Train Hurt or Go Home! (or should you?)

No matter how careful you are in the gym, sooner or later you will be faced with some sort of achy extremity or throbbing appendage.  What you learn next could redefine how you train during injuries.

I got caught in an arm bar last Monday night at the Forge, where I am learning mma.  Yes, apparently I suck; however, after being caught in this rather precarious maneuver,  I thought my elbow had been broke.  Not so much from my arm going numb, or the excruciating pain in my elbow and shoulder, but mostly because of the huge tearing sound that made my opponent let go and say “did I break it”.  Not exactly what you want to hear.  Now the critical point… Am I just “hurt”,  or am I “injured”.  If I’m hurt but not injured, should I continue fighting or should I rest?  How do I know?

Let’s define the difference between hurting and injuring your body.  Here is my own rough definition:  when you are “hurt”, your body has sustained some sort of benign pathology, or an ouchee, that is sensitive to movement or touch.   The integrity of the tissue is usually not compromised to the point where continued movement will cause more or excessive damage to itself or surrounding tissue.  In other words, you’re ok; it just hurts like a bitch.  And then… and then… there is injury.  I don’t like any of the definitions I googled, so let’s look at some cinnamon’s (ha-I crack myself up) destruction, ruin, impairment, mischief… If tissue is destroyed or ruined, it could be said to be “injured”.  I’m not Webster, but let me make this clear.  When part of your body is compromised to the point that further use is unavailable, or attempting to use said body part may cause more damage, I would define this as an “injury”.  Now knowing these terms, how do we distinguish between being hurt, and being injured, without diagnostic equipment like an X-ray or MRI, or one of those cool scanners that “Dr Bones” had on Star trek?

To determine if you are injured or just hurt, in most cases, you can do a quick field assessment to get a rough idea if you should continue training/fighting/playing.  You must take into consideration your pain threshold when assessing your status.  For instance, if you’re like me, you could have a paper cut and think you need stitches or, on the other end of the spectrum, be like my father in law who could have a bone sticking out of his leg saying, “it just a little bump”.   If the pain was acute from a blow or a spasm, or a movement you just did during exercise, you may need to rest at least a day, as pain, adrenaline, and activity can mask your diagnosis.  Even if the incident is acute, you can still use these principals as long as your better judgment prevails.  This assessment is most accurate for a potential injury sustained over time, when the origin of when the pain began is rather ambiguous.  Usually if you sustain an acute, “potential injury” during training, it is usually best to stop the training session at least for the day, observe the pain pattern, and -of course- ice immediately.

If you find yourself hurting, and wanting to determine if you should train through the pain or not, try these simple rules…

  1. If the pain subsides with rest and continues to improve, you may not need to go to your physician.  If the pain worsens or remains exactly the same for longer than 4-5 days, it would be prudent to seek medical attention.  No matter how minuscule, if the pain decreases at all,  you might be able to continue training with modifications
  2. Establish if you have maintained full range of motion.  Decide with each movement if the pain decreases, increases, or stays the same. If the pain does not increase with each rep, continue to train but modify and decrease your intensity. If you do not have full range of motion,  train in the range you do have, as long as the pain doesn’t worsen throughout your training session.
  3. After training lighter and or modifying movements, decide if the compromised tissue is exacerbated immediately after training or throughout your day.  Did training aggravate it, if so, try to modify your movements further during your next training session.
  4. Upon waking up the next day, is it better, worse, or the same?  If the area is stiff but not worse, then you may be able to continue to train with modifications and with decreased intensity.  If it is better, you may want to slightly increase your intensity or range of motion.
  5. Continue to increase your range of motion, resistance, and intensity as the involved area continues to feel better.  It’s a slow process, but conservative measures will rehab the area and allow you to continue to train.

Please don’t be a douche-tard1 and take this to extremes.  I am only trying to give helpful hints so people serious about training can continue with some sort of confidence.  It is not the most conservative method out there, but it is a realistic approach for most of us who want to train hard or go home…

Pfiesterism1 (douche-tard) an insecure,  argumentative,  know it all ,that refuses to see the big picture due to a narcissistic tendency to be a complete and annoying ass.

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About Steve Pfiester

Certified CrossFit, TRX, Kettlebell Athletics Trainer with a B.S. in Physical Therapy. Owner of Longevity Max Fitness and BCx Boot Camp.

Posted on December 25, 2011, in INJURY PREVENTION, PFIESTERISMS, PFIT TIPS, RATED M and tagged , , , , , , , . Bookmark the permalink. 8 Comments.

  1. well…I dont wanna be a douchetard!
    and while for the last 2 weeks i’ve modified my workouts to only have the chiropractor screw me up more than I was to begin with…I’m going forward and pushing through the pain and going back to doing it my way! lol
    is this smart? who knows…
    but I’m going nuts and I’m in pain no matter what so may as well push on
    hmmmm does that make me a douchetard?

    • no way does that make you a douchetard. It takes way more than that. But we do have an anual vote for DT of the year, but that isnt till june. seriously, its ok to train through the pain unless each rep grows more and more painful. Especially if your pain tollerance is high, or if you are… haha
      please be careful… remember we train to be healthy and happy… injuries are neither and will eventually win out… just train smart sister!!!! ps. ICE ICE ICE

  2. Ugh, serendiptious that I found this blog post now when I most needed it. I’ve been pushing the bcx boot camp with a torn meniscus and each time I train I need 3-2 days off. Okay, upper body for me now. Hate it!

    • I too tore my medial meniscus and 90% tear in my mcl. Not training is not an option.. decide what you can do and try your best. Not every motion affects your meniscus. I was doing 5 pound, very limited leg extension, and just body weight limitid ROM ham curls, but here I am 4 months later and I am doing 20 pound ham curls and my quads are almost back to 75%… talk to a ortho doc and see what he will allow… go for it…

      • Thanks Steve. I needed to hear this. I haven’t stopped working out but I was being stubborn and doing things I shouldn’t have been doing and then suffering the consequences for days. I’m the first to say ‘listen to your body’, and the first to ignore my own advice. The advice coming from you though carries much more weight. I actually did Bonnie’s glute and ham workout today. I avoided the lunges and did bridges instead keeping in mind what you had said. Thanks again!

      • right on… thats the way to stick with it

  1. Pingback: Train Hurt or Go Home! (or should you?) « pFIT blog

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