Am I Sore or Hurt? How to Know the Difference and Train Safely
Some days you might be on the verge of injury or overtraining and need to either back off the volume or intensity of your workout, or even forego it for active recovery instead. Whereas on many other occasions, you might simply be what some old-school coaches call “good sore,” whereby you still have some muscular fatigue and are perhaps a little tight from yesterday’s session but need to just gut it out and put in high-quality movement. So how can you know which scenario is which and, having made that delineation, decide what to do next? This is what this article is all about.
Pain is merely a check engine light popping up on the dashboard. It’s your body’s way of saying heads up, you should address this area. The intensity of pain perceived is not necessarily a good indicator of the extent of corresponding tissue damage. Learn more about pain science from the pain science master himself, Lorimer Moseley HERE.
Know When You’re Hurt or Just Sore
An experienced coach, physical therapist, athletic trainer, or training partner can help you determine when it’s time to push on through soreness versus times when you need to back off because you’re actually hurt. But I also believe that you can learn to self-evaluate. To help, here’s a handy chart:
|
Sore & proceed |
Hurt & get help |
|
A bit of discomfort & stiffness that lessens as you get moving or as you go through warm-up |
Significant discomfort & stiffness that increases as you get moving or as you go through warm-up |
|
Tenderness in soft tissue body areas that are bigger than the size of your hand and about the same on both sides of the body |
Tenderness in a very small or localized area. You can pinpoint the area with 1-3 fingers and it’s only on one side of the body |
|
Mildly uncomfortable tightness or stiffness in body areas that you worked 1-2 days prior |
Moderately uncomfortable tightness or stiffness that are not areas you recall working recently |
|
Less than 5/10 pain in a localized area or specific body part that feels better with movement or strengthening exercises |
Greater than 5/10 pain in a localized area or specific body part that gets worse with movement or strengthening exercises |
|
Pain on a bone or in a bony area that does NOT increase in intensity when you bear weight on it. |
Pain on a bone or in a bony area that does increase in intensity or makes you wince when you bear weight on it. |
|
Pain is described as dull, achey, stiff, tight, or annoying and it stays in a small and specific area |
Pain is described as sharp, shooting, searing, burning, zinging, radiating, pinching & uncomfortable catching in a joint, or unbearable and it moves, jumps, or increases in area and size |
|
Achey or stiff joint pain that gets better as you move and is NOT accompanied by instability of that joint |
Sharp, pinching, wincing joint pain that is associated with catching, locking, or instability of the joint |
|
No redness, discoloration, swelling, or heat is noted in or around the sore area |
Redness, discoloration, swelling, or heat is noticeable in or around the sore area |
Pain scale definition
- 10/10 = Brutal, lasting, and unbearable pain that is what you would expect from a dog bite, a fall from a bike at high speeds, or getting hit with a fastball on the elbow. Your first instinct is that you probably have to go to the hospital.
- 5/10 = Noticeable, temporary, and tolerable pain that is what you would expect from a mosquito sting, stubbing your toe, or bumping into someone unexpectedly. Your first instinct is “ouch, but I’m fine.”
Know Your Tissue (KYT)
To go one step further in your sore vs. hurt self-assessment, you could print out this concise chart:
|
Tissues that typically respond well to working through mild discomfort |
Tissues to take caution with when moderate discomfort is noted |
|
Tendons |
Bones |
|
Muscles |
Nerves |
|
Ligaments |
Meniscus |
*Rules from the Sore vs. Hurt chart above still apply.
Training Around a Hurt Body Part or Area
Keep in mind that you can typically modify your workout to stay off or away from an area that you have determined is a no-go. For example, if you’ve used the charts above and/or expert advice and determined that your knee is a no-go, you can often do deadlift and hinge variations for your lower body because they don’t require much from the knee. Additionally, you might try an isometric hold of a more knee-dominant exercise, like substituting a wall sit for a squat. Often a cranky body part is irritated by the dynamic movement of an exercise more so than the position. Furthermore, a split squat hold or iso variation could be tolerable and doable for your knee in this example if lunges are off-limits.
Additionally, if the off-limits area is an upper-body location, there are typically core and lower body exercises that are very doable. Alternatively, if the off-limits area is in your lower body, there are typically core and upper body exercises that you could perform. It’s almost always appropriate and realistic to do something instead of nothing if you’re responsible and a bit creative.
Red Flag Signs to Stop
If you make the choice to proceed with some kind of training, keep an eye out for the warning signs below and make the smart choice to slow down or even stop a session if you experience one or more of them. If you’re facing an extended layoff due to injury, use the section above to train around the hurt area as best you can. You can also take a hot bath, do extra mobilization work, play with your kids, or do another kind of light, fun activity instead. Then re-test the trouble spot tomorrow. Still a no-go? Then consult a physician, physical therapist, coach, or another professional who could provide some additional insight and guidance.
- Greater than 5/10 pain that is worsening as you go
- Pain increases in intensity and location in the 12 to 48 hours after your workout
- Redness, discoloration, swelling, or heat is noticeable in or around the sore area
- Pain is accompanied by joint instability
- Nerve pain that is increasing as you go and is described as lightning bolts, burning, or radiating
ABOUT THE AUTHOR
Tim DiFrancesco, PT, DPT spent 6 seasons as the Head Strength & Conditioning Coach of the Los Angeles Lakers and is the founder of TD Athletes Edge. He is nationally renowned for his evidence-based and scientific approach to fitness, training, nutrition, and recovery for athletes and fitness enthusiasts.