10 Ways to Tell Good Pain From Bad Pain
Oct. 04, 2017
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Pain may start as a minor tweak or a twinge. At first it may hurt only when you move a certain way, but it soon morphs into a chronic pain. From knees to shoulders to elbows to ankles and every other body part, an active lifestyle makes it likely that you’ll experience inexplicable aches or pains. Figuring out when it’s safe to work through the pain or when to stop and see a doctor can be difficult. “Pain is a protective mechanism to avoid damage,” says Steven Gausewitz, M.D., Chief of Staff at Hoag Orthopedic Institute in Irvine, California. “Whenever you have substantial pain, it’s a sign you’re doing too much or doing it too fast.” We’ve compiled the most common workout pains and explained how to tell the difference between those you can work through and those that may be damaging.
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Ankle Strains and Pains
From landing awkwardly during squat jumps to twisting unnaturally in Zumba class, your ankle often pays the price for missteps. This can cause mild to severe sprains of the ligaments on the ankle’s exterior. For any sprain, avoid walking on it and treat it with rest, ice, compression and elevation. If it’s simply sore, it may be due to tendonitis, says Gausewitz. “Rest and ice it. You can’t really work through it.” Biking, rowing and swimming are better choices than weight-bearing exercises. SIGNS OF A BAD PAIN: If you can’t keep weight on your ankle, see a doctor for X-rays, says David Geier, M.D., an orthopedic surgeon in Charleston, South Carolina. “This is especially important if combined with tenderness felt when touching the bone on the outside of the ankle, which could indicate a fracture.”
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Knee pain can occur suddenly or begin as a crunchy sound and turn into a chronic ache that hurts while climbing stairs. “For the most part, knee injuries are rarely an emergency unless you’re lifting heavy weight and tear something,” says Dr. Gausewitz. Pain while walking down stairs, for example, is often due to patellofemoral problems, during which you feel discomfort behind the kneecap and a grating sound in the knee if the leg is extended straight. You can work through it by avoiding exercises that trigger the pain (such as lunges and deep squats) and modifying exercises such as squats by squatting only within a pain-free range of motion. SIGNS OF A BAD PAIN: Hearing a pop at the time of the injury, significant swelling within the knee or buckling or locking of the knee can indicate a serious injury and should be checked by a sports-medicine doctor, says Dr. Geier. “These symptoms indicate a possible torn ligament or meniscus tear.”
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Hip pain should never be ignored. The location of hip pain helps suggest the cause, says Dr. Geier. “Pain felt in the groin usually comes from the hip joint itself (the ball-and-socket part of the joint) or the femoral neck (the top of the leg bone).” Repetitive activity can cause bursitis and pain on the outside of the hip, and a pain in the buttocks may be nerve-related or result from a lower-spine condition. SIGNS OF A BAD PAIN: One worrisome symptom with hip pain often occurs in both young and perimenopausal women engaging in long-distance running, says Dr. Geier. “Pain in the groin that increases toward the end of a run, especially if it is coming on earlier and earlier and taking longer to go away, could be a sign of a stress fracture in the femoral neck.” This injury may require surgery and should be checked by an orthopedic doctor.
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Pain, stiffness or discomfort in the lower back can happen even if you’re not a regular exerciser, but it’s more common in athletic people. “It is often a muscle strain,” says Dr. Geier. For mild pain, avoid exercises that make the pain worse, such as incline treadmill workouts (keep it flat), bent-over rows (do seated rows), high-impact aerobics and overhead shoulder presses. Simple treatments like rest, ice and stretching are often enough to resolve the pain. SIGNS OF A BAD PAIN: Pain accompanied by nerve symptoms such as numbness or tingling down the leg and weakness indicate that a herniated disc may be causing pressure on a nerve root. Dr. Geier urges seeing a doctor immediately if you experience these symptoms.
