Muscle Pain | How Much Pain During Training is Too Much?
By Myprotein Writer Christopher Tack: Lead clinician and owner of All Powers Rehabilitation & Conditioning Combat Sports Physiotherapy service & St Thomas Hospital Private Physiotherapy Service in London.
Do you experience muscle pain during training? Some people say we should feel pain during training or you’re simply not working hard enough. But how much pain is too much pain?
As preached by seven times Mr Olympia and 38th Governor of California, Mr Arnold Schwarzenegger; apparently pain when working out is good and separates champions from the also rans. This ethos is common, and hardly new to society. This article will help you decide whether Arnold was correct in his pain philosophy, and when pain during exercise should be present or when it is suggests a problem.
Tough Love Training
Earlier this year, I read an interesting piece in the American College of Sports Medicine’s Health & Fitness journal1, which discussed the risks of “over motivating” individuals to exercise too hard. The piece discussed the risks and consequences of using “tough love” as a training strategy by coaches and fitness instructors, and at the same time identified the linked to Schwarzenegger and aerobics guru Jane Fonda as the primary predecessors of this concept. The “no pain, no gain” and “feel the burn” messages from back in the 1970s and 80s are still alive and kicking today, something that I regularly will encounter in discussions with clients in my physiotherapy clinic as they return to sport or training. Most people think exercise should come at a painful price and not be enjoyable.
Sometimes feeling uncomfortable during exercise is good. However, I would personally differentiate between the positive sensations felt during exercise and the pain caused by the body in response to injury.
See how I describe exercise sensations as “positive”, that’s purposeful. That is not to say they are “comfortable” or anywhere near “pleasant”. No such luck. The truth is that exercise at the level to produce the OPTIMAL effect is hard and uncomfortable. You will certainly see improvements with exercise outside this degree of intensity, however you do not get to be Mr Olympia or win a gold medal without some foray outside of your comfort zone.
Exercise-induced muscle pain
When describing resistance training the American College of Sports Medicine2 makes no mention of the word “pain”, whereby exercise guidelines state exercises should be:
“Rhythmical, performed at a moderate-to-slow controlled speed, through a pain-free range of motion”3.
When looking at these educated sources, this indicates that in any healthy individual pain should not be present when exercising. Good advice for a novice in the gym.
However, during resistance training (particularly weight lifting) the aim of the exercise is to produce an effect to increase the size of the soft tissues and increase the ability to produce force. Weight training causes non-permanent muscle “damage” whereby as a result, the body’s tissues react and grow larger through a series of natural repair processes4,5,6,7. Pain is a result of the nervous system’s perception of the incoming sensation this “damage” causes in the tissue. For example, I perform 4 sets of 10 repetitions in a bench press with 80% of my 1 repetition maximum. Each set my muscles work against the resistance of the weights. The action of this repeated loading of the muscle causes a degree of muscle fibre damage including changes to the muscle cell structure (e.g. Z-line streaming)8 and an influx of inflammatory chemicals in the muscle and in the blood.
All of these changes stimulate receptors in the tissue (e.g. movement, pressure, temperature and nociceptor/ “pain” receptors) and send a bunch of signals up through the nervous system to the brain. If the amount of nociceptor signals hits a certain threshold whereby the brain thinks that the tissue is being damaged and sends a signal back to the pectoral muscles in the form of pain. This signal is a “warning” that it may want to modify its behavior or it could cause damage to the body.
Now if you are fully aware of the result of bench pressing this much you could potentially be quite happy that the body is not “under threat”, and that any form of “damage” that may occur is exactly what you want from this work out. Pain then is contextual. In this circumstance you are aiming to cause “damage” to the pectorals, just enough so that they can grow. In the world of bodybuilding or power lifting, athletes will see this sensation as a product of a good work out and their body may slowly adapt to the rigours that are placed upon it. I personally have witnessed body builders and mixed martial artists push far beyond what I thought was possible regarding pain and they have lived to lift again.
