Troubleshooting Pain with Exercise
Most seasoned lifters or athletes have experienced some pain or discomfort with exercise.
Fear of injury can be a large reason people don't engage in strength training despite it being one of the best things you can do for your health.
If you do experience some pain or discomfort with an exercise the important thing is that you don't stop, you figure out what to do instead.
Follow these steps to troubleshoot exercises to see if you can find something that is more comfortable so you can continue training and make gains without aches and pains.
Change the Grip, Stance, or Placement
Sometimes all it takes is a slight modification in the exercise set-up to make big changes to how a movement feels. Before you totally change the exercise, try alternating your stance or grip by an inch or two.
Pain in the wrist, elbow, or shoulder with bench press? Try a close grip bench, reverse grip bench, or swiss bar bench.
Pain in the back, hip, or knee with squats? Try moving from low bar squatting to high bar squatting.
You would be surprised how great things can feel with these small changes. In seconds, a painful and concerning exercise feels great and you're back on the gain train.
Modify the Range of Motion
Exercising within your body's most full range of motion is definitely important. No half reps allowed. But, sometimes this technique is an excellent way of making a painful exercise more tolerable. The key is to slowly increase the range of motion back to the full lift.
If your shoulder hurts when you bench through a full range of motion (bar to chest), try benching to a board, performing floor presses, or performing benching off the pins in a power rack. You can eliminate the painful range of motion while still training the press.
This is exactly how I returned to bench pressing after years of pain from a traumatic shoulder injury. Here is me benching 300# using a 4.5-inch block recently. I am now back to the regular bench press with no issue.
Here's a link to the bench block I use.
For squats, try box squats or pin squats just above where you would normally experience discomfort.
Lifting off small blocks or doing rack pulls are great ways to do the same for barbell deadlifts.
The same idea here is to slowly do larger ranges of motion until you are back to the real deal.
Change the Stimulus; Keep the Pattern
Another way to relatively unload in times of pain is to change the way you are doing the lift without having to totally remove it from your program.
If you are having back pain pulling from the floor in a deadlift, you can try to swap your pulls for a few weeks with a high handle trap bar.
For many, this change in range of motion and weight displacement will be different enough to not cause any pain or discomfort but still keep you moving in the right direction in terms of reaching a training goal.
A front squat can be swapped with a back squat for a similar reason. This is still a squat, but the loading and the stresses that are placed on the body are different enough to allow for pain-free training.
I have worked with many people who say they cannot squat or lunge because of knee pain, but a front foot elevated split squat feels great.
Sometimes you have to be creative with these. Just think, what muscle am I training? What movement am I training? What else trains those things? Probably 100 exercises... a good coach will know what to do.
Take a Total Deload
This is the least favorite option for most trainees but works wonders.
Most of us are hitting the gym because we love training and want to get results. Taking a few weeks off is not always a viable option for our own sanity and for reaching aesthetic or performance goals.
In fact, full rest is seldom the answer to managing non-traumatic pain or injury.
Instead of total rest, try to take a deload from your current program. There are three ways I like to program a deload.
The first is by cutting volume. Let’s say your program calls for 4 x 8 squats with 1RIR on each set. That’s a hard squat workout. The deload week would only be 2 x 8 with 1RIR. The volume was cut in half but the intensity remains high. The next step is to cut volume and intensity. This deload week would be 2 x 8 with 3RIR. Finally, a total deload from a structured program means do whatever you want and what feels good in the gym. This week may be a 3 x 10 on the hack squat; or just going for a hike and not stepping foot into the gym.
Final Notes on Managing Pain
Pain and injury are complex parts of training, sport, and life that should be dealt with on an individual level. There are many factors that contribute to pain and injury in and out of the gym including rapid increases in training volume and intensity, stress, poor sleep, etc. While most non-traumatic injuries can be worked around in the gym and will resolve spontaneously in just a few days or weeks, sometimes we should get things checked out.
Follow this checklist about when to consult a healthcare professional about your pain or injury: 1. Pain that was related to trauma (slip and fall, car accident, dropping a weight on your foot, getting hit with a baseball bat, etc) 2. Pain that does not improve with rest or altering activity 3. Pain that is accompanied by other symptoms like headaches, vision changes, numbness or tingling in the limbs, pains in your chest, trouble breathing, or loss of bowel/bladder control. 4. Severe pain that is present constantly and interferes with your life beyond just making some exercises difficult.
Our bodies are incredibly resilient and strong. Given the opportunity, we can adapt to most things when given ample time to recover. Let your body recover by implementing some of these load management strategies when you are in pain OR use some of them before you ever experience pain to help give yourself exposure to a wide variety of physical tasks and develop great, general adaptations to loading.
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