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Mid-Back and Upper-Back Pain
Lifting weights and feeling a twinge between your shoulder blades may simply be a sign of bad lifting technique. Lifting too quickly can also cause a tweak of the spine, says Dr. Gausewitz, “although sometimes neck problems create referred pain to the shoulder blades.” Be sure you’re using the correct weight to allow you to perform your repetitions with proper form. SIGNS OF A BAD PAIN: See an orthopedic sports doctor if you experience sharp, stabbing pain or have difficulty breathing, says Dr. Geier. “It could suggest a more serious condition, such as a thoracic herniated disc.” In some cases, pain between your shoulder blades may be a sign of a heart attack. If you’ve never experienced this sensation and it is accompanied by chest pain and breathlessness, call 911 immediately.
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If you feel pain in your shoulder or a sudden heavy catch or snap while lifting something overhead, you may have strained or injured the rotator cuff muscles responsible for stabilizing the shoulder. “It may start out as a simple impingement syndrome, one of the most common causes of shoulder pain,” says Dr. Geier. This occurs when the shoulder blade puts pressure on the rotator-cuff muscles. Arthritis or bursitis may also be behind the pain. For simple strains, ice, avoiding overhead activities, anti-inflammatories and cortisone injections usually resolve the problem. SIGNS OF A BAD PAIN: If your shoulder feels as if it’s coming out of the socket or you experience severe pain and swelling, you may have a tear or other serious injury and should be evaluated by a doctor. Some cases may require surgery.
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Achilles Tendon Pain
Jumping around on your toes in aerobics or high-impact classes can cause pain in the Achilles tendon. This is the largest tendon in the body and connects the calf muscle to the heel. “Most ‘good pain’ refers to a muscle that gets sore,” says Dr. Gausewitz. “Any pain around a joint that’s around for a few days is normal.” If you notice pain and swelling near your heel that worsens with activity, you may have Achilles tendonitis. Ice, rest and stretching the calf muscle will help. SIGNS OF A BAD PAIN: Swelling and symptoms that worsen with walking, especially uphill or on uneven surfaces, may be signs of a partially torn Achilles. Other signs may arise while walking on stairs, running, jumping, hopping or when performing heel raises. See a doctor immediately -- delaying treatment can result in a shortening of the torn tendon. Surgery may be required.
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Even if you’ve never played golf or tennis, pain on the inside of your elbow, called golfer’s elbow (medial epicondilitis), and pain on the outer elbow bone, called tennis elbow (lateral epicondilitis), are common overuse injuries. A muscle weakened from overuse can develop microscopic tears in the tendon resulting in inflammation and pain. Resting the arm, anti-inflammatories, changing your grip and using a stiffer tennis racket can help, says Gausewitz. SIGNS OF A BAD PAIN: Your doctor may recommend surgery for extreme cases if the pain does not improve with traditional treatments after six to 12 months.
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If you feel pain in the middle of your heel or along the arch while running and it’s particularly painful when you first step out of bed in the morning, you may have plantar fasciitis. This inflammation of the connective tissue that runs along the bottom of your foot occurs on the underside of the heel and increases the risk of knee pain over time. “It can take a long time to get rid of,” says Elizabeth Matzkin, M.D., assistant professor in the department of orthopedic surgery at Brigham and Women’s Hospital in Boston. If you suspect plantar fasciitis, avoid speed work and hill training. Massage, anti-inflammatories, supportive footwear, and ice can also help. “Flip-flops offer zero support and can contribute to plantar fasciitis symptoms,” says Matzkin. Take preventive measures by gradually increasing training mileage, replacing worn running shoes and running on soft surfaces instead of asphalt or concrete. SIGNS OF A BAD PAIN: If the pain lasts for more than a few weeks, see a sport podiatrist. Treatments include orthotics, cortisone injections, splints and anti-inflammatories.
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If you run the same route every day or recently took your run from the treadmill to the asphalt, your shins may become painful. Pain may start in the front of your ankle and continue up to your kneecap in some cases. Shin splints can cause pain during your run as well as afterward. Shin splints refer to an inflammation of the bone usually caused by overuse. Decrease your mileage at the first sign of shin splints -- they could lead to a stress fracture if left untreated. Ice, rest and anti-inflammatories help. SIGNS OF A BAD PAIN: If, after modifying your mileage, icing and resting, the pain does not decrease or subside, seek medical attention. In some extreme cases, shin splints manifesting as severe stress fractures may require surgery.
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