It hurts when I exercise, should I stop?
It depends!
Yes, I know that no one likes a response of “it depends” but it is the best answer in this care. It depends on intensity of pain, it depends if the pain gets worse as you continue exercising, it depends whether the pain is sharp or dull, it depends whether the pain causes you to change your form, it depends if the pain is still present when you stop, in short it depends. As a rule of thumb, you can continue to exercise when it hurts as long as the pain does not increase in intensity over the workout, gets better or remains unchanged, is not sharp, does not alter your form, and does not remain for long after stopping exercising.
I know you want to continue exercising for mental health, physical health, and fun, but sometimes it is necessary to take a break for your body to heal. I never like telling a client to stop any exercise, but sometimes it is necessary in the short term. Stopping also does not mean that you cannot exercise at all, but that you may need to take a break from a particular exercise. Biking and swimming are poor replacements for running, to runners. High reps/low weight strength exercises are also poor replacements for those who love heavy lifting. I always give exercises as part of treatment, but I understand that a few exercises to re-educate your muscle activation patterns are a poor replacement for running 5 miles or deadlifting 300lbs. Low intensity strength and neuromuscular reeducation exercises just don’t give you the runner’s or lifter’s high. I get it, and my goal is always to keep exercise breaks as short as possible. The hard truth is that if you keep exercising through pain, then you may end up with a more serious injury which requires a longer break. This is why I recommend clients take time in the moment and assess any new pain you experience while exercising to ensure you are making a smart choice and avoiding a more serious injury.
In order to come to terms with any exercise break, it can be helpful to understand what pain is. Acute pain is a protective mechanism for the body. It is a sign that injury, trauma, or tissue damage is occurring. When pain is sharp, your body is telling you that an injury is likely to happen if you continue or has already occurred. When pain worsens with continued exercise, your body is telling your that further trauma is occurring. When pain alters your form, you are at risk of further (and possibly worse) new injury due to the change in form. When pain remains after the exercise, your body is telling you that you have caused some trauma to your body.
Chronic pain is often not a sign of physical injury at all. Sometimes chronic pain is due to continued improper or incomplete healing, but this is not always the case. Sometimes the communication systems within the body can become confused, and pain is experienced without injury occurring. Because of the complicated pathways that exist in the body, chronic pain that is dull, does not change with continued exercise, and does not alter your form is usually a sign that no true physical injury exists.
Some people experience pain with exercise that is truly due to the healing process or due to your body getting used to the a new motion. When returning from injury or starting a new exercise some people do experience pains temporarily. Pain will usually be sharp, increase in intensity, or alter your movement if you have returned from injury too quickly or you are using positioning and form that your body does not like. Pain that improves with continued repetitions/time/distance usually means that your body is figuring out the movement and making sense of the new sensations. As your body realizes that you are not actually injured the pain goes away and you are safe to continue.
In short, it is likely ok to continue exercising through dull pain, that does not worsen with continued exercise, and does not cause you to modify your movement patterns.
My advice is to be smart. Without evaluating you, I cannot tell you whether you should stop or keep exercising because it depends. I can give you the knowledge to make educated choices for yourself. Hopefully this helps a few of you avoid more serious injury.