The Pain Scale: Weight Loss, Discomfort & Pain

One of the expressions I really really hate hearing is “no pain, no gain,” as if in order to make any kind of progress, you have to hurt yourself! That seems a little counter-productive: “let me blow out my back lifting 150 lbs so I can have really great biceps!” I know that no one really thinks like that, but it does happen.  We’ve been told by countless trainers and fitness programs that we need to “push past our comfort zone” to make progress! Pushing past the Comfort Zone, yes; pushing into the Pain Zone, no!

Anyone familiar with the medical profession or even just medical shows is likely familiar with the Pain Scale: “on a scale of one to ten, ten being the worst pain you’ve ever felt and one being no pain, where is your pain at on the scale?” If you’ve had surgery or broken a bone, you are no doubt familiar with the scale numbers up past five, and if you’ve sprained a muscle or a joint, you are probably familiar with the numbers on the lower half too, but what isn’t on that scale is Discomfort. I really believe that we need to add that to the scale (maybe as – 1 or -2?) to keep people from confusing Pain with Discomfort.

Pain is usually sharp or stabbing or a deep ache because it’s our body’s way of telling us we have an injury! If you are out running or you are lifting weights and you feel a sharp pain in your arm, leg or shoulder and it hurts to use it, that is pain! If something starts swelling, like your wrist or ankle, or if it stiffens up, you have obviously injured yourself.  A tearing sensation is another indication that there is something wrong and that what you are feeling is really pain.

I can hear you thinking it: duhhhh! no-brainer! But before you click off the page, let me give you this scenario: you are working out with dumb bells and you do a lot of reps with a lot of weight and the next day, your shoulders and arms hurt a lot. Is that pain or is that discomfort? Obviously, your upper body is probably going to be a little stiff and really sore from the workout, but did you injure yourself? The only way to answer that question is how much pain you are in and how long it takes you to get over it.  Achy muscles aren’t really pain (injury): they are discomfort.  When you’ve been walking a lot and your legs and feet are tired or you have burning in your muscles from exertion, or even if you are a little short of breath and your heart is pumping, you are feeling Discomfort, not actual Pain. Granted, it probably hurts to walk and you will probably be a little stiff the next day, but compare that with an injury. Say you fell and sprained your ankle while on that walk: your ankle would likely swell and you would not be able to put much weight on it, if any at all. If you’ve ever twisted an ankle or sprained any joint, you know that’s much higher on the Pain Scale than sore feet and legs!

If something you are doing causes pain, that’s a clear indication that you need to stop what you are doing, but many of us are in the opposite end of the equation: we are so afraid of Pain that as soon as we feel Discomfort, we stop.  While you don’t need to work out to the point of causing Pain, Discomfort is neither Pain nor Injury.

I admit I have hard time with the Pain Scale, mainly because it is highly individualized.  I was recently at my doctor’s office for a routine check up and we went through the Pain Scale as it relates to the arthritis in my knees and back.  I was asked to “rate my pain”: average day; bad days; better days; blah blah blah.  My problem is that I have a high tolerance for pain: when something ‘hurts,’ I ask myself the question I’ve put to you here. “Is this Pain or is this Discomfort?” Most of the time, it is just Discomfort, as in sitting causes an ache in my back or walking a lot causes an ache or stiffness in my knees.  Does it hurt enough to keep me from walking or sitting? When it does, it’s actually graduated to Pain.  That is how I differentiate between the two: when it keeps me awake at night, again it’s grown from Discomfort to Pain.

It’s up to you to determine your threshold between Pain and Discomfort.  You are the one who lives in your body and if your workout instructor wants you to do more than you feel comfortable with doing, then tell her! Even if it’s just more Discomfort than you want to live with, you are allowed to say no. One of the exercises my trainer likes to do really aggravates an old shoulder injury of mine, so I modify it to keep my shoulder from hurting the next day. I am reasonably sure it’s not an actual injury, but it bothers me enough that I don’t like dealing with it.  Does that mean I am slacking off on my workout? Not at all since I am the one who has to deal with a shoulder that hurts when I raise my arm over my head or reach for anything.  Is it Pain or just Discomfort? While I don’t usually take anything when it happens, I’d call it Discomfort, but at the same time feeling the twinge each time I raise my arm or reach, it is still uncomfortable!

This brings us to the other issue when it comes to Pain and Discomfort: how we medicate ourselves.  Many of us are told repeatedly that if it hurts, take a pill! “There’s no reason to be in Pain!” That is correct.  Pain is debilitating and depressing and chronic pain drains victims of concentration, energy and happiness. There is no reason to suffer with it if you can alleviate it.  But again, Discomfort is not Pain, and while you are the judge of what counts as Pain or Discomfort in your body, we should not be afraid of feeling a little Discomfort, especially if our fear of ‘hurting’ is getting in the way our being active. Sore muscles and a little stiffness should not be anything to be afraid of and if it’s too much Discomfort for you, it is a temporary condition! There is a reason trainers shout No Pain, No Gain at their clients: the more you use those muscles, the more you have to work to make them sore. In short, if you keep moving those muscles and joints, they will get stronger and eventually, they will hurt less, so while it’s not exactly “No Pain, No Gain,” it’s close enough to make the point.

 

 

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