Normal Training Pain vs. Pain You Shouldn't Ignore

Your first few weeks in the gym almost always come with some kind of pain, and that part is normal. The problem is that beginners can't easily separate ordinary muscle soreness from a signal that something is going wrong, so they either quit for no reason or push straight through an injury. Here are the concrete limits: what you can tolerate, what you change in your training, and what goes to a doctor.

The pain that shows up a day or two later (DOMS)

Delayed onset muscle soreness starts 12 to 24 hours after training, peaks between 24 and 48 hours, and usually clears within 72 hours. After your first serious session it can last 5 to 7 days. It's worst after exercises with a heavy lowering phase: squats, lunges, Romanian deadlifts, running or walking downhill.

You recognize it because:

• it's spread across the whole muscle, not in one spot you can point to with a finger;
• it's symmetrical, meaning the left and right side hurt about the same;
• it's worst in the first few movements in the morning and eases off after 5 to 10 minutes of walking or a light warm-up;
• it gets smaller every day, not bigger.

The simplest test: if 5 minutes of light warm-up reduces the feeling, it's muscle soreness. If it makes it worse, it isn't.

The burn during a set

The burning feeling on the last reps, say reps 8 through 12 of a set of 12, is metabolite build-up and it disappears 30 to 60 seconds after you rack the weight. The same goes for the muscle shaking at the end of a hard set and for weakness that clears within 2 to 3 minutes of rest. That's not damage and you don't need to avoid it.

What is not normal

• Sharp, stabbing pain that sits in one point and shows up at exactly the same part of the movement every time.
• Pain that forces you to change technique mid-set, for example shifting your hip sideways in a squat or shrugging your shoulder up in a press.
• Tingling, burning nerve pain or numbness travelling down an arm or leg. That's a nerve, not a muscle, and the set stops immediately.
• Joint pain (knee, shoulder, elbow, hip) instead of pain in the belly of the muscle.
• Swelling, heat or redness in one spot that is still there 24 hours after training.
• A pop or snap followed by a sudden loss of strength.
• Pain that wakes you at night or is present at rest, with no load at all.

The 0 to 10 scale as a working rule

Rate the pain from 0 (nothing) to 10 (the worst you can imagine) and act on it:

• 0 to 3: carry on as normal, no changes.
• 4 to 5: drop the weight by 30 to 50% or shorten the range of motion; if the pain stays flat and doesn't build through the set, you can finish the session.
• 6 and up: stop that exercise for the day.

Two rules go with this. First: pain must not increase from rep to rep within a set. Second, the 24-hour rule: the next morning the pain must not be worse than it was the day before.

A joint is not a muscle

In beginners the most common complaints are pain below or around the kneecap in squats, pain at the front of the shoulder in the bench press, and pain on the outside of the elbow during pulling work. Before you drop the exercise, try three changes: cut the depth or range by about a third, drop the weight to 50 to 60% of your usual, and shift your grip width or foot stance by 5 to 10 cm. One of those three is usually enough to make the pain disappear.

What to do when pain shows up

1. Stop the set, rest 2 to 3 minutes, then run a test set at 40 to 50% of the weight for 8 to 10 reps.
2. If the test set doesn't hurt, continue the session with that lighter load. If it does hurt, swap in a variation that doesn't hurt (dumbbell press instead of barbell, leg press instead of squat).
3. Don't go to complete rest. 20 to 30 minutes of easy walking per day reduces stiffness faster than lying down.
4. Skip that muscle group for 48 to 72 hours, but keep training the rest of your body normally.
5. Sleep 7 to 9 hours, eat 1.6 to 2.2 grams of protein per kilogram of body weight per day, and drink 30 to 35 ml of water per kilogram. That doesn't heal an injury, but it shortens recovery from ordinary training.

When to see a doctor

• Pain lasting more than 2 weeks with no improvement at all, or joint pain lasting more than 3 to 4 weeks.
• Sudden pain with a popping sound and loss of strength, or being unable to put weight on a leg or lift an arm. Same day.
• Swelling that hasn't gone down after 48 to 72 hours, visible bruising without any impact, or a clear difference in size between your left and right limb.
• Tingling, numbness or weakness that lasts longer than a few minutes after you stop the exercise.
• Dark urine the colour of tea or cola, heavy swelling and pain out of proportion to the session, 24 to 72 hours after a first very hard workout. That's urgent, it can be rhabdomyolysis.
• Chest pain, shortness of breath, dizziness or fainting during training. Stop immediately and get emergency care.
• Fever, redness and heat over the painful area, or pain that wakes you from sleep.

The short version

• Muscle soreness is diffuse, symmetrical, eases with a warm-up, and clears in 72 hours (up to 7 days after your first session).
• Sharp one-spot pain, joint pain, tingling or numbness are not normal and the exercise stops there.
• Use the scale: 0 to 3 continue, 4 to 5 cut the load by 30 to 50%, 6 and up stop.
• The next day the pain must not be worse than the day before, and within a set it must not build.
• See a doctor if there's no improvement after 2 weeks, or for a pop with loss of strength, swelling past 72 hours, numbness, or dark urine.