How Much Pain is Too Much?
That is the question which is most commonly asked of me when training athletes in the gym. In healthy individuals most people will cease any activity well before the outer limits of what their muscle tissue can tolerate. However, each example will be context dependent. Here are a few questions to ask yourself if you feel pain when working out.
1.Where is the pain?
Probably a silly question but can you pin point where it is coming from? Is it localised or a more vague sensation over a greater area?
A localised sensation on one spot lets us identify the specific body tissue which may be reacting to the exercise. If it is in the muscle belly or tendon, it is likely due to the muscle taking load. If it is right at the joint (away from the muscle) it may be more likely that your technique and alignment may be faulty.
2.When did the pain occur?
Here we are trying to establish the relationship between the movement and the pain. If it is sore when you lift what you would call an “easy” amount of weight then the sensitivity of the tissue suggests having a rest as more “pain” signals are being sent to a normal amount of loading.Sometimes the pain will accumulate throughout the session. This can sometimes occur in the stabilising muscles of the body which have to work throughout lots of different movements. This is a sign that they are fatigued and already have been over loaded. Again this may be an expected result of the exercise, however pay attention to these sensations and perhaps modify the rest of your work out.
Alternately, sometimes pain comes a long time after completion of exercise. For example, you may go and run 5k and get home and relax. Over the next couple of hours your back starts to feel sore generally across the lower region. This is again likely indicative of fatigue. As you rest, your body starts to react and may not like being held in one position for too long. This is a good time to stretch and move for 10 minutes, then apply some heat to relax the muscle.
Remember also the concept of delayed onset muscle soreness (DOMS). This is the form of muscular ache which occurs following an episode of acute exercise but does not become apparent for 1-2 days following the activity. This will be generally located to the areas which were trained, and will be apparent only when the muscle is used (stretched or contracted) but not at rest. Other types of pain will be present also at rest and should be checked out by a doctor or physiotherapist.
3.What type of activity caused the pain?
Generally pain during exercise should be reserved for resistance training. Pain is not usually apparent or an expected part of, for example, running or playing tennis. In these sports pain is more likely to be a sign of either fatigue or an injury. It will be related either to longer duration of activity or a specific movement (e.g. landing, changing direction, collision with another person).However, in resistance training it is less likely to be this simple. The exercises are more likely to be controlled (which is a good thing) however the direct load to a specific tissue will be greater and may cause greater acute “damage”. The form of contraction will also be important to consider. There is more likely a greater amount of tissue change with eccentric training (where the muscle is put under load as it is elongated). Also, eccentric training has been found to result in more DOMS than other contraction types9.
A Rule of Thumb
An important rule to follow is that pain during exercise can be worked out by assessing your tolerance level.
Pain severity – the reaction to rest= Your tolerance level to muscle loading
So, if you rate the pain severity as 6/10 whilst lifting a weight for 10 repetitions, but the pain stops immediately when you drop the weight, then the capacity of the muscle is sufficient. If the pain persists after dropping the weight for less than 2-3 minutes then again I would say this is ok, however if the pain persists for more than 3 minutes then I would drop the weight in the next set. Remember all of these examples are for healthy tissue, as in injured tissue the balance between pain and correct loading must be very finely tuned to allow successful rehabilitation. Pain is more often (and correctly) avoided during rehabilitation programs but this is due to prevention of over stimulating the nervous system and reduction in tissue over load. In this situation the “tolerance” level to pain must be much lower and should remain well below 5/10 severity and always should reduce with 1 minute after ceasing exercise.
Take Home Message
Pain can be a part of weight training but if it persists for longer than 5 minutes after an exercise, consider resting that body part. Pain during other forms of exercise should be evaluated if it is more than a simple ache at the end of a long session. If the pain comes on slowly after a work out and persists at rest for the days succeeding the session, then consider getting it checked out by a professional.