'Good' vs 'Bad' Pain - Identifying the difference after a pole class

An important part of progressing your training is determining how hard to push your body. I was recently asked, ‘how do we know if we are pushing ourselves enough when we train?’ And there is quite a simple answer to this.

If you’re not pushing yourself hard enough, you’ll quickly plateau and make zero progress in your pole strength and skills. But push yourself too hard and your body will end up very sore with delayed onset muscle soreness (aka DOMS) for many days on end, or even worse your body will even break down and injure.

• So how hard is pushing our bodies too hard?

• How can we differentiate DOMS pain from injury pain?

• What is a normal amount of DOMS and why do we need it?

• Can we avoid DOMS completely and still make progress?

• Is it ok to train with DOMS and other pain?

These are all valid questions that we will cover in today’s blog! Let’s begin!

What is DOMS?

As mentioned earlier, DOMS is delayed onset muscle soreness and its intensity can vary from mild discomfort to quite severe. The symptoms typically manifests as muscular style aches, reduced range of motion, reduction in strength and even swelling. Sounds like similar symptoms to a new injury, right?

The difference is that DOMS will usually begin the day following an activity and peak at the 48-hour mark, lasting no longer than 72 hours. Usually it occurs after starting exercise (i.e you’re relatively new to the activity) or if you’ve increased the intensity of your usual exercise. DOMS will occur when the physical stress placed on the body is higher than its capacity to handle. i.e It’s out of the normal ranges of intensity for the body.

Why do we experience it?

To get stronger our body needs to break down to build itself back up again more resilient and powerful than before. DOMS just happens to be the side effect of this process.

When we take a close look at the muscle under a microscope before and post exercise, we can see some clear differences. Particularly with eccentric style exercise (muscle contractions when the muscle is on stretch). After exercise there is micro tearing and breakdown of the muscle fibre contractile units, as well an increase inflammatory response that we consider normal. This process occurs over many hours which is why the pain of DOMS is delayed.

How do you treat DOMS and get rid of it quicker?

It’s firstly important to understand that DOMS is an important process our body undertakes to build new muscle strength, so don’t panic if you’re experiencing it after a harder than usual workout. If you experience DOMS after every workout however you may be down training your muscle strength and not allowing adequate recovery between sessions so touch base with a qualified health care professional to reassess your training programme and recovery strategies.

Recovery from DOMs is quite simple with the most important strategies being nutrition, hydration and sleep. Additionally, wearing compression garments and programming your exercise more effectively have been shown to be helpful in assisting DOMS recovery.

And strangely enough, drinking cherry juice has been shown to reduce strength loss and pain associated with DOMS. Cherries have very high levels of anti-oxidants and anti-inflammatory compounds which are believed to have a protective effect in reducing DOMS after exercise. But cherry juice is certainly not for everyone! Take into consideration any gut based issues before trying.

Additionally, I would encourage you to check out my blog on ‘17 Scientific Ways to Speed Up Recovery’.

Should you workout if you're still sore from DOMS? In the case of DOMS we know that muscular soreness experienced is not a reflection of structural damage (i.e physical injury). And unless the poler/aerialist is unable to move due to intolerable levels of pain, returning to exercise within a few days of working out is extremely beneficial. Working out will lead to increased blood flow and transportation of the nutrients required by the muscles to function and speed up recovery If a poler/aerialist has overdone it and is experiencing global discomfort, I would still highly recommend a very low impact light cardio and mobility session at the bare minimum to commence the recovery process. And touch base with your doctor or physiotherapist if there is an injury concern.

More pain after exercise = More Gain, Right?? WRONG!

DOMS is an important process our body undertakes to build new muscle strength, so don’t panic if you’re experiencing it after a harder than usual workout. However if you experience moderate to severe DOMS after every workout you may be training yourself into the ground, not allowing adequate recovery between sessions and putting yourself at risk of future injury There is zero science that supports the concept of 'More Pain = More Gain'. And it's important to understand that muscle DOMS/soreness is not an indicator of muscle growth. Instead, high levels of soreness such as DOMS is simply a result of the body being subjected to a level of intensity beyond what it is capable of. This is why DOMS is extremely common for people who are just starting out and subsides as training continues and they build strength. Continue to exercise too hard however and your body will start to break down instead! Sometimes with exercise less is more.

DOMS may be a sign that something in your workouts is going wrong. Check for:

1. Proper form & technique during your tricks & gym sessions

2. Appropriate progression - keep it slow & don’t push yourself too quickly

3. Correct weight - Choose the right weight for you at the gym. And you can modify your weight on the pole with resistance bands if your body isn’t strong enough to handle the demands

Workshops & Performances

There are a few more important considerations to take into account. For example, workshops are a great way to learn new skills and mingle with the best instructors the world has to offer, but they do spike your training load. Make sure you take a few extra days off afterwards to recover.

Same goes with performances. We tend to increase our load in the weeks leading up to a competition and try to load up our routine with the hardest tricks we can do. Ensure you have your tricks nailed 4 weeks out from the competition date and allow for plenty of recovery in the lead up to the performance. You don’t want to be burnt out before you’ve had a chance to perform.

How do you recognise the difference between ‘good’ and ‘bad’ pain after exercise?

At the end of the day pain is pain and should be respected, regardless of whether it’s DOMS related pain or injury related pain. Recovery strategies should be implemented regardless of the cause of pain.

