Training With Pain

The title of the post can lead to misleading. What I want to explain today is what happens if we perform a workout with pain. The ideal is to always train without pain as we will see now.

Patients who have gone through knee surgery will quickly understand what I am going to tell. I take this example because it is very frequent and almost all of us have experienced some case up close. After being operated on one knee we have to train the muscles because they have become very loose. The most visible and striking is the quadriceps, which is the muscle we have in the front of the thigh. It is easy to see that the muscle has lost strength when comparing the thigh to the healthy side.

Classically this lack of force was blamed on disuse. The abandonment of the exercise, the bedding and the days that we limped believed the factors that made the muscle lose strength and volume. Today it is more than clear that this is not the main factor. The culprit of loss of strength is a mechanism mediated by pain receptors. That is, our knee is damaged, our body detects it and there is an atrophy of the muscles surrounding this joint. Atrophy involves loss of strength and endurance capabilities in the muscle. The aggression that surgery involves for the knee will set in motion this mechanism. We do not have to notice the pain. When I speak of pain I mean that the receptors of our body detect damage, not just the pain we can feel.

Training With PainIn the knee the usual is to do an arthroscopy (we put a camera to see inside the joint). Once inside, the lesions of the menisci can be repaired, for example. In more aggressive surgeries, such as the reconstruction of an anterior cruciate ligament, the atrophy is greater. To many you will hear cases of players with injuries to the knee. The best known case was that of Ronaldo. Not that of now, the one that was in Real Madrid and Barcelona a few years ago. These players take an average of 7 months to return to play a football game. It’s flashy, right? We are accustomed to miraculous recoveries of these super-athletes with all the medical means at their fingertips. However, it takes many months to recover. The reason is in this mechanism that we have spoken.

The mechanisms by which this phenomenon occurs are not known with exactness, much less how to avoid it. The cost to the person and society is enormous. This mechanism makes recovery difficult and sometimes leads to chronic pain. The more aggressive the surgery or the damage that occurs, the greater the muscle atrophy.

This mechanism occurs in the same way in the back. We do not see it as well because the muscles of the back are behind and surrounded by tissues that hide it; They are not appreciated like those of the leg. A back that hurts or is operated on undergoes this process of muscular atrophy; Especially at the level of the extensor muscles, such as the famous multifidus. I have set the example of elite athletes with their knees so you understand how difficult it can be to regain normality after a major injury. And not only this, it also affects muscle training.

During muscle training the goals are clear: We want to gain strength and endurance. Occasionally, there will be exercises that will produce pain. At other times, we will notice pain when we have been doing the same exercise for a long time. Here we are in doubt whether we are doing the right thing. Well, if we provoke pain during training, the muscle will not develop, it will not grow. Having some discomfort when starting an exercise or at some times is not important, but we must avoid the pain.

If we do an exercise that produces pain, we must suspend it and look for another. If we have pain when walking for 30 minutes, we should walk less time. It will not do any good to have walked if we hurt because the muscle will not improve its capabilities. Performing the right type and the right amount of training, as well as respecting rest times, is critical to proper recovery.

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