Pain Should Not Be The Only Metric You Use During Rehab

Using pain as the only metric to decide if you are still injured is a recipe for re-injury.

Injuries can happen for a wide range of reasons. A common one in rowing and sports in general is when the training load exceeds the body’s capacity. 

Previously we have spoken about the capacity and load and used the analogy of balancing scales. On one side is our capacity. This is what our body can effectively recover from and comfortably within our ability. On the other side is load. This is everything from our training schedule, volume, daily activity, life stress, and essentially everything we put our body through. 

Repetitive injuries and overload injuries happen when our balancing scales are uneven, and the load exceeds our capacity. 

Of course, there is the argument that training adaptations happen when the body is subjected to a greater stimulus than normal (picture load > capacity). While that is true and physiological adaptations do start here, it is also crucial to highlight two points.

The first is that workouts and training provide the stimulus and start the process of creating physiological adaptations. However, the caveat is that recovery is where the real adaptations happen, and your recovery determines how efficient the training stimulus is.

The second is that no training program consistently does weeks of hard workouts. It is widely suggested that 80% of any training program should be at a low intensity and focus on aerobic work (aka UT2). Successful training programs do this and gradually build up mileage and intensity. Consistent adaptation over a long time is effective, sustainable, and smart.

So, with all of that said, when you get injured, you will probably experience pain as well.

You might also have other symptoms like stiffness, limited mobility or range of motion at joints, weakness, swelling and so on. The list is varied, and everyone is different.

The main point I want to get across to you is that by only using pain as a metric to guide your rehab, you are doing yourself a disservice.

Bringing it back to our scales, you got injured in the first place because the load you put your body under was greater than your capacity. Therefore, a key step in your rehab will be symptom management first, which is about increasing your capacity. Everyone can do the first step, and usually, if you limit what aggravates your pain, it will go away on its own. If you don’t do step two (increasing your capacity) then when you go back to training you will end up in a repetitive cycle of reinjury.

“So, what should I do instead?” 

Pain is a good subjective marker, but it cannot be the only thing you focus on. 

You need, must, and have to focus on functional markers like range of motion at joints, strength, endurance, and eventually graded exposure and return to sports protocols.

An intelligent rehab program includes strategies for symptom management and functional markers to make you stronger and able to manage the demands of the sport.

Here is an example of functional objectives you can focus on in the early stages of rehab (to clarify this, only look at how you are moving, not looking at strength and performance markers.)

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Sophie Hudson

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