When to Push and When to Rest: an Exercise in Common Sense

When we exercise in any regard, we look to push our limits. We want to do better than before, to feel good about progress. I know after I run a route that’s new and maybe a little tougher than I’m used to, I feel it—maybe feel it a little too much. Soreness can be debilitating and injuries can flat out handicap you…and if you push your body when it has already had enough, it could cause an injury that is the beginning of the end. Yet, how do we make this distinction? How do we know how much soreness is too much soreness? Furthermore, is it possible that this soreness is just in our head, that we’re making something out of nothing and are missing days for ‘recovery’ when no recovery is even needed?

Well, it’s not all in our head, but it turns out that some of it may be. According to an insightful study conducted by Eric Hall and Nicole Razor at Elon University, there is a potentially heavy implication of “fear avoidance” that may or may not incite a vicious cycle that prevents runners from resuming normal activity, which translates to delayed healing. That delayed healing consequently means extended pain and inhibited performance. Basically, runners and other athletes may be worrying so much about their injury that they actually amplify its effects—insane, but understandable.

Hall and Razor essentially just gave a few questionnaires to various athletes that told them to indicate the degree to which they agree with sentences like “I will never be able to play as I did before my injury” & “I worry if I go back to play too soon, I will make my injury worse.” They also administered the Fear of Pain Questionnaire, the Pain Catastrophizing Scale and an anxiety questionnaire. For the record, these questions were given to injured athletes before intense exercise.

Perhaps predictably, the athletes’ answers seem to have played a role in how much pain they were feeling in the one to two days following their workout. Athletes who scored higher on these tests also reported more pain after exercising in addition to a greater fear of re-activating their injury. Just as well, athletes who cited experiencing levels of high anxiety also cited more pain and a greater fear of re-injury.

Now, we should keep in mind that, of course, this is not a cut-and-dry case, and this does not necessarily mean that soreness is all in our heads. The concept of the fear-avoidance model is subject to much debate, and as a result still needs to be substantially proven. The current results of Hall and Razor’s study merely provide a foundation for what will hopefully become a topic researched in great detail. In the meantime, its results/implications are intriguing.

For instance, if you stay off a sprained ankle too long because you are so afraid of hurting it again, you may actually be hurting it more in the long-run. Our injuries certainly need time to heal, but too much recuperation only results in a weaker, more vulnerable, more likely-to-be-hurt-again recovery that does nobody any good, least of all the athlete in question. Yet, if you get right back out there with an injury, you may only be making it worse, thus resulting in the same weakened recovery.

There is a balance to be struck and often this balance can only be found with experience. It takes time to realize what injuries are bad, which ones are minor, and which ones can be endured. I suppose the main takeaway here is this—listen to your body.

Pay attention to the degree of pain and to the extent of the injury’s seeming vulnerability. If it’s not that bad, act accordingly and deal with it. If the pain is excruciating, act responsibly and take some to time rest. More research will come; but in the meantime, practice common sense.

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