Should I keep exercising or am I making the injury worse? Knowing when to continue, modify or stop an activity can be difficult. Pain is an important signal from the body, but it doesn’t always mean that damage is occurring. Mild discomfort can sometimes be an expected part of returning to exercise or recovering from an injury. At other times, pain may indicate that the activity needs to be modified or stopped.
Pain does not always equal damage
Pain is influenced by many factors including tissue sensitivity, previous injury, fatigue, stress and sleep. After an injury the affected area may remain sensitive even when it is safe to begin moving and rebuilding strength. Completely avoiding movement can sometimes further contribute to further stiffness, weakness and reduced confidence. For many conditions, some carefully monitored discomfort can be acceptable. It may be reasonable to continue exercising when the pain is mild and manageable and the discomfort doesn’t progressively worsen in the 24hrs following exercise.
A simple traffic light guide
Green light (0-3/10)
You can usually continue when the discomfort is mild, stable and settles shortly after exercise. You are moving normally, and your symptoms are no worse the next morning.
Amber light: modify (4-6/10)
Consider reducing or changing the activity if the pain is moderate, increases throughout the session or remains noticeably worse afterwards.
You could try:
- Reducing the weight or resistance
- Completing fewer repetitions or sets
- Shortening the distance or duration
- Slowing the movement
- Increasing rest periods
- Changing the exercise or range of movement
If your symptoms repeatedly remain elevated into the following day, this may indicate that the current workload is greater than your body can recover from.
Red light: stop and seek advice (7-10/10)
Stop the activity if you experience:
- Sudden, sharp or severe pain
- A pop or crack associated with immediate pain or loss of function
- Rapid swelling, significant bruising or visible deformity
- An inability to bear weight or use the affected area normally
- New numbness, weakness or loss of coordination
- Pain that continues to become worse despite reducing the activity
- Pain that regularly wakes you at night or is worsening without an obvious reason
What about muscle soreness
Delayed onset muscle soreness often develops after performing a new exercise or completing a harder session than usual. It is usually most noticeable over the following one to three days and then gradually improves. DOMS usually feels like general muscular aching, stiffness or tenderness. You can often continue with gentle movement or train a different area while it settles. Pain that is sharp, very localised, associated with significant swelling or worsening each day is less typical of ordinary muscle soreness and may need assessment.
You may not need to stop exercising completely
When one activity is aggravating your symptoms, complete rest is not always necessary. It may be possible to temporarily reduce the irritating activity while maintaining fitness through an alternative.
For example, a runner with pain may be able to reduce their running distance, remove faster sessions and use cycling or swimming to maintain cardiovascular fitness. Someone with shoulder pain may be able to modify pressing exercises while continuing to train their legs and completing suitable shoulder rehabilitation. The appropriate modification will depend on the condition, its severity and your individual goals.
Finding the right balance
Some discomfort during exercise can be acceptable and does not necessarily mean you are causing harm. Mild symptoms that remain stable, do not alter your movement and settle by the following day are generally more reassuring.
Pain that is severe, worsening, changes the way you move or is accompanied by swelling, weakness, neurological symptoms or loss of function should not be ignored.
If you are uncertain, a physiotherapy assessment can help remove the guesswork and give you a clear plan for continuing to exercise safely.
