Know Your Pain: Good vs Bad Pain

painscale

I often tell my classes that it’s okay to work through good pain (my muscle feels tired and sore doing these squats), but no one should work through bad pain (my join hurts or my tendon feels like there is glass in it when I do that exercise).

The problem is, sometimes the difference between good pain and bad pain is slight or hard to determine. If you are someone who lives with pain, movement might hurt in what seems like a bad way every time you move, but you’ve got to move.  If you are an athlete or avid runner, you might push through acceptable pain so often then when you feel actual bad pain you push through it to the point of injury.

So how do you know the difference?

In my role as a Pilates Instructor, I always want people to leave feeling better than when they walked in the studio. I never want people to leave in pain, feeling like they hurt something.  That is not the goal of movement.  But research has shown that in almost all cases it’s better to move through pain.  If you have a surgery, you need PT and some of the exercises might hurt.  You may be breaking up some scar tissue.  If you have arthritis, movement will hurt, but you have to move.  If you’ve ever pulled your back, you know the worst thing you can do is sit still.  So how can you tell when to stop or when the pain is too much?

Good News:  No Pain, No Gain isn't true.  You don't have to hurt to feel better.

Good News: No Pain, No Gain isn’t true. You don’t have to hurt to feel better.

There isn’t research that gives specifics on when to stop. Obviously, a shooting, sharp or tingling pain isn’t normal.  You should stop.  You may be able to adjust the way you are doing the movement and find a safer place to begin (Pilates is great for teaching that).  Pain that stops when you stop moving might be okay, but how do you know for sure?

I was working with a client who was also having PT for plantar fasciitis and Achilles tendonitis. She mentioned she was concerned because a lot of the stretches caused her pain and she couldn’t tell if it was good or bad.  It felt like the same kind of pain the she felt when she developed the tendonitis, and she wouldn’t describe the feeling as a stretch.  Both her doctor and PT said she would feel that pain.  It was normal and she should work through it.

I’m not a doctor or a PT. We have different roles.  I wouldn’t tell them that they were wrong, in part because we don’t have the science to back up whether they are right or wrong and the answer might depend on the person.  In my training if someone told me what I was doing hurt and they were concerned, I would ease off.  And here’s why.

Completely anecdotally, but based on working with hundreds of bodies since I started teaching Pilates and working with post-rehabilitation clients, I have found that a body in pain does not respond to pain. If you want something to stretch or release or reduce inflammation, irritating it doesn’t seem like the answer to me.  Just try stretching the tightest muscle in your body to the point of strain or shaking and decide if you think that is making the muscle lengthen.  If you’re entire body braces with tension how can that reduce pain?

So how do we determine what pain to work through? The client with the tendonitis was in pain when she started PT. All movement hurt her, but she needed to move.  And I agree with that.  But when she started to mention her concern, it was weeks into PT.  Something was different.  Knowing this client really well, I also know that she is Type A and lives with a good deal of pain, manages her pain and can withstand a lot of pain.  So when a PT who doesn’t know her that well tells her to move through pain, the PT may not realize what this individual is willing to push through.

So I set a guideline that she could set. Because I can never feel her pain or understand what it feels like to be in her body.  She needs to make that judgment call.  When push comes to shove you know our body better than me, a doctor or a PT.  You need to listen to the knowledge we’ve all accumulated over time, do your research and on some level trust and listen to what your body tells you.  When she did any exercise that hurt her, she had to assign it a number on a pain scale (1-10).  She sets the scale.  So her 3 may be my 10, but it doesn’t matter because it’s based on her assessment.  If the pain was below a 3 she should do it.  If she hit a 6, I thought she should ease off.  It just seems like too much discomfort for the body to heal itself.  Now, remember, we’re talking bad pain here.  A muscle getting tired during a squat is different.

Every instance is different. Every body is different.   When you feel bad pain, you may need to access it differently each time.  Using a numerical scale is helpful.  And even if I’m wrong and listening to your body, monitoring the pain and not going past a certain degree isn’t the answer, the worst that happens is it slows recovery.  But maybe for some bodies that is better.  Maybe it will last longer.  Maybe it will help you stick with the movement longer.  We don’t know.  But we can empower people to learn to listen and work within their personal limits by accessing and scaling their pain.

It is okay to be gentle with yourself. Sometimes I think we all need to go a little easier on ourselves to heal.  The options for gentle movement are endless.  Remember, I’m always an advocate for movement.  Movement is always better, even if it hurts.  The question we need to answer, is how much should it hurt?  It’s your body.  You should have some say in the answer.

2017-10-25T16:00:36+00:00

About the Author:

Maggie Downie
Thank you for giving your time to stop and read my blog. I hope it encourages you to keep moving. Move and the body will be happier. And when you're moving you can hike, run, swim in Jell-O, race over non-Newtonian fluids, travel the world or build igloos--if that's your thing. If not, you can watch me do it. This is just a spot to try and feel good about life.

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