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Starting a new workout routine can leave you wondering whether what you’re feeling is normal muscle soreness or a sign of injury. This article explains the difference between “good” exercise soreness and pain that may need attention, including warning signs such as pain that worsens, swelling, sharp pain with movement, or symptoms that don’t improve over time. Learn how delayed onset muscle soreness works, when to modify activity, and how physiotherapy can help you stay active while preventing injuries from becoming long-term problems.
The start of the year often comes with the promise of increasing activity levels and getting back in shape. If you’re like most people, starting an exercise program for the first time has likely led to some aches and pains that may be unfamiliar to you. Is what you're feeling muscle pain or soreness? When is pain a pain and when is it a “good” pain? Understanding which pain you're having will help to determine how to manage it.
What is pain?
There are many factors that can impact your pain levels. If the pain is from tissue damage, then the more damage there is, the more pain you may feel. But not all pain is from tissue damage. Pain is complex and can vary from person to person. Pain is often defined as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” (National Institute of Health).
Pain isn't always about damage
Injury or damage is just one factor that impacts your pain perception. Other factors include your previous experience with pain in the region or in other areas as well as how the pain is affecting you. For example, an ankle pain for a delivery person is going to be perceived as a higher pain than for someone that works from home and sits all day.
Muscle pain or soreness?
Not all pain is bad. While exercising, your muscles and joints are put under stress. The more these muscles are loaded during an exercise the more aware you'll be of them. In the long term this stress will improve the strength of the muscles and supporting structures.
Generally, a movement that:
- Initially was fine to do at the start of the exercise
- Starts to be felt more with continued repetition.
- Once the exercise is stopped the soreness fades away
Is a good muscle pain.
Delayed onset muscle pain
Sometimes the pain from exercise isn't felt until later. Lactic acid may have accumulated within the muscle which can present as delayed onset muscle soreness. Tendons that are adapting to the new loads placed on them can also take time to strengthen.
This recovery process could take up to 1 week and you could be feeling pain while your muscles are repairing. This is normal and is the “good pain” that you've probably heard about.
When the pain isn't good
However, there are a few signs that may be warning you may need to exercise caution. These include the following:
Pain with movement
If you're noticing that a portion of the movement is painful from the first repetition or the start of your run, it could be a sign that the supporting muscles and structures haven't built up their strength sufficiently or that the weight is too heavy. Repetitive overhead exercises and poor movement mechanics can also contribute to rotator cuff irritation and shoulder pain. Read more on our shoulder pain physiotherapy page.
Trauma and inflammation pain
If there was a traumatic movement. This could be from an unexpected slip or fall that results in immediate and unrelenting pain. If this happened then there's a greater chance that your pain is inflammatory. Inflammatory pain is often accompanied by swelling, bruising, redness or heat.
Pain that's getting worse
Another indication would be pain that is getting worse. This could be that the pain is happening faster (10 minutes into a run instead of 20), is getting more intense or taking longer after the exercise has finished to subside. If your exercise pain is centred around your spine or symptoms are limiting walking, lifting, or sitting tolerance, visit our back pain physiotherapy page to learn more about treatment options.
Muscle pain that isn't improving
As you adapt to a new exercise your symptoms should be improving. If a new exercise keeps giving you the same pain after a few weeks, this could be another indication that it isn't a good pain. This could be because your joints and muscles are not capable of handling this type of strain and the exercise or movement may need to be modified.
Form and past pain
If the exercise you're trying used to be pain free but now isn't, this could be the result of an unresolved past injury. Compensations for past injuries may be affecting your form (technique) during the exercise and may to be addressed. If you're more experienced with exercise then this can show up as avoiding certain exercises or movements because they don't feel good either during the exercise or afterwards. Poor exercise technique and muscle compensation patterns can also contribute to ongoing neck tension and headaches. Learn more about common causes and treatment options on our neck pain physiotherapy page.
Exercise pain management advice
Our previous post talked specifically about whether to use heat or ice and can be read by clicking here. Briefly, if it's acute and hot, cool it down. If it's sore but not hot then heat often helps.
Experienced physiotherapists can help you overcome your pain
Physiotherapists with experience in assessing and treating sports related injuries can perform an assessment to determine the factors that are preventing you from achieving your fitness goals. Assessments related to finding the cause of the problem will focus on screening all of the related areas which can be from head to toe. Modifications of your exercises may be necessary in the short term so that you can maintain and improve your conditioning while underlying limitations are resolved. When the problem is addressed before the inflammatory pain has set in the process to full resolution is much shorter requiring fewer clinical treatments.
