I get asked this question in the clinic every week. How much pain is acceptable when recovering from an injury?
Sharp pain is an indication that you need to stop activity. Dull aches are warning signs of something not right, especially if you experience stiffness with that dull ache.
In the initial stages of an injury, you will experience more pain and swelling. It generally takes 14 to 21 days to fully resolve the swelling in a muscle or joint injury. During that initial stage we advise our clients to use ice to reduce pain and swelling for the first week. As the swelling and pain settles down then you can start to use heat before your exercises and stretches and ice afterwards. After 2 weeks, if the soft tissue pain is reduced you can start to use heat only. Unless you push the tissue too hard during your exercise session, then you can use ice afterwards to calm down the area.
Our philosophy in rehabilitation is to work to pain, but not through pain. If you work up to pain and stop you will not damage the healing that has occurred. If you work through pain, you will cause more bleeding and swelling which will prolong your recovery. You must pay attention to how your injury part is feeling, do not ignore pain. When you are dealing with an injury the old philosophy of “No Pain, No Gain” does not apply. That philosophy is only when you have a normal muscle and you are trying to get it to grow by gently overloading it.
In rehabilitation it is more about getting the endurance back in the muscle tendon unit, before you start to overload the muscle for the strength gain. We often tell our clients to work up to 3 sets of 20 to 30 reps to get that fatigued tired feeling in the muscle, but no increase in pain, before we prescribe the next level of strengthening.
For return to activity, if you experience pain while participating in your activity, it is too early, if you experience some pain afterwards, then we can manage that. I often tell clients if you experience pain while playing a sport that is your body telling you to stop before you have a major injury. If there is no pain during, but muscle soreness afterwards we can manage that with ice, rest, and some rehab exercises to restore normal function in the muscle or joint.
In summary, when dealing with recovery, do not ignore pain, it is there for a reason to tell you that you are doing too much. You need to be patient with your injury recovery times and allow for full healing to occur before you get back to full participation in your sport or pastime you enjoy.
Blair Schachterle on behalf of the Nose Creek Sport Physiotherapy team.