As soon as we begin to normalize injury and pain in participants, we are heading into a strange place.
Is it really the case that post-training soreness means we are getting stronger?
Get-Fit Guy is hosted by Kevin Don. A transcript is available at Simplecast.
Have a fitness question? Email Kevin at getfitguy@quickanddirtytips.com or leave us a voicemail at (510) 353-3014.
Find Get-Fit Guy on Facebook and Twitter, or subscribe to the newsletter for more fitness tips.
Get-Fit Guy is a part of Quick and Dirty Tips.
Links:
https://www.quickanddirtytips.com
https://www.facebook.com/GetFitGuy
https://twitter.com/GetFitGuy
https://www.kevindon.com/
Welcome back to Get-Fit Guy, Kevin Don here with some fitness noticings to get you thinking about what you are doing in the gym and your life that might push the needle from sickness to wellness.
If you are a regular listener of the show, you will know that I love a good anecdote. So, I’ll kick off this episode with a little story from my life this week. As you know, I do a whole bunch of different training, including karate, judo, boxing, and gymnastics. Now, this past week, the weather here was really cold, and the gymnastic facility I go to had no heating. During my tumbling training, I felt fine, but later that evening, I had really painful knees. Bilaterally, under both kneecaps. I have actually had surgery here before, on the patellar tendons. So, it's likely that I had a bit of tendon inflammation, probably from the cold making things a bit stiffer. The next day, I went to judo training and said to one of the coaches that my knees were sore. One of the other, older coaches then chimed in with “I can't remember the last time my knees didn’t hurt” as he pulled on two knee braces to get ready to train.
Now, what this tells me is that, to some extent, this coach has normalized pain and injury, which is something that I see very often. In 2018, I was working with a gym in Iceland on coach development for their staff and during a meeting, the owner of the gym claimed that his gym had the lowest injury rate in Iceland. This is a claim he couldn’t actually make, because firstly, his gym had no reporting procedure or record keeping of client injury and secondly, they didn’t have access to the records (or lack of) from other facilities. I took him down to the gym floor to look at a class where several participants were wearing ONE knee sleeve. You only wear one knee sleeve or one wrist wrap if you have one sore knee or one sore wrist. Walking wounded are injured clients!
In my view, as soon as we begin to normalize injury and pain in participants, we are heading into a strange place, because that's not what fitness is about. In my very first episode here, I defined fitness as the absence of disease or injury in an organism. If our actions as coaches or as singular exercise participants result in injury or pain, then we have failed in the goal of being in a state of fitness.
But that old adage “no pain, no gain” is still prevalent in the fitness industry and in how people perceive their training. But where does the expression come from and what does it really mean? We can find similar expressions going back all the way to the 5th century BC, where the Greek poet Sophocles wrote “nothing truly succeeds without pain” and even Benjamin Franklin expressed something similar in 1758’s The Way to Wealth, saying “there are no gains without pains.” But the phrase itself entered popular vernacular with Jane Fonda, who used it repeatedly in her popular 1980s exercise videos.
But what was Jane Fonda getting at? She was referring to what is known as DOMS, an acronym standing for Delayed Onset Muscle Soreness. It typically occurs 24-72 hours after training. It's not entirely clear what causes it, though there are a couple of theories. The first is that it’s microtrauma to the muscle fibers and the second is that calcium accumulates in the muscle, inhibiting some cellular processes and causing a build-up of inflammatories such as histamines. Regardless of the exact cause, what you need to know is that DOMS has not been shown to reflect a severity of damage or a decrease in function.
It also generates what is called “repeated bout effect” where soreness is reduced next time and also the duration of the effect is reduced. Of course, like all things we do, this has some degree of specificity, meaning that an adaptation to DOMS in the legs doesn’t mean you won't have upper body DOMS if you decide to train a hard upper push-pull day.
Irrespective of the fact that DOMS itself is not injurious, it’s definitely not on my list of fun things to get out of my time at the gym. So we should try to make sure that we are applying any new exercise carefully. We should look to manage the loading and the volume. We can't go straight to the maximal dosage of exercise, which is one reason I am such a big fan of individual program design rather than group classes. Of course, classes have a lot going for them such as a positive and supportive environment, socialization, and so on, but since the program isn’t written with an individual in mind, it can be easy to overdose on the exercise prescription. Caution when first starting any new exercise regime, even if you play other sports or do other forms of exercise, is always admirable.
