Pain: What you should know

Hurt doesn’t always equal harm.

I’ve become a fan of the Stronger by Science podcast. The hosts, Eric Trexler and Greg Nuckols are a pro natural bodybuilder and an accomplished powerlifter, respectively. They both hold science-related degrees and they’re trained in research and statistics. They translate research into meaningful information. They do a good job of discussing the weaknesses and strengths of various studies and they debunk a lot of fitness-related nonsense, a lot of which is floating around.

I recently listened to episode 22 in which they interview Dr. Michael Ray, DC, a contributor to Barbell The topic was pain, a subject I find fascinating. It’s a good interview, one that gave me a new view of a subject I’ve studied for years. Following the interview, I went to and found an excellent article titled Pain in Training: What do? (I think it was probably intended to be titled Pain in Training: What to do? but I’m not sure.) If you’re a fitness or rehab professional or if you’re an athlete or fitness enthusiast who’s in pain then you should read it. Learning about pain will help you overcome it. Here are the key points I took from the article:

  • Hurt does not equal harm. You can have pain without damage and damage without pain. The intensity of pain is often a poor reflection of the magnitude of damage—if there’s any damage at all.
  • Trainers, coaches, and therapists should not create fear of movement. The article states, “So it is reasonable to coach a particular movement style for the purposes of performance and efficiency, but we deliberately avoid pairing our movement cues with unnecessary messages (either overt or subliminal) of danger or threat. In the same way, we criticize irresponsible healthcare professionals who warn those with back pain that ‘One wrong move and you’re paralyzed,’ we similarly criticize coaches who perpetuate the belief that ‘If you let your technique slip, you’ll get injured,’ since these ideas induce unnecessary hyper-vigilance and threat around exercise.”
  • Rest rarely works. The article says, “One approach we typically do NOT recommend for most routine aches and pains in the gym is absolute rest.” And, “Additionally, we have evidence in several contexts that absolute rest often results in either no improvement (e.g. in tendinopathy) or worse outcomes (e.g., in low back pain).”
  • Find an entry point to exercise. This stuck in my mind. It got me thinking. Here, we want to “find a type and dose of exercise stimulus that results in either improved symptoms or stable symptoms over the subsequent 24-48 hours after training. A marked increase in symptoms during or after training reflects a dose of stimulus that is likely too high in terms of intensity, volume, or both.”

    Variables that may be manipulated include load, range of motion, tempo (pace the lifter uses while lifting), or exercise variation. I haven’t experimented with tempo, or speed of movement. I’ll will have my clients moving with different tempos in the near future.

I’ve studied pain for years and I feel like I have a solid grasp of how it works and what it means, but it’s always useful to revisit this information. I always learn something new. Read the entire article to learn a lot more.

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