Some Pain is Good Pain.

Difference Between Good and Bad Pain

Some discomfort is part of athletic activities and is often part of a successful training program. For muscle strength to increase, muscles must experience an increase in stress and this stress is usually perceived as the “burn” in muscle during activity.

This mild burn is what we call good pain and is the basis of the popular phrase, “No pain, no gain.”

This pain should be short-lived and resolve soon after the activity ends.

‘Good Pain’ Versus ‘Bad Pain’

Fatigue after a good, strenuous workout is a sign that the exercise is pushing the limits of the athlete’s fitness…
but it too should not be excessive. This fatigue should leave you somewhat exhilarated but not overly exhausted.

Chronic fatigue after excessive exercise suggests that the individual may be over training. If after appropriate rest the fatigue continues, it may be a sign of other medical problems and you should consult a doctor.

What are the signs of bad pain?

The muscles, tendons, ligaments, cartilage and bones of the body are living structures that react to the stress of exercise only gradually. If they see stress too fast, they cannot respond effectively and may begin to fail. When this occurs, each one of these tissues responds a little differently and this can result in bad pain.

Muscles:

  • Muscle soreness typically occurs if you do a new exercise to which you are not accustomed or if you do a familiar exercise too hard.
  • This soreness typically begins within a few hours but peaks one to two days after exercise.
  • This soreness is called delayed onset muscle soreness.
  • A little soreness or discomfort means that the muscle has been stressed, but if the muscle is exercised too much, the muscle can become very sore to move and touch and may even swell.
  • To prevent this problem with your muscles, we usually recommend the following rule:

Take the amount of exercise you think you can do and cut it by one third the first few times you do it.

Tendons:

  • Tendons that connect muscle to bones may get irritated if they see too much stress too rapidly.
  • They respond by getting inflamed, which is characterized by pain and sometimes swelling.
  • Tendonitis pain typically occurs during exercise and can continue afterward when performing activities using that muscle or tendon.
  • In more severe cases the tendon may become swollen and any movement of the tendon or knee joint can hurt.

Bones:

  • Bones need time to respond to new stress.
  • When bones see increased amount of stress, such as an increase in running when preparing for a marathon, they respond by putting more bone in the areas of the bone that are seeing more stress.
  • The first sign of this stress reaction is pain along the bone, which occurs with activity. As the situation worsens, a stress fracture can develop.

Cartilage:

  • Cartilage also needs stress applied very gradually.
  • Cartilage is the slippery white tissue on the ends of the bones in the joint that allows the bones to glide and move smoothly over one another.
  • When the cartilage sees too much stress too rapidly, it can result in pain and fluid in the joint. Swelling in a joint is a worrisome sign meaning that the cartilage is irritated.

How can this pain be treated?

The treatment for any ache or pain after exercise is to cut back on the exercise for a period of time. How long to rest the area depends upon the severity of the pain. Typically we tell patients not to do anything that hurts. It is important to maintain aerobic capacity or stamina when resting a body part, so other exercises that do not cause pain are usually acceptable.

The second way to treat a painful area is by icing. Ice should be used after activity with an ice pack or ice massage for 20 minutes. The old standard of ice for 48 hours followed by heat is no longer recommended. We believe that ice is your friend. However, if pain persists despite the use of ice, more serious problems may exist and you should consult your physician.

The third thing to do if you have aches and pains after exercise is to continue to move the joint or extremity to avoid stiffness. If the joint becomes stiff over time it will affect the ability of the joint to function normally and may affect athletic performance as well. Range of motion exercises or stretching to maintain the motion of the joint should not be confused with exercising the joint, which tends to stress the structures and make the pain worse.

The fourth way to treat aches and pains is with over-the-counter pain relievers or anti-inflammatory agents. These medicines include acetaminophen, ibuprofen, naproxen and aspirin and are believed to be effective at decreasing pain and swelling. If you do not have any contraindications to taking these medications, we suggest following the instructions on the label.

When should I be concerned about bad pain?

There are several things you should look for when judging how concerned to be about your pain.

  • First, the pain should not last long after exercise.
  • Pain that does not go away with rest is not normal.
  • Pain that begins to affect your function outside of sports, such as walking or sleeping, is not normal.
  • Pain that is constant or increasing over time and does not go away is not normal.
  • Pain that does not improve with treatment may be something to be concerned about.
  • Pain that begins to wake you from your sleep is also a concern, especially if it increases over time.

Fevers, chills or severe sweating at night are not normal and you should consider seeking evaluation right away.


If you have any question about whether an injury is serious or not, you should seek treatment.

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