When should I stop or modify exercise?

Whenever someone attends PT it is very common that therapeutic exercise is a large part of their treatment intervention. Often times when coming to therapy it is likely you are experiencing some form of pain, or it is likely you haven’t performed exercise for a long period of time. In these cases people often ask, what exactly am I supposed to be feeling when I do exercises and when is it best to stop or modify an exercise?

In general, during strengthening or mobility exercises it is common to feel tired, fatigued, or weaker as you begin performing an exercise. In order for you to adequately build strength, we have to work that muscle pretty hard to create “micro-damage” or “micro-tearing”. This micro damage to a certain muscle group then begins a whole cascade of events in which your body then tries to rebuild that muscle. That muscle will then build strength and resiliency to the given stimuli and becomes stronger. This type of small mirco damage paired with the rebuilding is exactly what we want. In most cases this can feel very fatiguing, sore, tired, and weak. Also, lets be honest here people, sometimes it just doesn’t feel good! Is it necessary and safe to work through these sensations? You betcha!

Along those same lines, you may notice some pain in your muscles around 24-72 hours following a workout which we refer to as DOMS or delayed onset muscle soreness. This is that feeling of pain or stiffness in a muscle often felt when trying to stretch, lengthen, or contract a muscle after a workout. This feeling is 100% okay for you as long as it’s manageable and allows to to continue to function. If it significantly impacts you then you know you maybe “went a little too hard” with your strength training and it may be helpful back off before attempting that same resistance again.

Now in some cases when working with an injury, recent surgery, or pain it is likely to you may sometimes feel sensations that give you hesitation and pause. When your body is in pain, your sympathetic nervous system which is responsible for your “fight or flight” response becomes overactive and heightened. It is likely that you will get some sensations of discomfort at times during physical therapy, but as a rule of thumb, I always pay attention to how the pain is reported. Often times I look to change, modify, or adapt an exercise when a patient states their pain is:

  • sharp
  • stabbing
  • burning
  • numb
  • stinging
  • “pinch-y”

There are hundreds of different ways we can perform, adapt, and modify exercises that specifically target your needs and achieve the same goal. Frequently, when performing an exercise I use 2 different descriptive words. Is this pain or sensation “temporary” and is this pain or sensation “tolerable”. More times then not when you put it in this context you find you can do a lot more than you ever thought possible. Sometimes removing the internal conversation your “fight or flight” nervous system is having inside your brain, you can find new ranges of motion and strength you never knew you had. That’s why I am a huge advocate for working along side a physical therapist who is specifically trained in the body’s movement to help you navigate those muddy waters.