Good pain. Bad pain.

No pain no gain.

We’ve all heard the expression and the fact is, there is both truth and danger in it. Sure, pain can indicate muscle engagement and growth, but it can also reveal injury. It’s important to understand when your pain is typical and when it’s cause for concern.

Pain and exercise

We feel it in our muscles when we exercise because muscle strain causes inflammation, which also leads to hypertrophy that increases size and strength. The soreness means change is occurring and it typically only lasts a couple of days.

But what about when that feeling is painful? When there is sharpness or stabbing? And it doesn’t go away when you stop exercising?

Great Basin Orthopaedic’s Dr. Richard Mullins says that’s the time to back off a bit. “Stop doing what you’re doing and try something low-impact like an elliptical machine,” he says.

He adds that you can try and relieve the pain and swelling through the RICE (rest, ice, compression, elevation) method, as WebMed shares:

  • Rest. Rest and protect the injured or sore area. Stop, change, or take a break from any activity that may be causing your pain or soreness.
  • Ice. Cold will reduce pain and swelling. Apply an ice or cold pack right away to prevent or minimize swelling. Apply the ice or cold pack for 10 to 20 minutes, 3 or more times a day. After 48 to 72 hours, if swelling is gone, apply heat to the area that hurts. Do not apply ice or heat directly to the skin. Place a towel over the cold or heat pack before applying it to the skin.
  • Compression. Compression, or wrapping the injured or sore area with an elastic bandage (such as an Ace wrap), will help decrease swelling. Don't wrap it too tightly, because this can cause more swelling below the affected area. Loosen the bandage if it gets too tight. Signs that the bandage is too tight include numbness, tingling, increased pain, coolness, or swelling in the area below the bandage. Talk to your doctor if you think you need to use a wrap for longer than 48 to 72 hours; a more serious problem may be present.
  • Elevation. Elevate the injured or sore area on pillows while applying ice and anytime you are sitting or lying down. Try to keep the area at or above the level of your heart to help minimize swelling.

If that doesn’t work, Dr. Mullins says it’s important to get a professional opinion to determine if it’s something serious that needs further attention. “It could be an over-use injury, a stress fracture, a tear or something worse,” he says.

If you already have joint issues, visit an orthopedist when you experience discomfort. If you don’t have diagnosed joint issues, you’ll want to see your general practitioner to find out what’s going on. They’ll refer you to an orthopedist if necessary.

Guided exercise

For those with muscle, bone or joint issues, exercise comes with some caveats. To ensure health and safety, the guidance of a credentialed trainer is key. “There are those with deep experience and training in this kind of thing,” Dr. Mullins says. “And there are those who might be decent coaches, but they don’t know anything about injury prevention.”

While the trainer at your local gym may know how to help you increase your bench press, if you have joint issues, you need a specialist. Someone trained in injury prevention is better equipped to help you reach your goals safely with better long term outcomes.

Aging and pain

Dr. Mullins says a certain amount of pain is just a part of life, particularly as we get older. “If you’re over 50 or 60, you’re always going to feel something,” he says. “The goal is to moderate the pain.”

He emphasizes that we shouldn’t rely on pharmaceuticals to moderate that pain. “Narcotics typically mask the pain, but you’re not dealing with the source,” he says.

Instead, he recommends, you guessed it, exercise. “Stiffness is a big enemy as we get older, especially around our joints and muscles,” he shares. “Regular movement helps address that.”

This puts you in a bit of a Catch-22, since you don’t want to antagonize the offending ligament or joint any further, but you also don’t want to quit exercising. This is where professional opinions really matter, of both your doctor and your trainer.

The key is to keep moving, but to do it in a way that works for your body.