But what if we do find ourselves the victim of the dreaded DOMS? Well, we can wait it out or we can look to anything which will increase localized blood flow. So, in the event of DOMS in the legs, you could look to walking or very low resistance, low effort cycling. Maybe even a sauna or hot tub. Gentle massage or palpation of the muscle (a really hard massage or hard foam roll might cause further muscle damage—if the muscle damage hypothesis is correct). In the only two studies done on the effect of cold (cryotherapy or ice plunge) on DOMS, one found it to be effective and the other found it to be ineffective. All studies done on ibuprofen and DOMS found it to be ineffectual.
The biggest thing for me when we come to look at pain in training is that, just like I don't find I can trust most (although not all) clients with things like RPE in training, I don't find we are great at recognizing or admitting to ourselves that we have DOMS and not an injury. In my example earlier about the gym in Iceland—if you are wearing a single knee sleeve to train for weeks on end because your knee is sore, you have a chronic injury (irrespective of the severity) and not DOMS, so in this case, “no pain no gain” as a maxim is ill-advised! We have to be able to objectively evaluate our pain experience and see what we can do to continue to train without worsening our physical situation because injury is NOT a state of physical fitness.
Now, I want to take some time to answer a listener email! This one comes from a listener in Melbourne, Australia, who writes:
“My name is Martin. I am 66. I have mild to severe heart failure, however I am fairly active. I have had 3 open-heart surgeries (aortic valve replacements) the last was in 2009. The breaks I take from training are usually organic, in that I may be away for a holiday and not train for a couple of weeks, every 2 to 3 months. I notice lately, (over the past 3 weeks), that I have found it hard to keep up 3 training days a week (the routine that I aspire to). I don’t spend any more than 45 minutes at the gym, however I train in a very consistently regulated manner with timed breaks between sets etc. I decided today to take a week off from training as even the thought of going to the gym is abhorrent to me lately. Is that enough time off for somebody of my age and health? Should I make my breaks longer, and/or take them more frequently? Do you have any other comments or advice for me?”
Hi Martin, thank you for the email and for the training and physical background. I’m not sure I have enough data here to make a really meaningful intervention, meaning that you haven’t really indicated what is stopping you from keeping up with the 3 days a week you have set for yourself. Is it fatigue, not able to recover, pain or injury, or just motivation?
But I can talk about you finding the gym “abhorrent.” In any program, as a coach or a researcher, we can look objectively at things and make recommendations on the “best” type of training or exercise. But actually, the subjective nature of things is perhaps more important here. The biggest predictor of success in any exercise program is adherence. And the biggest predictor of adherence is enjoyment. Right now, it doesn't sound like you enjoy the training. So I would say that a really good first step here would be to maybe think about what things you don't like doing at the gym and maybe just stop doing those, at least for a while. Maybe you might consider trying out a new activity. We are definitely never too old to start—I have a new karate student who is 75 years old and he is loving learning something new!
You asked me if taking a week off is long enough. I would probably reverse the question there and ask if it's too long. Whilst I don't think that a week off is fundamentally going to downgrade your fitness, if it's because you aren't enjoying things, a week off won't change anything because the things you are doing at the gym won't change when you return. In terms of actual training, we very often find that as we get older, our bodies become more resistant to muscle building and other fitness outcomes. It's called anabolic resistance. So we actually find that more regular dosing is useful in older populations. So, I would say that longer, more frequent breaks would be the opposite of my advice here.
However, I think it sounds like the root cause here is a lack of enjoyment rather than anything else, so I would put aside the gym routine you have for now and try to do something new to see if it’s fun. Maybe join a group exercise class or activity, where there could be a social aspect, which will make things more engaging. Although I often refer to exercise as a medical intervention, we know that no one enjoys forcing down a pill, so things have got to be fun—you have to find a way to hide the pill in cheese!