Written by Dr. Masi Njawaya – ‘The Sport, Exercise & Lifestyle Physician (Doctor)’. Bio available at www.herselfhealth.com
Ooooh! Sometimes that first week after starting your journey to fitness can feel like you’ve been on the battlefield. Your muscles ache. Your body feels ‘battered and bruised’. It can be hard to convince your brain otherwise If your trainer wears army-like, camouflage, workout gear and bellows out commands like “Get down and give me twenty!” or “Go! Go! Go! Go! Go! Go!” Even if no yelling is involved, gentle words of encouragement like “Come on, you’ve got this”, can sound a bit too strong or hard to live up to.
Aaaah! If you manage to power through that first week mentally, physically and emotionally, four weeks later you reach the land of promised fitness gains. Now you are feeling more energised and your body feels stronger. You're beginning to see well-earned firming up of your upper arms, narrowing of your waistline, and tightening up of your butt. It’s been worth it. Now when your trainer yells out “Give me 20!”, your inner voice confidently answers “Bring it on!” This is going really well! 4 more weeks and you will have reached your weight goal and may even be able to fit (not squeeze) your waist into your favourite outfit from 5 years ago.
Hmmm? As you make strength and fitness gains, your trainer gradually increases the reps and weights in your training program. You wake up one morning and notice one part of your body seems to ache a little bit more than usual. Should you be concerned about this? Is this the time for mindset over matter? You get up any way and turn up for training. You get through it okay. You are proud of yourself for not giving in to “just a little niggle”. A few days later, you notice a similar ache in the same spot. You recall how it went away the last time. You remember a quote you saw on social media “Pain is just weakness leaving your body”. So, you get up and turn up for your training session. However, this time you find yourself needing to chant the mantra “No pain, no gain!” through most of the workout. You barely make it through. At least you have the weekend to recover.
The new week comes along. You feel better but now you are doubting yourself and your body. Your imagination runs wild. What if this niggle turns into an injury and affects you going to your workouts and work? That could be costly. Worried, you wonder “Should I wake up to train or shut down and reboot?”
So, when is pain normal during a workout/fitness training? When is pain not normal during a workout/fitness training? When should you seek medical advice for pain that follows a workout/ fitness training? These are frequently asked questions (FAQ’s) by anyone new or seasoned in the health and fitness world.
As a Sport and Exercise Medicine Doctor, I often see injuries that occur when people do not listen to their bodies or don’t talk to their trainer about “little niggles”. Pain is not weakness leaving your body. It is your body talking to you so listen carefully. Now let’s answer some of these FAQ’s...
When is pain normal during a workout or fitness training?
It is normal to feel some generalised muscle soreness 24 - 48 hours after starting new or unaccustomed physical activity. This occurs due to mild muscle strain. It is a normal muscle response and adaptation to training. It generally feels worse on day 2 and gradually improves within a few days. Cool showers, ice, gentle stretching and wearing compression garments can help with symptoms. it is a good idea to tell your trainer what you're feeling. They may need to modify your exercises. Medical treatment is not usually required.
When is pain not normal during a workout/fitness training?
If you experience pain during a workout, it is important to stop and notify your trainer. Your trainer may need to ensure you're using the correct technique or lower the intensity of the exercise. If the pain persists or gets worse despite any modifications, it may be an early sign of an injury. You may need to stop the exercise. Make a written note of how you feel. Write the level of pain on a scale of 1 (no pain) to 10 (severe pain). The aim of early basic first aid for simple (mild to moderate) soft tissue injuries such as joint sprains or muscle strains to the arms or legs is to:
Reduce pain and swelling;
Prevent further damage; and
Allow the body the best conditions to heal itself.
Basic first aid advice I give for these simple (mild to moderate) soft tissue to the arms or legs is:
Speak up: If you experience pain or discomfort during or following a workout, it is important to stop and notify your trainer.
Do no H.A.R.M to the injured area: The acronym stands for Heat, Alcohol, Rub or Massage. Avoid any of these in soft tissue injuries as they can cause more swelling.
Do P.O.L.I.C.E. the injured area: This acronym stands for Protect, Optimal Loading, Ice, Compression and Elevation. Protect the injured area by avoiding movements that are painful. Optimal loading means avoid putting too much pressure through the area if it hurts. If comfortable to do so, apply ice frequently to the area during the first 48 to 72 hours. Wearing compression garments or compression dressing may help. If practical elevate the injured area.
When should you seek medical advice for pain that follows a workout/ fitness training?
If you have severe pain, or pain that doesn't get better with basic first aid measures, or you're concerned seek medical advice. For physical activity related injuries including those during exercise, sport or leisure time activities it is best to see a Physiotherapist or Sport & Exercise Medicine Physician (Doctor) such as myself. However, sometimes it may be easier or more convenient to start by seeing a physiotherapist as you do not need a referral and they have experience managing exercise related injuries.
What is a Sport & Exercise Medicine Physician/Doctor?
A Sport and Exercise Medicine Physician is a doctor who specialises in getting and keeping you physically active. Because we are specialist medical doctors, we are especially trained in treating and managing sport and exercise related injuries and illnesses that affect your ability to exercise. To see a Sport & Exercise Medicine Doctor you need to ask your General Practitioner (GP)/local doctor to write you a referral. You can still see a Sport and Exercise Doctor without a referral from your GP, however if you're eligible for Medicare rebate you will not be able to get one.
Another advantage of seeing a Sport & Exercise Medicine Doctor, is that we can:
Diagnose injuries,
Refer you Xray, MRI or other imaging only if you need it. This has the potential of saving you money and unnecessary worry. Because we are trained to look at the imaging as well as explain what is going on by looking at the pictures (not just the report) we can work out if the changes on the imaging are connected to your symptoms or important.
Advise you on correct rehabilitation and fitness exercises and approximate times to recover.
Work together with your trainer to modify your training
Recommend appropriate practitioners and therapists you may need or wish to see (e.g. physiotherapist, osteopath, chiropractor, podiatrist, massage therapist, acupuncturist etc),
Refer you for more specialised tests or to see other specialist doctors
Advise if you might need to consider surgery and go see e.g. an orthopaedic surgeon, neurosurgeon, general surgeon etc.
We are doctors who specialise in getting and keeping you physically active. We work as part of the team that helps you return to your chosen activity. So next time you “feel a niggle” or find yourself wondering something like “Should I wake up to train or shut down and reboot?”- STOP and listen to your body. Talk to your trainer. Try some basic first aid for soft tissue injuries a day or two. If it’s not getting better or if you are concerned, book in to see your physiotherapist or come and experience what a Sports & Exercise Medicine Doctor can do for you.
Disclaimer: This article and all our content is intended for general information only. It is not intended as medical advice. If you believe you have a medical condition or injury, including one discussed in any of our content, you should see your doctor or other registered healthcare professional without delay. DO NOT use our content to diagnose yourself.