Most of the people I talk to with a joint or muscle injury have a story of how they got injured doing almost nothing at all, and that can feel intensely disheartening when it happens to you. It feels like your body is fragile, and the idea of exercise feels like a disaster waiting to happen.
You’re doing the thing: exercising consistently with a sensible dose, but now your legs hurt going down stairs and your shoulders ache when you reach for the seatbelt. It’s common to worry about what pains are normal and what may be indicating that you’re harming yourself.
This very understandable question stops a lot of exercise programs in their tracks. I can’t tell you what’s happening in your body, and neither can anything else you read on the internet. What I can do is give you a sense of what’s ordinary, what isn’t, and how to tell when you’ve stopped being able to work it out on your own. Most things you’ll feel in the first month fall into three categories: sore, hurt, or “just new to this”.
Sore is the common one. It shows up late, usually one to three days after your session, not during the workout. It’s spread across a whole muscle. It’s dull and achy, not sharp (but may be very tender to the touch). It’s worst when you first get up and it eases as you move around. And it fades on its own in a couple of days. Soreness is not a reliable indicator of the outcome of a training session, it’s mostly a measure of how adapted your body is to a given stimulus. We tend to get more sore from novel stimuli (specific exercises or specific ways of carrying them out in terms of reps, sets, rest time, etc). It’s fine to be sore. And if soreness is all that’s going on, training through it is usually fine too. By the time you feel sore your body is more recovered than you might think, and a moderately-intense session can help you feel better. That’s a big “if”, though, and we’ll address the implications of that next.
Hurt is the cateogry where you stop trying to work it out yourself. This isn’t a checklist for ruling things out. It’s a list of reasons to quit guessing and let somebody look at you.
“Hurt” tends to show up during a specific rep or activity rather than the next morning. It’s sharp, tight, or burns in a way that feels wrong. You might be able to put one finger on it. It may sit in a joint instead of in the muscle. It doesn’t loosen up or feel better as you move. It’s the same or worse on day four than it was on day two. It may come with swelling, bruising, numbness, tingling, or a knee or shoulder that feels like it might “give out”. It might wake you up or change how you walk and move.
Any one of those is reason enough to see a doctor or a physical therapist. As a coach it’s outside of my scope of practice (or capability) to diagnose injuries and pathologies, and I’d rather you spend forty dollars on a copay than six months working around something that could be improved more safely with a therapeutic intervention. Frustratingly, the absence of everything on the above list doesn’t guarantee that nothing’s wrong.
Just new to this is the category that people can overlook, and it can cause a lot of worry. This can look like:
- Muscles burning during the last few reps
- Being out of breath faster than you expected
- Legs shaking on the walk back to the car
- Smaller muscles (like those that power your grip) failing even when the bigger ones (like your legs or back) do
- Feeling wobbly and stupid doing a movement your body has never practiced
These are all signs of a body that unaccustomed to the physical effort you’re demanding of it, and they stop feeling alarming once they stop being unfamiliar.
So here’s what I’d ask you to do this week: when something hurts, before you decide what it means, write down three things:
- when it started
- whether you can point to one spot
- whether it’s better or worse than yesterday (using a 1 - 10 pain scale is a good way to measure this). Those three answers won’t tell you what it is, but they’ll tell you whether it’s changing, which is useful. These are also questions a doctor or PT is almost certainly going to ask you so it doesn’t hurt to have the information recorded, because our memory of these things isn’t always reliable.
Use this as a way to check in with yourself and be mindful of the sensations your body is sending you. It is not a diagnostic tool and it can’t tell you whether you’re fine or injured. I’m not a medical professional, and even a qualified physician or physical therapist wouldn’t be able to write a self-diagnosis flowchart in a blog article. If something is worrying you, that’s reason enough to have it looked at by someone who can examine you.
You don’t need to be brave about pain and you don’t need to be scared of it. You need to learn to read it, and part of reading it is knowing when you’ve reached the end of what you can read on your own. Every body is different, and there’s a lot more to pain than tissue damage and nerve signals (look into the biopsychosocial model of pain to learn more about this).
If you’re working around an ache or you’ve been given instructions from a healthcare provider to restrict certain movements or exercises and you’re not sure what you can safely train in the meantime, that’s a conversation worth having: Contact Me.