Pain doesn’t always have to mean stop moving
One of the biggest fears we have when we’ve been hurt or injured is making it worse or getting hurt again. It would set us back even further, make us feel even more incapable, and cause more frustration and confusion than we already have.
Knowing whether or not it is appropriate to do certain movements can be tricky. We have four “Pain Rules” that we give clients to help guide this decision. These rules can be followed to make clear, and confident decisions about whether or not the movements you are doing are the right thing.
Before we dive in, we would like to define some terms we will to help you understand what you may be experiencing and to make the best decision for what you are feeling.
Insult - An unconscious response to a stimulus. For example, right now, your shirt is insulting your skin. The seat you’re on is insulting your thighs. These things aren’t even on your radar most of the time, but they are input into your system.
Irritation - A conscious response to a stimulus. For example, if I were to ask you to freeze where you are and hold that position for an hour, you could likely hold it for a bit, but eventually you would have to adjust your position. The moment you decided you needed to change position, insult became irritation. Irritation can range from the benign feeling to readjust to excruciating. Irritation is not a bad thing per say, as it is a stress we feel during training in order to drive positive adaptations. However, we want to be aware of our irritation boundaries, as exceeding them could cause more harm than good.
Pain - The negative emotional response to irritation, typically tied to uncertainty. For example, the first time a child stubs their toe they may panic and cry as it is a novel sensation. Now imagine that you stub your toe. Yes, it hurts, but you probably won’t register it as an emergency. The difference is that the child hasn’t been there before and is uncertain and afraid. The emotional response is what we call pain.
Injury - The decision that “I can’t do ___” based on the irritation or pain we experience. If someone has a joint that hurts them so intensely that they choose not to use it, they will consider themselves injured in their ability to perform that movement. For example, if someone reports a 9/10 pain in their knee when they walk down stairs, but not when they bike, walk, or run, they might consider themself temporarily injured in their ability to go down stairs right now. It is important to shift our thinking from “I have a ‘bad’ knee” to “I have a knee that doesn’t go down stairs well right now.”
Now that you are familiar with some terminology, we will introduce our four “Pain Rules”:
Rule #1: During movement, irritation is never to exceed a 4 out of 10.
Rule #2: As we move, irritation must either stay the same or REDUCE.
Rule #3: When movement stops, irritation stops.
Rule #4: Within 48 hours, irritation should register as no greater than during exercise.
Pain Rule #1: 4/10
The first rule is that during movement, irritation is never to exceed a 4 out of 10. We want to know that during movement, irritation registers as less than or equal to a 4/10 according to you.
This is important because some irritation is often needed for adaptations to happen, especially when body parts are not used to certain movements or have been bothered by them in the past.
Pain Rule #2: Stay the Same or reduce
The second rule is that as we move, irritation must either stay the same or REDUCE.
For example, if you’re going through a set of eight repetitions of an exercise and it feels like a 4/10, if you feel okay to continue, we want to know that from rep to rep, irritation either remains a 4 or decreases to a 3, 2, 1, or 0.
If either of these is the case, great! We are clear to continue. If irritation increases from rep to rep, we stop and change something.
Whether it’s the range of motion, weight, or movement altogether, something needs to be altered so we can make progress without undue irritation.
Pain Rule #3: Movement stops, irritation stops
The third rule is that when movement stops, irritation stops. For example, as you complete your set and return to rest, we want to know that what you felt during exercise stops while you aren’t moving.
So, when you put the weight down, there’s nothing residual telling you that it hurts. This is a great sign and movement should continue.
If you stop the movement, put the weight down, and feel a lingering irritation, it means we need to adjust our approach and that there are certain tissues that need to be stimulated in a different way or to rest altogether in order to return to a state of greater health.
Pain Rule #4: no worse after 48 hours
The fourth rule is that within 48 hours, irritation should register as no greater than how you reported it during exercise.
For example, if you’re doing three sets of high-pulls on a Friday, we want to know that by Sunday, irritation has made its way down to a 3, 2, 1, or 0 - no higher than 4. If by Sunday we feel muscle soreness, but none of the irritation we felt during exercise, this is a great sign we should continue the path we’re on. If we wake up Saturday morning and it feels like there’s a knife in our shoulder, this means we need to adjust the next session’s demands to more perfectly and conservatively meet your shoulder where it is so we can move forward from a new baseline.
move forward with confidence
Before stopping movement altogether the next time you are experiencing irritation or discomfort, we encourage you to use these “Pain Rules” to check in with your body! How would you rate your level of irritation from 1-10? How does it feel while you move? When you stop? Are the sensations recreated or any worse 48 hours later? With these tools, we hope you now feel empowered to make the right decision for you and your training.