However, just like DOMS, injury pain may not appear until 24 hours after exercise which makes it difficult to distinguish the cause of pain and determine whether it’s safe to continue exercising.

So instead of trying to determine if the pain is ‘good or bad’ pain, I’d encourage polers to look for the following factors:

1. Location of pain - If the location of pain is widespread muscle then it is more likely to be DOMS than an injury. Localised pain is a common sign of an injury. Also determine whether the pain matches up the muscle groups that were used during the workout.

2. Time since completing exercise - If the pain started during exercise or immediately post cool down then it is an injury and not DOMS. And if the pain persists longer than 72 hours then it is an injury.

3. Pain level - If the pain is at a reasonable level then exercise can continue. I encourage no exercise to occur until pain levels are below a 3-4/10. Why? Well, because your body may not be fully recovered from the previous session and you require further individual assessment to determine if you can continue

How to manage acute and chronic pain

Pain is complex. No truer statement has been said. Pain does not always correlate with damaged tissue. I.e. placing your hand next to a hot stove does not mean you are burnt. But you certainly will feel pain if you’re too close to the stove!

Pain can act as our protective system – our alarm bell if you will. It’s there to warn you that something may happen if you continue to touch the stove. In this situation, our pain system is helpful.

But sometimes it’s an unhelpful alarm system. In patients who experience pain chronically this alarm system can ‘ring’ unnecessarily. I.e. a person may experience pain every time they bend forward or when they load up their shoulder. This is non-helpful pain and can be off putting for many people.

But the great news is that whether you’re returning from an acute injury or managing more persistent pain, training with pain is acceptable, and even encouraged as a good thing.

Exercising with chronic pain

A 2017 systematic review by Smith et al. (2017) demonstrated that individuals suffering chronic pain (pain present for more than 3 months) who performed exercises with some level of pain present, reported lower levels of pain in the short term over individuals who performed completely pain-free exercises.

Another article demonstrates exercise is the best method in managing hip and knee osteoarthritis and mild pain occurring whilst exercising is acceptable (Brosseau et al., 2017).

We apply a similar approach for acute style injuries. Another study by Hickey et al., (2019) demonstrated that rehab exercises in the presence of pain actually resulted in faster return to play times compared to those who completed their rehabilitation pain free. And they had significantly more strength on return!

Final Note

Unfortunately, polers and aerialists will get injured at some point during their journey but if there is anything to take from today it’s this:

‘The body is incredibly resilient and adaptable’

It may not always be possible to identify the difference between DOMS and injury but understanding correct loading of the body is imperative to reduce the occurrence of injury.

And training through mild levels of pain is acceptable if adequate recovery has occurred between sessions and the pain doesn’t increase above 4/10 during exercise. I highly recommend that any ongoing pain is assessed regardless of pain level.

At no point however is training through >4/10 pain acceptable without immediate assessment and a plan from a qualified health care practitioner. It may still be possible to train but modifications may need to occur under qualified guidance.

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Are you experiencing pain lasting greater than 72 hours after training?

Online telehealth appointments can be booked with the Pole Physio via our ‘Book Online’ page that can be found here. Assessment and tailored rehabilitation are provided in accordance with best practice and evidence-based treatment to help you unleash your 'poletential'.

Until next time, train safe.

The Pole Physio

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References:

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2. Cleary, M. A., Sitler, M. R., & Kendrick, Z. V. Dehydration and symptoms of delayed-onset muscle soreness in normothermic men. Journal of athletic training. 2006 Feb 41(1), 36–45.

3. Hill J, Howatson G, van Someren K, et al Compression garments and recovery from exercise-induced muscle damage: a meta-analysis. British Journal of Sports Medicine 2014;48:1340-1346.

4. Dupuy O, Douzi W, Theurot D, Bosquet L, Dugué B. An evidence-based approach for choosing post-exercise recovery techniques to reduce markers of muscle damage, soreness, fatigue, and inflammation: a systematic review with meta-analysis. Frontiers in physiology. 2018 Apr 26;9:403.

5. Marqués-Jiménez D, Calleja-González J, Arratibel I, Delextrat A, Terrados N. Are compression garments effective for the recovery of exercise-induced muscle damage? A systematic review with meta-analysis. Physiology & Behavior. 2016;153:133-148.

6. Kuehl KS, Perrier ET, Elliot DL, Chesnutt JC. Efficacy of tart cherry juice in reducing muscle pain during running: a randomized controlled trial. Journal of the International Society of Sports Nutrition. 2010 Dec;7(1):17.

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9. Smith B, Hendrick P, Smith T, Bateman M, Moffatt F, Rathleff M et al. Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis. British Journal of Sports Medicine. 2017;51(23):1679-1687.

10. Brosseau L, Taki J, Desjardins B, Thevenot O, Fransen M, Wells G et al. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs. Clinical Rehabilitation. 2017;31(5):596-611.

11. Hickey J, Timmins R, Maniar N, Rio E, Hickey P, Pitcher C et al. Pain-Free Versus Pain-Threshold Rehabilitation Following Acute Hamstring Strain Injury: A Randomized Controlled Trial. Journal of Orthopaedic & Sports Physical Therapy. 2019;:1-35.

12. Silbernagel K, Thomeé R, Eriksson B, Karlsson J. Continued Sports Activity, Using a Pain-Monitoring Model, during Rehabilitation in Patients with Achilles Tendinopathy. The American Journal of Sports Medicine. 2007;35(6):897-906.