‘good’ pain vs ‘stop that’ pain

Jeremy asks, “How do we tell the difference between the pain of injury, and the pain of correcting an injury in the context of exercise and rehabilitation?”

A fine question, good sir.

In my experience, there are a few key concepts to help guide us.

1. Change usually carries some kind of discomfort with it. Not always, but often … you know this already, as it’s what you point towards when you talk about ‘pain of correcting an injury.’

2. Correcting an injury is often a series of well-planned micro-injuries. An example of this is unfreezing a ‘frozen shoulder,’ or rehabilitating an broken-then-casted ankle, or even just working out. We’re often micro-tearing the soft tissue (muscles and connective tissue), re-aligning it, and bringing in just enough inflammation that our body ‘sees’ this area again and brings nutrition, and even better neurological pathways.

Too much of this micro-injuring and we’ve re-injured ourselves. Think of running stairs for an hour off the couch … too much too soon (for most of us, anyway). It takes forever to recover, much more time than it would’ve taken to, say, split that workout up into two sessions over a few days.

3. Pain, even a pleasurable sensation of stretching, does not necessarily equal rehab. As in, you could spend plenty of time stretching out the ligaments in your otherwise-healthy and normal-ROM ankle, and it would have that rehab-stretch kind of pain feel, but would certainly do you no good. You would increase mobility in an area that doesn’t need it, which would actually increase risk of injury like a sprain.

In other words, whatever exercises you’re doing should be intelligent ones, corrections that make sense and not just shots in the dark.

4. In general, any sudden or sharp pain means ‘stop doing that.’

5. You’re the best one to understand your own body in a subjective way.

Put all those together and I think you’ve got this: Correcting an injury should should be part of a well-thought-out process, and happen within the limits of what your body can effectively deal with. Just enough so there’s an increasing range of motion or fiber re-alignment or whatever … not so much that your body’s inflammatory response brings you back two steps. If you’re not recovered from whatever kind of workout in a few days, it was probably too much.

That’s my take … keep me posted!

And, to anyone else reading this, I’d love your two cents.

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