What Kind of Pain Is OK to Train Through?

“How do I know what pain is OK to train and race through and what might be injuring me?”Timothy Triage

We hear slogans like, “Pain is temporary. Glory is forever,” and I often see highly motivated, driven, results-oriented athletes (sound familiar?) who are concerned they are hurting themselves by ignoring pain while training. You might have a goal race coming up, or you might simply be worried about losing hard-earned fitness by taking time off What’s the best thing to do? Soldier on or become a couch potato?

You have to understand the difference between acceptable pain (or just plain hurting) and injury. So how does an athlete recognize the warning signs?

The “old sports guys” used to say that 4/10 pain or less is safe to train through. Obviously, the issue here is subjectivity. Athletes who expose themselves frequently to intense training are more comfortable with being in discomfort, so a 4/10 for them is quite different than for someone new to sport. However, here are some red flags:

• Sharp pain within the bone that is site-specific, increases with pressure, and prevents the ability to single-leg hop may indicate a stress fracture.
• Sharp joint pain, particularly if there is instability
• Worsening pain that is not responding to RICE (Rest Ice Compression Elevation)
• Pain that lasts for several days. DOMS (Delayed Onset Muscle Soreness) should ease after a day or two following a hard training session.
• If you find yourself breaking form during training or notice that anti-inflammatories are your go-to yogurt topping, it’s probably time to seek medical advice.

Casey Maguire is a Los Angeles-based orthopedic physical therapist who has treated professional triathletes, cyclists, and multiple athletes in the NBA, NHL, NFL, and USTA. His focus is on functional biomechanics.