Sometimes feeling pain during or after a workout is not a problem, but sometimes it is. Often, the question is What kind of pain can I ignore? 

The answer is straightforward; you should never ignore pain, but you should understand the difference between pain and discomfort, says Susan Ryan, DO, who is board certified in emergency medicine, has a certificate in sports medicine and has also been a team physician for professional, collegiate and Olympic athletes. The body is telling us something important and it is essential to listen. 

“Instead of saying pain is good or bad, let’s say pain just is,” Ryan says. “It’s the way your body is trying to communicate; the better you know your body, the more information that pain will give you.”

When pain is a signal from the body that something is not right, it is sharp and immediate. “Soreness is different than pain,” Ryan says. “Sharp pain is telling you a joint, a tendon or a muscle unit has too great of a demand.” She also says if you can’t do the same exercise without pain the next day, but continue to do it anyway, you are putting yourself at risk for injury.

“An ache that goes away after a warm-up and stretch is probably fine to exercise through, but an ache that persists or comes on after you exercise is a red flag,” she adds. 

Sports medicine experts at Johns Hopkins Medicine concur and explain that “some discomfort is part of athletic activities and is necessary for improvement of performance.” Johns Hopkins’ experts caution that discomfort should be short-lived and that “fatigue (for example) that lasts for days means the individual’s physiology has been excessively challenged, and this means that the muscles and the energy stores are not being replenished after exercise.”

The good sore

Many people view soreness during exercise as positive and believe that working out a muscle and feeling discomfort the next day means muscles are getting stronger. Ryan notes that to some degree, that’s correct. “In order to increase the strength of a muscle, you have to damage it a little,” she says. “You will break down the muscle a little bit, and the reparative process makes it stronger.” 

This “good” pain is often referred to as the “burn”—which is the foundational concept of the popular saying “No pain no gain.” 

“Muscle soreness typically occurs if you do a new exercise to which you are not accustomed or if you do a familiar exercise too hard,” explain the experts at Johns Hopkins. They explain that this can lead to delayed-onset muscle soreness (DOMS). DOMS is described in the scientific literature as muscle pain and tenderness that typically develops within 24 hours of exercising only lasting for a few days. The intensity and discomfort of DOMS typically peaks between 24 and 72 hours. DOMS does not refer to pain felt in tendons or joints. The Johns Hopkins experts warn that “swelling in a joint is a bad sign” and you may have to see your doctor.

What can you do?

As we get older, we don’t recover from exercise stress as fast as we used to. Nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen can help speed the reparative process, but can also cause gastrointestinal upset. Fortunately, there are safer alternatives.

Several published studies have shown that a topical homeopathic ointment known as Traumeel® works as an effective, all natural anti-inflammatory. A 2011 study by Christian Schneider featured in the International Journal of General Medicine compared Traumeel to NSAIDs and the author concluded “…Traumeel may be considered as an anti-inflammatory agent that is at least as effective (as NSAIDs) and appears to be better tolerated than NSAIDs.” 

Several studies have also been done on many of the individual ingredients in Traumeel which include Arnica Montana, Calendula officinalis, Echinacea, Symphytum, Aconitum napellus, and Mercurious solubilus. However, Schneider concludes, “…the effect of Traumeel was found to be greater than the sum of the active components, suggesting a synergistic interaction between all components of the preparation…” Arnica Montana, a popular natural ingredient used for muscle and joint pain, is also available in capsule form.

In addition to natural anti-inflammatories, experts recommend these natural alternatives to reduce soreness:  

• Water. According to a 1999 report by Susan M. Kleiner, PhD, featured in the Journal of The American Dietetic Association, “it is well established that dehydration of as little as 1 percent decrease in body weight will impair physiologic and performance responses during continuous exercise.”
• Massage. A 2005 study published in the Journal of Athletic Training demonstrated that massage was effective in alleviating DOMS by approximately 30 percent, and it also helped reduce swelling.
• Reducing intensity and duration of exercise for one to two days, and targeting less-affected areas of the body in your next workout. But Ryan says that you shouldn’t skip a workout if you can help it because exercise can alleviate pain by breaking up tension in sore muscles.
• Stretching, both before and after exercise has been shown to help ease pain.
• RICE (Rest, Ice, Compression and Elevation)

Listening to your body is extremely important during exercise; ask yourself Is this discomfort or pain? Take the time to listen to the response.

Avoid the “bad” pain

Ryan says these simple steps can help you exercise without pain: 

• Strengthen your core. Developing abdominal and back muscles—your core—helps reduce risk of injury. “It doesn’t matter how strong an individual muscle is—if they don’t all work together in sequence and fire at the right time, you will have increasing demands in areas that aren’t supposed to do the work,” says Ryan.
• Increase gradually. As a general rule, Ryan says you shouldn’t increase activity difficulty more than 10 percent each week, because the body can’t handle much more.
• Practice mindful exercise and listen to your body. Don’t tune out while you’re exercising; instead, pay attention to the valuable information your body is giving you. Take a moment and ask yourself Have I overdone it? Is this an uncomfortable feeling I had before I did that exercise? “If you’re experiencing more and more discomfort from an activity and you continue to do it, you are not paying attention to your body communicating to you,” Ryan says.
• Focus on mechanics. “People have always said practice makes perfect, but really it is perfect practice makes perfect,” Ryan says “You need to practice the right way.”

While your reasons for exercising may change, your mechanics should not. “When you’re young, good mechanics in exercise are about your team and the sport you’re playing; as you get older, maybe exercise is for social reasons or weight management. As you start shifting into your 50s and 60s, you’re thinking about preserving your metabolism and bone density, and then as you shift into your 80s, it’s about keeping you from falling and keeping you independent,” she says. “But what people forget is it’s the exact same mechanics; nothing changes. It’s still a balancing act between strength training, cardiovascular training, flexibility and balance work.”