‘No pain, no gain’? Better yet: ‘Hear a pop, you’d better stop’

Former GeezerJock magazine editor Sean Callahan delivers some nice information in his latest article involving masters tracksters. He quotes M60 thrower Mike Thomason and sprinter Allan Tissenbaum, an injury expert and surgeon, who said: ” “Any time there’s swelling, that’s an injury. Stop the game, stop training, stop what’s going on. And anytime you feel a pop or hear a pop, that’s something to be paid attention to.”

Dr. Tissenbaum showed no pain in winning the M50 title for 200 meters at Sacramento masters nationals. (Photo by Ken Stone)


Here’s the story, in case the link pulls a hammie:

Are you sore or hurt?
Don’t quickly dismiss pain as ‘just a tough workout’

By Sean Callahan, Special to Tribune Newspapers

Maybe you’ve heard this one before: “No pain, no gain.”

When it comes to athletic training, sometimes that pain is not just well-earned soreness from a solid workout. Sometimes it’s a genuine injury.

How can an athlete — or someone who’s just trying to stay in shape — tell the difference?

Mike Thomason, 60, acknowledges he had a hard time discerning whether he was truly injured or just sore from working out earlier this year. Thomason, who lives in Ardmore, Ala., competes as a Masters track athlete in the shot put, discus, and hammer and weight throws.

He had been looking forward to 2010, because he had moved into the men’s 60 to 64 age group. He hoped to take advantage by being at the young end of the age bracket.

“I started throwing (training) seriously in March of this year, and I noticed after my workout sessions that my (right) bicep was sore,” he said.

He was also puzzled that he couldn’t throw the discus and the shot, which are lighter in the 60 to 64 age group, farther than the heavier implements used in the 55 to 59 age group.

“In my practice sessions, I had to throw the discus eight to 10 times and the shot at least six to eight times before my arm muscle soreness would go away,” he said. “I thought I had pulled or strained my arm; so for two weeks, no throwing at all.”

When he returned to training, so did the pain. Because the pain was a “dull, persistent ache,” he figured that it was arthritis in the shoulder. After having subpar performances in some local Masters track meets, he noticed that he had trouble tucking in his shirt with his right arm.

That was the last straw. He finally visited a doctor, who recommended an MRI.

“Two weeks later, I had shoulder surgery for a partial tear in my rotator cuff and ruptured biceps connector,” Thomason said. “I guess what drove me to think I was injured versus just in pain was the persistence of the situation.”

Tips to help decide

Thomason’s story can be instructive for clues on how to determine whether soreness is simple pain or an injury that needs attention. It’s also a frustrating example of how the clues often don’t lead to a definitive conclusion.

Asymmetry: One clue was the “asymmetrical” nature of the pain: It only occurred in one arm and not the other. That often indicates that the soreness is a real injury, experts say.

“If both legs are sore in the same spot, that is nearly always normal muscle soreness from a hard workout,” said Craig Godwin, a Masters track coach from Eugene, Ore. “If there is pain in one leg and the other feels fine in the same spot, that is certainly something to be concerned about.”

(But he cautions that this advice often doesn’t apply to throwers. “Since field events are inherently asymmetrical, asymmetrical soreness can also be normal,” Godwin said.)

Joints vs. muscles: Others say that pain in a joint — for example, the knees, ankles or shoulders — is different from muscle soreness and should be checked out if it persists. “Pain in a tendon, joint, bone is not normal or desired and should be treated as an injury,” Godwin said.

Even though Thomason’s injury was ultimately diagnosed as a rotator-cuff problem, the pain mainly presented itself in the biceps area, which made the issue appear to be related to the strain of stressful workouts. So when in doubt, let a medical professional decide if you are injured.

Swelling: Swelling is a key indicator of an injury that needs medical attention, says Allan Tissenbaum, an orthopedic surgeon with Washington Orthopedics and Sports Medicine in Washington, Pa. “Any time there’s swelling, that’s an injury,” said Tissenbaum, who is a Masters athlete and a former Masters world champion in the 100-meter dash. “Stop the game, stop training, stop what’s going on. And anytime you feel a pop or hear a pop, that’s something to be paid attention to.”

Thomason, however, couldn’t point to a specific time he was injured, and he experienced no visible swelling.

Gait: Tissenbaum notes that for runners “anything that’s affecting your gait should be dealt with” before it causes injury to some other part of the body.

Pain after workout: “My feeling is if you’re dealing with pain that persists past your workout, you’re doing too much,” Tissenbaum said. “If you’re doing more damage (to your muscle fibers) than you’re able to heal, you’re actually causing damage.”

Isolate the pain; work around it

Vonda Wright, an orthopedic surgeon at the University of Pittsburgh Medical Center, recommends that athletes in doubt after experiencing soreness or pain for a week or two would benefit from seeing a doctor. “Sometimes,” she said, “it helps to make sure they can keep training without hurting something.”

Even when athletes are diagnosed with injuries, Wright encourages them to keep working out.

“If you’ve hurt your right calf, let’s say, you still have an upper body, your core, and left leg that are healthy,” she said. “You can still keep those in shape and stay in cardiovascular shape.”

Thomason had his surgery in early August and has tried to rehab and workout as much as permitted.

