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Understanding Pain and Injury Part 1

November 28 2017 Knowledge

Understanding Pain & Injury Part 1: When to see a healthcare professional

Guest post by Scott Symonds, MSc. Physiotherapy

If you work hard in the gym eventually you will experience waking up the morning after a WOD, whether it be a tough benchmark workout like DT, sprint intervals on the Assault Bike, or a max deadlift, with an ache or pain in our body that is concerning. You brain may immediately start spinning: “Ice or heat?” “Should I take pain medication?” or “Should I push through the pain?”  Experiencing pain can be stressful if you are unsure of the cause or consequences. This post should help you better understand what symptoms indicate that it is time to go see a healthcare professional rather than soldiering on.

Our experiences with previous injuries, knowledge of human anatomy and physiology, and lifestyle will impact how we assess the situation. The simple answer to the question “can I workout” is yes, CrossFit can be modified and adapted regardless of your physical limitations and restrictions. The Ironstone coaches will be happy to determine an appropriate modification to the workout if you find yourself in this situation. That said, if an ache or pain persists for hours or days you may find yourself wondering if you should seek medical advice or treatment from a healthcare professional. Although there is no gold standard classification system that can be used to label you as ‘injured’ or ‘healthy’ the information below can guide you in deciding which course of action to take the next time you are debating if an ache or pain you are experiencing is just that or is the symptom of a bigger issue, such as an injury.

Pain as an indication of injury

The next time you have an ache or pain that is persistent consider the following 4 indicators:

Pain description

Pushing yourself to your limits while giving it your all during a WOD can lead to feeling sore afterward. You may even find yourself masochistically bragging to fellow members, family, or coworkers about not being able to tie your shoes without being fully aware of every muscle fiber in your hamstrings.This is normal, and it is called innocent soreness, a low grade tight, stiff, tired feeling. Although every step may be agony, it is surface level and often appropriate stretching or a good warm-up will help resolve the tight, stiff feeling. Innocent soreness will leave you with a muscle that fatigues faster than normal, so it will not be the best state to attempt a PR, but further exercise is unlikely to cause injury. Injury pain, on the other hand, is sharp, electric, well-defined to a specific area, throbbing, and sensitive. An attempt to warm up or stretch the related muscles may not improve your symptoms or may cause further damage, depending on the extent of the injury. Innocent soreness typically falls low on the Pain Scale ( <3/10) whereas injury pain tends to be greater than a 3/10. Additionally, innocent soreness is felt when the muscle or tissue is contracted or put under load (e.g. climbing the stairs). In contrast, injury pain can be felt both in the presence or absence of mechanical load on the tissue (i.e. sitting still, laying in bed).

Associated symptoms

Injury pain has several associated symptoms such as bruising, swelling, and redness, numbness or pins and needles, tenderness on touch, and altered movement patterns. Paraesthesia or altered movement patterns, such as leaning to the unaffected leg during a squat, are big indicators for tissue damage. Innocent pain would not have any of the above associated symptoms.

Symptom duration

Delayed onset muscle soreness (DOMS) is likely the most popular type of innocent soreness CrossFitters experience. It is the result of microtrauma to the muscles being exercised which usually presents as soreness 1-3 days after the workout. Innocent soreness should not last longer than 3-6 days and you should experience a marked improvement in symptoms 1-2 days after onset. Injury pain persists much longer, usually weeks to months, and the nature of the pain and associated symptoms can vary from day to day depending on how well an athlete is doing with pain management.

Physical function

Innocent pain will likely cause you to move a little slower while completing your normal morning routine, or lead you to stretch a little longer before starting the daily WOD, but it should clear up relatively quickly (3-6 days). You will have difficulty achieving previous benchmark numbers in the gym and may even cause you to debate whether you should exercise or not. However, if you find yourself routinely skipping classes, modifying movements heavily, or you are significantly under-performing based on your individual ability than you are likely experiencing injury pain. The same can be said for home or work; if you find that the pain has persisted for several days and has caused ongoing decreased work performance or has limited the tasks you can perform this is a sign that the pain is not innocent in nature and should be addressed.

At the end of the day we CrossFit to improve our fitness level which is reflected in our abilities at home, work, and other components of our life. To put it frankly, we are training to improve our lives and if pain interferes or inhibits that success, we’ve missed the mark in our training.

If you read the above and find yourself nodding to  the indicators of injury pain frequently, it’s time to see a health care provider and get a care plan in place. Catching an injury early can be the key to a timely recovery. If you have doubts, schedule an assessment rather than waiting to see if your symptoms will subside – your body and your mind will thank you for it. 

If you want to be proactive consider booking a mobility assessment to help uncover what some of your week points might be and ways to correct them or regularly attending mobility class. If you find yourself in need of a healthcare referral the team would be happy to provide you with one depending on your issues. Talk to a Staff member early and make an appointment!

Scott Symonds, MSc. Physiotherapy

Physiotherapist, Young Kempt Physiotherapy

Ironstone Member & Intern. Coac