RESISTANCE TRAINING & PAIN
Physical activity that puts demands on the body has many benefits that vastly outweigh the risks. From increases in strength, injury prevention, improved mental health, and longevity; we KNOW resistance training is wildly beneficial.
One thing to remember however, is that exercise is a stressor on the body. This means that from time to time we may experience discomfort, pain, and injuries.
The goal of this article is to explore pain with regards to resistance training and understand how to navigate through and around pain appropriately within your workouts.
WHAT CAUSES PAIN?
The sensation of pain is caused by nociceptors in the body recognizing a stimulus (i.e. tissue damage). Think of it this way: you get a paper cut… the response, it stings. It's a simplistic response and an easy one to comprehend because we can see the tissue damage with our own eyes. This is also true if you get a blunt force injury to an area and sustain a hematoma (bruise) shortly after.
But what about pain we can’t see or don't know the exact origin of? Like low back pain (LBP), the most common cause of disability worldwide. It’s not uncommon for those involved in rigorous resistance training to experience it from time to time. It can be incredibly frustrating when a bout of LBP stops us in our tracks and halts progress made with exercise.
Another factor to consider with pain is that it can be affected by several factors outside of direct tissue damage. This includes but is not limited to: poor sleep and nutrition, stress, depression, anxiety, poor work capacity (fitness), fear of movement, lack of physical activity (the less you move the more sensitized you become), false beliefs about pain, etc. Think of your pain as a cup and if it overflows with too much of those factors the pain sensation can become greater.
There is some good news with regards to LBP. Most cases resolve in as little as 6 weeks. I know what you’re thinking, “6 weeks is forever!” While this is true if your training involves working towards a very specific goal, i.e. a powerlifting meet, it’s really not that long in the lifespan of someone training for overall health and longevity.
LBP isn’t the only type of pain commonly experienced by the average gym-goer. There’s anterior (front) knee pain, hip pain that feels “pinchy”, elbow pain that can feel like it’s stabbing the bony prominences on the inside or outside, and shoulder pain (usually with overhead pressing or barbell bench press).
SO HOW DOES ONE NAVIGATE THIS PAIN ON THEIR OWN?
Ask yourself the following questions first…
Is this pain inhibiting my ability to perform most daily activities of living?
If so, consult a physician or physical therapist ASAP.
Is this pain affecting my quality of life?
If so, consult a physician or physical therapist ASAP.
Is this pain only affecting resistance training?
Start to consider some self management first.
How long has the pain been going on?
If it’s been a short time, < 4 weeks, you can try some simple regressions and modifications to see if the pain will dissipate.
As a coach, I like to try and guide clients to manage pain with weight lifting by having them make simple changes to their training to allow them to move with minimal to no pain so that they can continue working towards their goals.
Low hanging fruit that can be addressed without having to overhaul or completely halt strength training include taking a deload week, or deloading a specific exercise for a short period of time. Taking a full deload week of training where you drop volume (total sets and reps) or intensity (dropping the % of overall load used) is a great way to allow the central nervous system (CNS) to recover. If the pain is only specific to one exercise and not affecting someone otherwise we can deload that exercise by dropping the load being used by around 20-30% for a brief time and building back up.
If the exercise is still painful with a load decrease the next option would be to switch variations. Simple examples of this would be switching from conventional deadlifts to trap bar deadlifts. Another option would be going from barbell back squats to safety bar squats. You could even continue regressing exercises as needed down to simpler dumbbell or kettlebell versions.
By changing variations of exercises we typically change grip, where the load is at in relation to our center of mass, or range of motion. A transfer of the stress of the load can result in decreased or no pain with the movement pattern. The same could be said for switching your grip positioning on seated cable rows from overhand to underhand to neutral. This is often a good way to combat some nagging elbow pain.
There are even further options we can go to before eliminating an entire movement altogether. Partial range of motion (ROM) movements can be effective at allowing us to work within a comfortable ROM of a specific movement. Example: Let’s say you’ve regressed down to a dumbbell goblet squat but continue to have pain at the bottom of your squat. You could do box squats limiting you to just above 90 degrees of knee flexion.
OVERALL: If there is one thing I want you to take away from this email, it's that just because pain is present, it does not mean you are broken OR that you should necessarily be omitting your resistance training routine. There are plenty of options to keep you moving and help you rebuild while decreasing pain levels.
SOURCE: GREG LEHMAN
UNTIL NEXT TIME - COACH TOM