“The first couple of weeks after surgery I rode my stationary bike and found out how clumsy I am left-handed,” he said, adding: “So far my therapy is mostly stretching exercises.”

He has also done a lot of walking and some swimming — with no freestyle or backstroke permitted to preserve his shoulder. “I’m dying to get into the gym, but I am determined to be very careful and very limited in what I do,” Thomason said.

Tissenbaum agrees with the approach of not overdoing it. Some athletes — especially Masters athletes — tend to overtrain, he said. “When it comes to training as a Masters athlete, less is more.”

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September 30, 2010

8 Responses

  1. John - September 30, 2010

    Matt B – Did you even read the article? The very first “tip” was assymetry of pain. I think that would accurately cover the injury you described.

    The comment about hearing a pop was included in the story almost as an afterthought…unfortunately the headline chose to emphasize that one in the interest of making a cute rhyme.

    Hey, I thought this was an excellent article with a lot of good information for people who may be relatively new to the sport scene, and not wise to recognizing the difference between discomfort and injury.

  2. Matt B. - September 30, 2010

    John
    So what I took from the article was how to recognize whether you are actually Hurt as compared to just sore.
    “Are you sore or hurt?”

    I agree good information about recognizing differences between discomfort and injury, although I wouldn’t say it was just good for those who are relatively new, but for those who have struggled through these types of symptoms in he past as well.
    As an experienced runner I still have trouble deciphering between the two.
    So asymmetry of pain is certainly a symptom to look out for, but what I was referring to was when you actually get a serious acute injury that happens while you are actually running, to the point where you immediately have to stop. Mere asymmetry of pain doesn’t really apply.
    I had an acute injury and I was hoping to add that even acute injuries do not come with a “pop” but that perhaps a strange hard tug (the best I can describe it) is also a possible sign of being hurt.

  3. Marty Wright - September 30, 2010

    Gary- You beat me to the first two sentences of my post. I just haven’t figured out how to be smart other than trying to do a better job of shutting it down immediately. I recently felt my first “pop”, shut it down and it wasn’t as bad as many other injuries. When things are going good I start to worry because I know something “bad” is about to happen. It was much easier in the youngster days when all you had to do was will yourself to try just a little harder. I’m still mentally willing, but….Oh, I am trying something hopefully smart with two rest days per week.

  4. Craig Godwin - October 5, 2010

    I thought Sean did an excellent job of summarizing the topic. Below is the full text of what I told Sean if anyone is interested:

    The first key is whether the pain/soreness is symmetrical or not. If both legs are sore in the same spot, that is nearly always normal muscle soreness from a hard workout. If there is pain in one leg and the other feels fine in the same spot, that is certainly something to be concerned about. Not only is it more likely to be true injury that needs to be addressed, but continuing to train through it can easily cause additional problems from favoring one leg. Note that this rule mostly applies to runners and not field event athletes. Since field events are inherently asymmetrical, asymmetrical soreness can also be normal.

    Another important thing is how quickly the pain/soreness improves. All soreness is an injury to some extent, but to some extent this is a desirable part of training since these low level, micro-injuries are what causes us to improve athletically. A normal level of soreness will go away after one or two days, and will improve even while continuing easy training. If the soreness isn’t improving or lasts more than a few days, then it is time to treat it as an injury. A special case is after a hard race where an athlete may be more sore the second day after the event before starting to improve. If this is the case after a hard workout, that is a sign the workout was excessively hard and counter-productive, even if there isn’t an injury involved.

    The location of the pain is another factor. Hard training and competitions will stress your body and cause soreness. But this soreness is typically muscular. Pain in a tendon, joint, bone, etc. is not normal or desired, and should be treated as an injury. The reverse is not necessarily true, however. Just because it is a muscle that is sore doesn’t always mean that is okay. It depends on the level of muscle damage and the other factors I mentioned above.

    I can’t think of any particularly interesting stores offhand for either myself or athletes I’ve coached. These things usually follow the same pattern. There is a questionable pain. We take a few days easy (often icing as well) and see if the problem improves or not and then go from there. Other injuries are obviously an injury, so we immediately take the appropriate action in those cases.

  5. Who's your daddy - October 5, 2010

    Anyone care to give me advice?? I started the outdoor season slowly; by training for 10 weeks prior to racing. I just jumped and threw;and had a modest 100M time of 13.79 in May. I continued my training; and lowered my time to 13.58 by late June. I also ran a 63 second 400; and was very sore after both meets. Come late July; I couldn’t run better than 14.4 and 67.7 respectively. Am I over-training??

  6. Neni - October 7, 2010

    I agree if you hear or feel a pop, stop. I learned a hard lesson. Unfortunately, I felt a pop before Nationals and still competed. The hammer was not much of a problem but I had great difficulty in throwing the shot & discus. I felt a pop throwing in the Ultra Weight Pentathlon Championships 2 weeks later and now I have great difficulty walking and cannot move too well. My MRI results indicate a torn labrum hip tendon. Now the decision is whether to let it heal on its own which will take a long time since the throwing events require fast hip movement and one wrong move and ouch, the season is over or have surgery. I am trying to find a surgeon to consult with who does the laproscopic hip surgery that my insurance will accept. I was looking forward to the indoor season especially the nationals. What a BUMMER!

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