Whatever your fitness goals—from squeezing in a workout on your day off to competitive sports—sore muscles or pain with exercise might feel like a hurdle you have to jump on the way to your personal best.
“The mentality of most people tends to be ‘no pain, no gain,’” says Dave Granito, MS, ATC, director of recovery and injury prevention at Mass General Brigham’s Center for Sports Performance and Research. “Sometimes that’s true, but sometimes pain means there’s a problem.”
So when is it important to listen to discomfort and when can you push it? As a former athletic trainer for professional football teams, including the New England Patriots and Detroit Lions, Granito offers expert advice to help you stay safe while crushing your goals.
Defining the gray area between painful gains and injury requires some reflection on how the pain started, what it feels like and what happened afterward.
Granito highlights several symptoms that point toward injury, including:
Sudden, sharp and lasting pain that happened during an exercise
Pain that prevents you from doing an exercise or certain movement
Changes in appearance around the painful area, such as swelling, bruising or deformity of any kind
Numbness, burning or tingling that spreads to your hands or legs
Pain in an area of a previously healed injury or at the site of a recent surgery
“If something hurts and it’s limiting your function for more than 3 days, it’s something you likely need to see a doctor for,” he says.
Certain symptoms may suggest a more serious problem with your health. You should see a doctor if you have pain that wakes you up at night, or pain accompanied by:
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We’ve all done it: Strained a muscle, started to feel better after a few days and headed back to the gym. But if you get back into your workout and you still feel pain with exercise, then you probably haven’t rested enough.
“Healing a muscle injury is like getting a scab on a cut,” says Granito. “If you leave it alone, it scabs over and stops bleeding. But if you pick at it, you aggravate it, and the cut starts to bleed again.”
Pushing through workout pain could take something that wasn’t an injury and can turn it into injury. You might feel like you can’t take more time off, with a major game around the corner or a marathon in a month. But those few extra days of rest might mean the difference between long-term success and being out for the season.
If you wake up feeling stiff and sore, take things one step at a time. Do you feel better after walking around your room? After going for a walk or getting on the bike? You can try some light activity, and your soreness should lessen as you move.
“There are so many different things you can do for recovery: massage, hot tubs, cold tubs, stretching,” lists Granito. “But actually, the single thing that seems to be the most effective for decreasing healthy soreness after exercise is low-level activity.”
Normal muscle soreness starts soon after your workout and may last a few days. Especially if you did something you’ve never done before, it’s not unusual for a few days to pass before you start to feel better.
Muscle soreness after working out means your body’s musculoskeletal system—your bones, muscles, ligaments, tendons, cartilage and connective tissues—is healing and getting stronger. “Our musculoskeletal system is designed to repair itself after small traumas so that the next small trauma doesn’t cause the same damage,” explains Granito.
This process, similar to building calluses on your hands from lifting weights, allows you to progress to more challenging exercises over time.
Delayed onset muscle soreness (DOMS) describes a debilitating type of soreness that might make you question whether to see a doctor. You don’t typically need to, assures Granito, but you should rest. This type of soreness will only get slightly better with activity.
DOMS develops about two days after you’ve exercised too intensely. With DOMS come extremely painful muscles that feel very different from normal, aching muscle soreness.
“It’s definitely not a good thing, and you don’t want to work out to the extent that you cause DOMS,” says Granito. “You’ve actually exceeded those small traumas to the point of breaking down your cells.”
He explains that the pain, stiffness and limited function is your body’s protective mechanism. These feelings naturally help prevent your muscles from doing anything that could progress to more serious and potentially life-threatening conditions, such as rhabdomyolysis or compartment syndromes. In the meantime, resting, icing and taking over-the-counter pain relievers should help.
Wherever you are in your fitness journey, workout pain can keep you from moving forward. Granito points out the most important things you can do to ease pain after a workout and prevent future injury:
Check your form: “Wanting to do as much as you can is great,” says Granito, “but if you do it on bad movement patterns—meaning with bad form—you create injury.”
Stretch your muscles and joints: “Muscles are like rubber bands. You can stretch them as much as you’d like, but if the joints themselves are stiff and restricted, mobilizing the joint is the answer over stretching,” explains Granito. “When your joints are more mobile, your risk for injury decreases.”
Build rest into your workout plan: “You need to have cyclical, built-in periods of time where you can let your muscles, bones, joints or whatever you've stressed recover,” says Granito. “Otherwise, that stress can turn into injury.”
Listen to your body: “You should pay attention to what your body is telling you and adjust your movement accordingly,” Granito encourages. If an exercise hurts, don’t do it. If soreness, discomfort or pain doesn’t get better with rest and conservative treatment, it’s time to see a doctor.