Whether you’re a weekend warrior or a high-level athlete, you have likely experienced muscle soreness after a tough workout. You may even wear that discomfort as a badge of honour, a sign that your body has been pushed to its limit. But what if those aches linger or turn into acute pain? How can you tell the difference between soreness and injury?
Athletes are known for their high pain tolerance, but anyone who exercises regularly can experience a shift in their ability to withstand discomfort over time. That can help you power through the final miles of a long run or a steep climb on your bike but “overtraining and pushing through pain can lead to more significant injury,” said Angus Driver, a physiotherapist at Toronto’s Adelaide West Physiotherapy.
Be honest about your pain
Fitness enthusiasts will often go through verbal gymnastics to avoid admitting they might be injured, referring to exercise-induced discomfort as “a twinge,” “a bit of a pinch,” or “a little niggle.”
I’m guilty of this as well: “some achiness” in my hip turned out to be three hairline fractures, a “tender spot on my shin” was actually a stress fracture and a “little impingement” in my shoulder proved to be a chronic injury. The cutesy names I gave those issues didn’t make them any less severe: Because I didn’t take action, all three turned into much larger issues that ultimately led to long periods of time away from working out.
“Distance runners are notorious for training through pain that could have easily been remedied with some early treatment,” said Driver. “I have seen several runners that are training for a big race with symptoms for months. By the time I see them, they can barely walk, let alone run, and often can’t do their event.”
Spotting injury early
It’s common to experience delayed onset muscle soreness (DOMS) after engaging in a new kind of workout, at the start of a new workout program or if you’re returning to exercise following a period of inactivity. That achiness or tenderness usually starts around 24-48 hours after a workout and can last up to five days. But if your soreness doesn’t ease after that period, if the pain feels localized to a specific point, or if you have swelling or bruising, it may be a sign of something more serious.
Injuries can be obvious, like when you fall or hear a “pop,” but they can also come on slowly as a result of everyday movements and become exacerbated by further strain from exercise. “People who spend a lot of time on computers and phones often develop joint restrictions in their lower neck and upper back,” said Driver. “These restrictions then lead to altered shoulder mechanics that in turn lead to impingement issues for the rotator cuff. So the spine is the culprit and the shoulder is the victim.”
When your body is trying to protect the injured area, it can shift the way you move both during daily tasks and while training. Even if the issue isn’t particularly painful, continuing those altered movement patterns over time can lead to worsening injuries and muscle imbalances. If you notice you seem to be favouring one side to prevent discomfort, or if your symptoms aren’t easing or seem to be getting worse with training, it’s time to see a medical professional.
While DOMS might make it challenging to climb into bed or grab something off a high shelf for a few days, worsening pain, swelling, stiffness and brown urine could be a sign of a more serious and potentially life-threatening condition called rhabdomyolysis, in which the muscle tissue degrades into the bloodstream and causes damage to the kidneys. Though it’s often associated with intense strength training, rhabdomyolysis can occur after any gruelling workout including spin classes and running and requires immediate medical attention.
When in doubt, rest and see a specialist
If you’re not sure whether your discomfort is a minor ache or a major injury, take a break from training and make an appointment with a medical professional.
“Generally, any pain that is persisting or getting worse should be addressed as early as possible,” said Driver. How much rest you’ll need depends entirely on your body and your injury. On average, tissue damage like ligament tears and muscle strains will heal in about six weeks if you allow for proper rest and recovery. More serious injuries like fractures can take around 12 weeks.
And remember: as much as we may delude ourselves about our discomfort with cute terms like “a little tweak,” when visiting a specialist, it’s important to be honest about your level of pain or discomfort so they can provide the appropriate care.
Alyssa Ages is a journalist and the author of Secrets of Giants: A Journey to Uncover the True Meaning of Strength. She is also a strongman competitor and endurance athlete, as well as a former personal trainer and group fitness instructor.