrived with severe lower back pain and after some gentle movements and simple exercises, they walked out with a significant reduction in their pain. The exercises were difficult for the client at first but after some time they became easier and they are now on the road to a full recovery.

We have also recently produced a blog on managing pain without taking pills.  I would suggest you read this too and it links in very well with what we are going to be speaking about below.

This brings me back to the original point. Is it ok to exercise when in pain and how do you exercise when in pain? Below, the Bodylogics Team have put together some pieces of advice for you to be aware of and will hopefully help you understand what is happening with your body and how you can better manage in the long term. REMEMBER, PAIN DOES NOT ALWAYS MEAN DAMAGE.

If you’re suffering from pain, monitoring the following 3 activity responses can help guide you regarding when to back off or modify an exercise or activity (or the total volume of activities) and when it’s likely acceptable to continue or progress:

  • Pain DURING activity.
  • Symptom response for 24 hours AFTER activity
  • The TREND in symptoms over time

Ideally, we’d like to keep pain levels minimal to none (0-3/10), although in some cases moderate amounts are acceptable (4-5/10)

We’d also like to see it settle back down to baseline levels within 24 hours and that the trend over time is an improvement in symptoms and activity tolerance

If we’re not achieving this, we may need to review activity levels and modify them to create the desired response

If you’re having trouble figuring out how to keep your pain levels in these tolerable ranges, try to modify one or more of the following as it relates to your activity or exercise of choice:

✅ Range of Motion – If deep squats hurt, try decreasing the depth a bit

✅ Exercise – If an exercise hurts, choose a different one that is more tolerable and provides a similar stimulus

✅ Contraction Type- If concentric (shortening) contraction of the muscle hurts, try eccentrics (lengthening). If that still hurts, try isometrics (contraction without movement)

✅ Body Position – Seated shoulder presses hurt? Lean the seat back 5 or 10 degrees and try that instead

✅ Rest Time – Increasing the rest between sets can allow you to perform a bit more volume without being limited by endurance

✅ Frequency – If training 5x/week is too much, try dropping to 3 or 4x/week

✅ Duration – If a 20 minute run bothers your knee, try a 15 minute one. Or perform walk-jog intervals for 20 minutes

✅ Weight/Load – If deadlifting 315 lbs hurts, try decreasing the weight. If running on concrete hurts, run on a track

✅ Speed – Faster speeds usually require a greater capacity from the body. Try slowing down your reps or runs.

Tendinopathy is a great example where this exercise-pain model can be used very effectively. Check out our post here as to what is Achilles Tendinopathy and how you can manage it better.

How can Bodylogics help?

We are the leading Sports Therapy Clinic in North London, offering Sports MassagePhysiotherapy,OsteopathySports Rehabilitation and many more services, all of which are designed to get you back to being pain free and to enable you to get the best from your body.  Our Team are made up of specialists in different areas and we are confident we have a Team member who will be able to offer you the correct maintenance programme to keep you injury free or offer you the advice and treatment plan that will have you back to full fitness in the shortest time possible.  We do not cut corners, we offer genuine, true advice in order to give you the best chance of success.  We are proud of our reputation we have built and we are confident that you will share the thoughts of many others after visiting us.

To get in touch please see the information below and we look forward to welcoming you to Bodylogics The Sports Therapy Clinic in the near future.

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