We’ve all been there. You took a little too much time off from exercising and now that you’ve finally made your triumphant return to the gym (or track or treadmill or field etc). You wake up the next day wishing you had an escalator to get downstairs.
Figuring out how much is too much can be hard enough for the average gym goer, but when you’re a patient rehabilitating from an injury it can be very challenging to know how hard to push yourself while performing your home exercise program. Before we dive into the specifics, let’s define a couple terms.
- For the purposes of this post, soreness refers to “muscle soreness” – it’s the painful feeling you sometimes get in a muscle for 24-48 hours after working out and it’s different from the “symptoms” that brought you into physical therapy. This soreness is normal and doesn’t suggest you did anything wrong. This is the good sore! As your body adapts and you continue to work out more regularly, the intensity and duration of that soreness will likely diminish, so if you’re a bit sore after getting back into exercising, don’t be discouraged!
- Let’s define symptoms: Symptoms are, quite simply, the pain you feel that brought you into physical therapy. This pain could be in a muscle, a bone, a joint or even related to an irritated nerve. This is the bad sore!! Regardless, it’s important that when performing your home exercise program that you follow the guidelines given to you by your physical therapist and you pay attention to the difference between soreness and symptoms.
So how hard do I go?
Well, as always in physical therapy – it depends. Let’s work through a couple examples:
Example 1, the green light:
Since a flare up in symptoms sometimes manifests 24-48 hours after exercising or engaging in activity, you should start your first couple workouts at a moderate intensity to see how your body responds. If you have some muscle soreness but not swelling or symptoms you’re in the clear, you got the good sore! Feel free to continue exercising – just make gradual increases in your volume and intensity as prescribed by your therapist.
Example 2, the yellow light:
You begin your exercise program and during your workout everything seems relatively fine. You have some low-level symptoms that you might rate on a 2-3/10 (if 0 is no pain and 10 means you are currently on fire and being attacked by bees). After your workout, you have a little discomfort but you don’t notice any increase in swelling or any notable uptick in your symptoms. In this case, unless your therapist has stated that they don’t want you experiencing any pain or symptoms while exercising, you’re still clear to continue – but hold off on progressing the volume or intensity of your next workout until checking in with your PT. Having some minimal symptoms during your workouts isn’t the end of the world, but it’s a yellow light because
- There are some cases where we do want to avoid symptom reproduction (if you’re not sure, clarify with your PT).
- Even in the cases where symptoms are okay, we want to monitor them to make sure they are getting better and not worse as you continue through your rehab.
Example 3, the red light:
You begin your exercises and during your workout you notice an increase in your pain (let’s say a 5 or more out of 10.) While it’s rare that this occurs during performance of your home exercise program, in this case, your body is telling you that you’re not quite ready for this. If there are exercises that you can perform that aren’t bothersome, you can continue with those, however, it’s important that you check in with your physical therapist to let them know how your body responded. It’s very likely that your PT can chat with you over the phone or email to make some modifications prior to your next visit.
We hope this helps give you some guidelines in gauging how hard to push yourself. Keep in mind that sometimes we just have off days. Maybe you didn’t eat or hydrate enough and maybe you didn’t sleep great the night before, all of these factors can change your response to activity and exercise so make sure you’re listening to your body. However, as always, the best person to ask about what you should be feeling during your workouts is your therapist. If you ever have any questions, contact FX Physical Therapy and we’ll make sure you feel comfortable and in control of your programming.
