The old school idea of "no pain, no gain" is outdated and stupid. However, the pendulum has swung too far back in the opposite direction - a lot of people now are overreacting to pain. It is unrealistic to expect to not experience any pain when lifting.
If you want to make it very far in powerlifting, or any other strength sport, you need to have a greater understanding of what pain is. This article will cover that, as well as tips on how to identify if it's a real issue/injury or just insignificant pain, and how you should think about and respond to pain as a lifter.
Section 1: What is Pain?
Most people think of pain as being synonymous with an injury, or that it inherently means something is wrong, but that is not the case. You can have pain without physical damage to tissues (an injury). To understand why that can happen, we need to discuss what pain is and why it happens.
Pain is a sensation created by the nervous system as a response to inputs, like pressure, temperature, etc. It’s intent is to be a warning - to steer you away from anything that may be dangerous and keep you safe. Therefore, the cause of pain is the perception of threat, not necessarily injury.
Sure, when you're injured you experience pain because your body perceives threat, both during the incident and afterwards while that area is compromised and your body wants you to be cautious so as to not make things worse. However, pain and injury are not synonymous. Your body can have the perception of threat without having an injury or tissue damage. For example, if you are doing a new exercise and you’re in a new position that you don’t often train, or you’re loading a movement way more than you’re used to, it is easy to see why your body may perceive these as somewhat threatening. That could then result in you experiencing pain, but that doesn't necessarily mean you did anything wrong or that you hurt yourself.
This is where "insignificant pain" (the idea that you can have pain without injury or anything being wrong) comes in.
Section 2: Identifying Pain vs. Injury
So how can you tell if there’s actually an injury or if it’s just some insignificant pain?
This is not intended to be medical advice, simply educational. But the reality is we all experience pain, and sometimes it can be hard to tell if it is significant or not, so this is just a list of things to consider when making that evaluation for yourself. That decision isn't intended to be made based on any single factor either, but rather a combination of them leaning in the direction of significant or not. When in doubt, you should check with your doctor as soon as possible.
Considerations
How serious is the pain on a scale of 1-10?
1-3 is a lower likelihood of significance, but a 4 or higher is more likely significant.
How quickly does the pain clear up?
If it stops within 1-2 hours of the activity, there's a lower likelihood of significance. If it lasts for 24-48 hours afterwards, there's a more moderate likelihood. If it lasts more than 48 hours/2 days afterward, then there is a higher likelihood. *Please note that this is not referring to normal delayed onset muscle soreness, which is expected to peak around 24-48 hours after training.
Did the pain start from doing a new movement or one that was possibly progressed too quickly recently?
If yes, there's a lower likelihood of significance.
Does the pain keep recurring every time you do the exercise?
If still yes after more than about three weeks of regularly doing the movement, then that is less likely just insignificant pain from a new stimulus. There is a higher likelihood that it is significant, that you are performing the movement poorly, and/or that the exercise isn't a good fit for you.
Red Flags
These are factors that are a much stronger sign that something significant has happened, you may be injured, and it is worth getting it checked out by a professional.
Do you have a generalized feeling of doom/something is wrong?
If yes, high likelihood of significance.
Does the area not look or function normally?
If so, definitely significant.
Was it accompanied by a loud (audible by others) popping sound or an internal squelching sound, along with sudden abnormal sensations?
If yes, high likelihood of significance. Tissues can make these noises when they are seriously injured, like a torn muscle or tendon. *Please note that occasionally your joints can pop or crack without it being concerning - such as cracking your knuckles. This is called joint cavitation, but this isn't what we are referring to.
Is the pain radiating to other body parts or shooting down the legs?
If yes, high likelihood of significance.
Did you lose bladder or bowel control, or feeling/ability to move in a body part?
If yes, definitely significant.
Again, when in doubt please contact your doctor. In the event of an emergency, call 911.
Section 3: How You Think About Pain
The previous sections are important because they lay the foundation for you to experience pain and not worry about it. If you understand that pain isn’t always an injury or problem, then you can simply acknowledge that you feel it, logically decide if it likely is or isn't an issue, and then carry on with your life.
