by Michael Plank
*DISCLAIMERS – 1) Pain is incredibly complicated. 2) I am not a doctor. 3) This is not medical advice 4) Be smart
A few weeks ago, I fell off a ladder and injured my shoulder. I got lucky. I’m ok. My shoulder is steadily improving and I fully expect a complete recovery.
In a totally unrelated fall (not off a ladder), I injured my ankle about a year ago. It’s totally back to normal.
A few years ago, I would get low back spasms a couple of times each year that would put me out of commission for 2-3 weeks at a time. That’s massively improved and I haven’t had a serious spasm in 14 months.
All of this is to say, I’ve had some chances to think a lot about pain and training. As I said above, pain is super nuanced. So many things can cause it, can make it worse, and can make it better. People way smarter than me have written whole books on pain, and so this is going to be only scratching the surface of the surface, but I’ve been having a lot of conversations with people about it lately, so here are a few thoughts…
- Pain is normal (kind of). Completely normal is for your body to be pain-free. But if you’re reading this, you’re probably a pretty active person. You might work out, you might hike, you might play sports; you might ask a lot of your body on a regular basis. When that’s the case, sometimes you’re going to ask too much of your body and it will let you know that you crossed a line. It’s the same as what happens with any other relationship – spouse, kids, friends, etc. If you tweak something, you are not a failure, and you might not even be doing something that’s intrinsically dangerous.
- Pain should be taken seriously. The fact that it happens all the time does not mean that you should just “work through it.” This is one of the two most common approaches to injury that I see: people just grit their teeth and work out anyway, just like they did before they got hurt. It’s pretty self-evident that this rarely fixes the problem. Sometimes it keeps it the same. Often, it makes it worse. (We’ll get to the other common strategy in a minute).
If you injured yourself, the top priority is to fix the pain. There are a million ways to do this, but I don’t mean just take more Advil. We always see the best results working 1-on-1 with a professional who can help.
(Aside: some pain or discomfort in training is fine – a good rule of thumb for figuring out whether it’s fine or not fine is this: if it’s in the muscles, it’s probably fine – if it’s in the joints, it’s probably not fine) - Once pain is resolved, then it’s time to rebuild the injured tissue. There are also a lot of approaches here – you might need to address some things that are missing like range of motion or strength imbalances, but again, best to work 1-on-1 with a professional to see exactly what you need.
But here is the piece that most people miss (including me for a long time): most of the time, the rehab training should be pain-free. That doesn’t mean it must be easy. That doesn’t mean it won’t be challenging. That doesn’t mean there won’t be intense sensation.
But one of the things we’re trying to do when rehabbing a tissue is to regain confidence with movement. If my back hurts when I deadlift heavy, there’s probably a weight where it starts hurting… maybe a 6/10 in intensity. As I rebuild that deadlift, I want to stop adding weight when it gets to maybe 4/10 in intensity. I want my deadlifts to feel good so that when I get up to the bar I’m not scared, tense, and fragile. I want to remember what it feels like to feel good with that movement so that I can believe that my body is capable of it and so that I can slowly start to increase the level of challenge to get back to where I was and beyond. This might take weeks, it might take years. But slow and steady wins the race here.
This is hard to do, but only because we’re scared we’ll lose progress or because our egos have to take a hit to step weights and movements way back. If we can let go of that it’s easy. - The worst strategy (in my non-medical-professional opinion) is the other of the two common strategies I see and it’s this: stop training altogether. If squats hurt your knee, never squat again.
That’s a reasonable strategy, to be sure. If it hurts when you do that, don’t do that. But when we’re exercising, we’re typically talking about movements that you run into a lot in life. Deadlifting, squatting, pulling, pushing… these are things you do with groceries or house projects or playing with your kids. If you lacerated your shoulder fencing and you want to give up fencing, I fully support that. But being able to squat and deadlift and push and pull and carry for your whole life is objectively good. And 9 times out of 10, we can train to get better at those things.
Listen, this whole thing has been a little bit of a rambly, stream-of-consciousness, collection of thoughts, but to sum up: 1) don’t be afraid of pain. I had a coach once tell me “A little pain never hurt anyone.” 2) When you get injured, find a professional to work with you to get you out of pain. And then 3) Find a professional to help you get moving and regain function again. There are absolutely things that are impossible to recover from. But there are very, very few that can’t be improved. And after all, making your life better is what training is all about.