It is well known for everybody – especially athletes – that some discomfort is part of athletic activities and is often part of a successful training program.
To increase muscle strength, the muscle must see some increase in stress, and this stress is usually perceived as the ‘burn’ in muscle during activity. This mild burn is what we call good pain.
Fatigue after workout is also a sign that the exercise is pushing the limits of the body’s physiology, but it too should not be excessive.
The Signs of Bad Pain
Muscle soreness typically occurs if we do a new exercise or if we do a familiar exercise too hard. This soreness typically begins within a few hours but the peak is one to two days after exercise. This soreness is called delayed onset muscle soreness (DOMS) and may represent actual muscle damage.
DOMS is the result of microscopic tearing of muscle fibers, causing micro-damage to the muscle fibers and inflammation. This is often a result of eccentric muscle contractions, which occur when the muscle is contracting while it is being lengthened. Examples of eccentric activities are running downhill, downward phase of squats, or lowering weights. DOMS is perfectly normal, and happens to people of all fitness levels. It is part of the body’s way of adapting to new exercise, so that you are stronger and better able to handle the load the next time. Although there is no proven remedy to reduce muscle soreness, DOMS pain does subside on its own.
People often get DOMS pain confused with bad pain from a sports injury. Sports injuries can be acute or chronic. Acute injuries are easier to identify because they are a sudden onset, such as rolling your ankle. With these injuries, there tends to be sharp pain at onset, with associated swelling, bruising, and loss of range of motion. Chronic injuries can happen over time commonly through repeating poor movement patterns. Often there is pain during your activity, and it can be sharp. The pain persists and does not go away after a few days. There may be joint swelling and pain.
The muscles, tendons, ligaments, cartilage and bones of the body are living structures that react to the stress of exercise only gradually. If they see stress too fast, they cannot respond effectively and may begin to fail. The causes of the failure can be too much stress too fast, or it can be the accumulation of excessive stress over time. When this occurs, each one of these tissues responds a little differently. This can result in bad pain.
In severe cases, the muscle may be damaged to the point that the muscle starts to develop permanent damage. In extreme cases, individuals who exercise excessively can develop a condition where the muscle is permanently damaged and proteins are released into the blood stream, which can shut down the kidneys. While it is rare, there have been cases of death due to this extreme over-exercising of the muscles, so it is generally recommended that if you start an exercise program, you begin very slowly and build up gradually.
In a similar way, the tendons that connect muscle to bones may get irritated if they see too much stress too rapidly. They respond by getting inflamed, which is characterized by pain and sometimes swelling. Tendinitis pain typically occurs during exercise and can continue afterward when performing activities using that muscle or tendon. For example, tendinitis of the kneecap tendon is frequently seen in athletes who do jumping or squatting activities. The pain is made worse with these activities, but the pain may continue after sports activity when climbing stairs or getting out of a chair. In more severe cases the tendon may become swollen and any movement of the tendon or knee joint can hurt.
The bones also need time to respond to new stress. This response is called remodeling and strengthens the bone. However, if the area of bone sees stress too fast, the bone will actually begin to fail. The first sign of this stress reaction is pain along the bone, which occurs with activity. As the situation worsens, a stress fracture can develop. This may result in a limp and even pain at night. If untreated the bone can actually break, which can be a severe injury.
Along with aging process, it is common for the cartilage to see some wear and tear so that it is not perfectly smooth. When the cartilage sees too much stress too rapidly, it can result in pain and fluid in the joint. Swelling in a joint is a worrisome sign meaning that the cartilage is irritated. If the joint is not rested, the pain and swelling can increase and result in functional problems.
When should We Worry about the Bad Pain?
Immediately visit a physician if: