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Good Pain / Bad Pain - What's The Difference?

Ouch!

When you workout, your muscles grow by being overloaded and then repairing themselves. Some pain is a natural result. To make sure you're not injuring yourself, you need to determine if you're experiencing "good" or "bad" pain.

Good Pain is a mild burning sensation you feel in your muscles. It's the result of muscle inflammation and is generally an indicator you're making gains. If the pain is making you feel uncomfortable, simply slow the pace down and it should quickly subside.

Bad Pain is anything sudden, sharp or a pain on just one side of the body. Pain in your joints might indicate a problem with the tendon or a joint-related injury. Any pain that comes with swelling, bruising or loss of motion in the joint is bad pain. If you've got any symptoms of bad pain, get professional medical help.

A more severe pain is when muscles are sore one or two days after a workout. This is usually caused by something called Delayed-Onset Muscle Soreness or DOMS. DOMS is the result of microscopic tearing of the muscle fibers. DOMS is painful, but it is not a critical injury. It is your body's way of repairing the damage and telling you to be more careful in your future workouts. For more information on DOMS, see our article from April 3, 2003, The Truth About Pain and Gain.

Unfortunately, the pain you feel may not always be so clear-cut. If you're not sure you need professional help, use the table below and rate your level of discomfort.

  • Stage 1 (Minor) - This is the burning sensation you feel while performing an exercise set or the muscle ache you have when you finish a workout. As long as the pain stops when you finish a set, or if it goes away later the same day, it's generally stage 1.

  • Stage 2 (Moderate) - When pain starts at the beginning of your workout but still dissipates within 3-6 hours, it's more than likely stage 2.

  • Stage 3 (Elevated) - Pain that restricts your body movements, the exercises you can perform or pain that forces you to stop working out is stage 3.

  • Stage 4 (Severe) - After you finish exercising, if you still feel pain the next day and even light physical activity or movement is a problem, that's stage 4.

If your pain is stage 1 or 2, it can generally be treated with over the counter pain medication or RICE. That stands for Rest, Ice Compression and Elevation. RICE is often the best treatment for soft tissue injuries such as bruises, sprains and strains. RICE also works on pulled muscles and to relieve muscle spasms.

Treating Injuries with P.R.I.C.E. - Does it really work?

Pain that's stage 3 or 4 you should seek medical help for immediately.

If you have an injury, but are cleared to workout, how you work your muscles is important. Keep your movements smooth and not jerky. Avoid exercises that aggravate the injury and make sure you're maintaining perfect form. If you're using free weights, consider using machines because they offer slightly more control, stability and isolation of the muscle groups.


Pain and Over-the-counter Medications

Many headaches respond to acetaminophen (the active ingredient in Tylenol). Unfortunately acetaminophen does not fight inflammation. If your muscles are inflamed, doctors recommend ibuprofen. But ibuprofen has a downside, it inhibits muscle growth. If you're constantly working your muscles to the point you need to take an anti-inflammatory, you're not giving yourself enough time to heal and you're cheating your body out of muscle gains.

Be extra vigilant when you workout because the endorphins (your body's natural morphine) get going and they can mask some ailments. You might feel fine during the workout but experience pains later that night or the next morning.

Take Along Info

If you end up having to see a doctor, the Association of American Physicians and Surgeons has a list of questions in their Patients Handbook you should ask at every visit. Print this list out and use it every time.

  1. Diagnosis. What's wrong, what causes it, and how serious is it?

  2. Tests: What tests do you recommend, and what is the purpose?

  3. Results: How will I find out about the results? Will I be advised if nothing is wrong, or only if something needs attention?

  4. Options: What treatment choices do I have?

  5. Medications: What are my choices? What are the side effects, and how will it interact with other prescriptions or over-the-counter drugs? What's the dosage and frequency? Should I take with or without food, or avoid alcohol?

  6. Doctor's Orders: What activities do I need to avoid? Am I contagious? Do I need a follow up visit? Should I watch for anything special?

  7. My Questions: (Jot down things you want to discuss so you don't forget them, but try not to overwhelm the doctor with a ``laundry list.'')

(To see the complete Patient's Handbook online visit this link: http://www.aapsonline.org/patients/handbk.htm)

By aware of the signals your body is giving you and treat them accordingly. The goal of any exercise program is to help you get fit. Don't ignore pain. Identify it, deal with it and grow.

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3/17/2006
Updated 4/9/2015
Updated 10/11/2016