This is especially powerful because how you think matters for how you feel. If you think that the pain is a big deal, worry about how it will impact your training, fret over how long it will take to get better… all of these are just making it hurt worse. Anxiety, fear, and other negative emotions are strongly connected to pain. Pain isn’t just a physical thing, so your emotional state can amplify the sensation.
Not overreacting or freaking out is always a good first step when you are experiencing pain, and will help in the decision making process of evaluating its significance.
Section 4: What to Do About Pain
Most people’s response to pain is to stop moving that area until it eventually stops hurting on its own. While this "just rest it and let it heal" approach may be appropriate in some situations where there’s a serious injury, like a broken bone that needs to repair, that same approach should not be applied to insignificant pain. If there is no obvious injury, then generally the best course of action is looking for how you can keep moving the area in ways that make it feel better and better. This is the idea of desensitizing pain.
Since pain is largely a perception of threat, part of how you can clear it up and get back to feeling good/training normally is to desensitize the motions that hurt. For example, if bending your knee into deep ranges of motion under load is causing pain, then you can start out at a more moderate range of motion and/or more moderate load, to where it only hurts like a 3/10 pain or less. Then, do reps so it gradually starts feeling better.
In the early stages of desensitizing this pain, that may look like doing very easy isometric muscular contractions multiple times per day. You can do them frequently because these are not hard, stressful activities that require much to recover from. Plus more frequent exposure to them will further help in desensitizing the pain. As it improves, the rehab starts to look more and more like regular training till nothing makes it hurt anymore.
I would also recommend modifying your training only as much as is needed in response to pain. For example, if you were planning a set of three reps on squat at RPE 8, I wouldn’t just remove the squat and replace it with something totally different like a leg extension. I would stick as closely to the original plan as you’re able. I would first try just modifying one or two variables. For example, if you experience pain in the bottom of the squat, you could reduce the range of motion by squatting to a high box, then work to gradually lower it each session till you were back to full depth. Alternatively, if you had pain at heavy weights, you could add a tempo (4 count lowering and 2 count pause) to your squat, so you can reduce the weight but still push hard like the RPE 8 that was planned. Tempo, range of motion, and how the exercise is loaded (e.g. front squat instead of low bar back squat) are all variables that you can alter rather than just removing the exercise.
Section 5: Injury Risk
On the topic of lifting and injury, I think it is important to remind people that despite what most common folk think, lifting is extremely safe. It is one of the only sports where you are in control of the amount of stress on your body and there's not a changing/dynamic environment to respond to. It is the same thing over and over, and you choose both the quantity and the loads.
Lifting being very safe is supported by meta-analyses of injury rates in sports. “The injury incidence in weightlifting was 2.4–3.3 injuries/1000 hours of training and 1.0–4.4 injuries/1000 hours of training in powerlifting” (Aasa et al., 2016). Let's compare that to other sports. Prieto-González et al. (2021) reported soccer had 7.21 injuries/1000 hours and basketball 4.31 injuries/1000 hours.
So while pain is not uncommon with lifting, injuries are fairly rare. Don't be scared away from strength sports.
Conclusion
As a lifter, it's important for you to understand that not all pain is significant, and that pain doesn't necessarily mean you're injured or did anything wrong. Not overreacting to every little pain or niggle will be necessary for you in the process of achieving your best performance. Also, remember these tips on how to identify if the pain is significant or not, and how best to respond to pain, or else save this page as a reference to come back to when you need it.
If you have an injury or pain that you want help with, then I would highly recommend working with Dr. J’aime Goguen-Locke! She is a clinician that works almost exclusively with strength athletes, so she is familiar with the types of issues we have, the stressful tasks we are trying to return to after rehab, and how to best get you back under the barbell as quick as possible. She works with Kodiak Barbell, and does online consultations so she is able to help anyone in the world.
P.S. I am not affiliated with Dr. J'aime or financially benefiting from this recommendation in any way. She is just really good at what she does, and I want more lifters to end up in good hands for their rehab needs!
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Best,
Michael Elrod-Erickson
Founder and Head Coach, Premier Power & Performance
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