Training around pain

Two pieces of advice about pain get handed to lifters, and they point in opposite directions. One says push through it, because discomfort is the price of progress. The other says stop everything the moment anything aches, because any pain means damage. Both are trying to be careful, and both go wrong the same way: they treat pain as one signal with one meaning.

Pain is not one thing. The burn at the end of a hard set, the stiffness two days after one, the dull ache of a joint you have trained around for years and the sharp catch of something that went wrong on the last rep are different signals, and they ask for different answers.

Lifting is not a dangerous sport

Worth saying first, because the fear of getting hurt stops a lot of people before they start. A systematic review of injuries across the weight training sports found injury rates relatively low compared with common team sports, and bodybuilding, the style closest to ordinary gym training, had the lowest of all¹. When lifters are hurt, it is most often the shoulder, the lower back, the knee, the elbow or the wrist, and the commonest injuries are strains, sprains and tendon problems¹. Those studies were of competitive lifters, so read them as a yardstick rather than a promise.

Stop and get help today

Some signs are not a training question at all. Stop, and get urgent medical help, if any of these is true²³:

• You heard a crack when it happened, or the joint or limb has changed shape or points at an odd angle.
• The injured area is numb, tingling or has pins and needles, or the skin around it has turned blue or gray or feels cold.
• You cannot put any weight on it, or cannot walk more than a few steps.
• Back pain comes with pain, tingling, weakness or numbness in both legs, a loss of feeling around your genitals or bottom, or a change in your bladder or bowels.
• Back pain is severe and started suddenly, is getting worse quickly, or comes with feeling hot, cold, shivery or unwell.
• You have chest pain.

Do not drive yourself to emergency care with one of these. Ask somebody to take you, or call for an ambulance³.

See somebody soon

Most aches from training settle on their own, and the guidance for both back pain and sprains is to have it looked at when it does not. Book an appointment with a doctor or a physical therapist if²³:

• it has not improved after a few weeks of looking after it yourself, or a sprain or strain is getting worse rather than better;
• it is stopping you doing ordinary things away from the gym;
• it is worse at night, or does not ease with rest;
• you are worried about it, or struggling to cope with it.

For a sprain or strain that is taking longer than usual to get better, physiotherapy may help³. A physical therapist can examine the area and help you work out what you can load while it settles, which is the question this page cannot answer for you.

When something goes wrong in a session

A sharp pain on a rep, or a pain that gets worse with every rep, ends that lift for the day. Not the set: the lift. Finishing the set to get the reps buys nothing that next week cannot buy more safely, and the NHS advice for exercising with a sore back is to stop if the pain gets worse².

For a fresh strain or sprain, the first two or three days are for protecting it, resting it and keeping the swelling down. Once you can move it without the pain stopping you, the advice is to keep it moving so it does not stiffen. Most feel better after about two weeks, and the same guidance suggests avoiding strenuous exercise on it for up to eight³.

What usually does not help is stopping everything. For back pain, the guidelines recommend staying active and getting back to normal activity and exercise, and rest is one of the treatments they say is used too often²⁴. In practice that often means training the parts of you that do not hurt while the part that does is looked after, unless somebody who has examined you says otherwise. A sore elbow does not have to cost you your legs.

A pain you have had for a while

A long-standing ache is different again. For adults with persistent muscle and joint pain, trials comparing exercise that was allowed to hurt a little against exercise kept pain free found no clear difference in pain or disability, and the reviewers concluded that pain during exercise may not need to be avoided altogether⁵. The evidence behind that is low certainty, and it comes from people being treated for their pain, which is why it is something to work out with a physical therapist rather than alone. What it does tell you is that a familiar ache is not, by itself, proof that training is making things worse.

Sharp, sudden or getting worse ends the lift. It is not a set to finish.

What Reckoner does about it

Reckoner cannot feel the pain, so everything it does starts with you telling it.

• In setup. Setup asks whether anything hurts and offers seven areas: shoulder, lower back, knee, hip, elbow, wrist and neck. Tick one and Reckoner will not put an exercise that loads it into your program. Adding an area changes the lifts that load it straight away. Clearing one waits until your next block, so a lift does not come back the day after a pain eases.
• On your watch, mid session. Hold UP and choose Something hurts. The weight for that lift comes down 20 per cent, onto a weight your gym can make, and the day is held: next week repeats that session as written rather than progressing it off a day that went wrong.
• On your phone. The log has a note for when something happened. Write down what hurt and that day is held the same way.
• The form question. Answer Rough and the weight holds rather than going up. Two Rough answers running on the same lift take it down a step.

What Reckoner will not do is decide that a pain is fine. It will not tell you to train through one and it will not tell you what one is. When a pain needs a person, it needs a person.

Tell Reckoner what hurts, train what does not, and let somebody qualified look at the rest.