Training with Pain: Key Principles for a Smart Approach
Pain is an unavoidable part of physical training, but injury doesn’t have to be. Understanding the difference between discomfort and actual harm is crucial in ensuring that your workouts remain safe, effective, and sustainable. Whether you’re dealing with an old injury or simply feeling the natural strain of training, having a structured approach can help minimize setbacks and maximize progress.
First Rule: Do No Harm
The most important principle of training with pain is simple—do no harm. While pushing through minor discomfort is sometimes necessary to improve strength and mobility, creating or exacerbating an injury should never be the goal. Any training approach should aim to improve function while respecting your body’s limits.
Understanding the Different Sensations of Pain
Not all pain is created equal. Being able to distinguish between different types of pain can help you make better decisions about your training. Here are some key distinctions:
Soft-Tissue Pain (Muscles, Tendons, Ligaments) – This is the most common type of discomfort in training. It might present as mild soreness, tightness, or a dull ache. The goal when training with soft-tissue discomfort is to keep pain levels under a 3-4/10 on a pain scale and ensure it returns to baseline within 24 hours. If it lingers beyond that, it’s a sign that modifications are needed.
Bone Pain – Bone pain is typically sharp, deep, and often worsens with weight-bearing activities. Unlike soft-tissue discomfort, bone pain is a red flag that should not be ignored. Continuing to train through bone pain can result in stress fractures or other serious injuries, requiring immediate referral to a doctor.
Insertional Tendon Pain – Insertional tendinopathy occurs where a tendon attaches to a bone, making it easy to mistake for bone pain. Common areas include the achilles tendon and patellar tendon. These conditions are prevalent among active individuals and typically result from chronic overuse and excessive loading. While they require careful management, they do not always indicate the need to stop training altogether. In fact, strengthening the tendon to build capacity in a non-compressive position can alleviate your pain. This is where working with a knowledgeable healthcare professional is essential in determining the actual tissue affected and ensuring a smart, progressive training approach.
Nerve Pain – Often described as burning, tingling, shooting, or numbness, nerve pain should never be present during strength training. If you experience these sensations, stop and consult a medical professional.
Two Approaches to Training with Pain
When dealing with a past or existing injury, there are typically two ways people approach it:
Avoidance Approach – Some individuals completely avoid working an injured area out of fear. While this may prevent short-term pain, it rarely addresses the underlying issue and can lead to chronic dysfunction or compensatory injuries elsewhere.
Progressive Approach – The better option is to complete an evaluation and address the issue directly. This approach acknowledges that some discomfort might occur but aims to systematically improve function and alleviate the issue long-term.
The Importance of Injury History in Training
A past injury is one of the biggest predictors of future injury. Being open and honest about previous injuries, surgeries, physical therapy experiences (or lack thereof) allows for a smarter, more personalized training plan. The goal is to respect those previous injuries while continuing to build strength and resilience in a way that minimizes future risk.
Pain Does Not Always Mean Damage
One of the most important concepts to understand is that pain is a sensation, not always an indicator of tissue damage. While we should listen to pain, we should not let it dictate avoidance of movement altogether. Pain is complex, influenced by factors like stress, past experiences, and even emotions. The key is to respect pain without aimlessly pushing through it and creating a bigger problem.
Risk Factors Contributing to Injury
Injuries don’t happen in isolation—they are often the result of multiple factors combined. Understanding these risk factors allows for better prevention and smarter training adjustments. Some of the most common contributors to injury include:
Past Injury – A history of injury significantly increases the risk of recurrence. Proper rehabilitation and progressive strength training help restore function and reduce future risk.
Muscle Imbalances – Overdeveloped or underdeveloped muscles can lead to poor movement mechanics, increasing stress on joints and tendons. Strengthening weak muscles, creating balance from side-to-side, and improving coordination can help restore balance.
Asymmetric Range of Motion – When one side of the body has significantly different range of motion than the other, it can lead to compensatory movement patterns that increase strain on tissues. Mobility drills should be incorporated to address imbalances.
Inadequate Load Management – Overtraining or increasing intensity too quickly without proper adaptation can overload tissues. Strength training programs should follow the principle of progressive overload that accounts for recovery and tissue tolerance.
Poor Movement Mechanics – Improper technique places unnecessary stress on joints, muscles, and tendons. Working with a coach or therapist to refine movement patterns can significantly reduce injury risk.
Lack of Recovery Strategies – Insufficient sleep, poor nutrition, and high levels of stress can slow recovery and make the body more susceptible to injuries.
Rehabilitation and strength training often follow similar principles but operate at different ends of the spectrum. The key is addressing both biomechanics (how the body moves) and capacity (strength & endurance) simultaneously. A well-structured program ensures that movement is optimized while progressively increasing the body's ability to handle stress.
The Role of an Athletic Trainer in Bridging the Gap from Pain to Performance
Licensed Athletic Trainers are healthcare professionals who specialize in evaluating, treating, and rehabilitating orthopedic injuries. In the state of Michigan, Athletic Trainers are licensed medical providers who play a crucial role in guiding individuals from injury recovery to optimal performance.
Garrett provides the perfect blend of strength training and rehabilitation for active adults, helping them address pain, overcome injuries, and live a healthy, pain-free lifestyle. His approach ensures that training is both safe and effective, balancing rehabilitation principles with performance training.
Final Thoughts
Pain is part of the training process, but injury doesn’t have to be. By understanding the different types of pain, respecting injury history, and taking a progressive approach to training, you can continue to build strength while minimizing the risk of long-term setbacks. A smart, structured training plan tailored to your needs ensures that you’re training with your best interest at heart.
If you’re dealing with persistent pain or want your training plan to address pain AND function, and are unsure how to proceed, don’t hesitate to seek professional guidance to develop a plan that works for you! Contact Garrett to learn more about the different services which might help you.