Maximising the gain while minimising the pain

It’s hard to know what to do when your exercise regime is affected by aches and pains. Do you stop exercising for a few days? Or do you continue exercising through the discomfort? Or reduce the intensity of your exercise?

As physiotherapist Spencer Turvey, a member of the Irish Society of Chartered Physiotherapists (ISCP), says: "Anyone taking up a new exercise is often going to experience pain, especially if they haven't done any kind of exercise for a long time.

"They get muscular aches and pains, known as delayed onset muscle soreness, and they can feel sore for 48-72 hours [after a session]. The pain will gradually go away as people become fitter or get more into the exercise."

It all depends
Advice "depends on who you talk to and what their background is. There's a whole load of people working in this area so there is going to be different advice from different people.

“I would always say that if you have issues, you should speak to your GP or a chartered physiotherapist.

“With gym instructors, it depends on their background and training. You need to be cautious and check out their training and qualifications.”

(The third-level colleges that train physiotherapists are the Royal College of Surgeons in Ireland , UCD, University of Limerick and Trinity College Dublin. )

Aching muscle pains experienced after taking up exercise “is probably not something to be too concerned about. You will get better. You shouldn’t stop exercising. The muscles are painful if you haven’t really exercised them before. They’re being worked on beyond their normal capability. The more you work the muscles, the stronger they’ll get and you’ll feel less aches and pains.”

Type of pain
While it's normal to experience pain after embarking on an exercise regime, Turvey says it's important to identify the type of pain. "I'd be more concerned if someone was complaining of joint pain or sharp pains as opposed to muscular aches that go away in two or three days. Joint pain needs to be examined by a physiotherapist and treated appropriately."

People can develop chest pains and other disturbing reactions to exercising. “If this happens, you need to see a doctor or attend A&E. Some people can get visual disturbances or dizziness from exercise. They might become breathless, sweat excessively or start to feel sick.”

The mistake people make when they’re new to exercise is expecting it to have a very quick impact. “In fact, improving muscular strength can take time. I often say to patients that it can take six to eight weeks before they’ll see an improvement.

“It’s a matter of sticking with it and being realistic about results. If you haven’t exercised before and you do loads of exercise in week one, you’re going to feel tired and weak. It’s really a matter of starting off small and building up.

“Walking is a good exercise. Running on the road is not great for the knees but in general, any form of activity is good.”

Appropriate exercises
Older people who are developing arthritis "should be assessed by a GP or a physiotherapist and be advised on appropriate exercise that ensures they don't do any harm".

Stephen Swanton is the chairman of the Sports & Exercise Medicine Clinical Interest Group of the Irish Society of Chartered Physiotherapists.

He says that since the start of the recession, there is less gym membership “and more people taking to the road because it’s free and you’re out in the fresh air. Running clubs all over Ireland are seeing an increase in membership.”

Swanton stresses the importance of heeding pain that is localised in the joints or near the tendons. “If you’re getting unusual pains in these areas while exercising, they need investigation.

“It’s when the pain is actually within the knee joint and not above or below it that you need to pay attention to it. Another thing to look out for is joint swelling.”

People aged over 55/60 who have a greater risk of cardiovascular disease should be checked out by their GP before taking up exercise.

“Usually, a GP will carry out an exercise stress test which will stratify the patients in terms of risk.

“Gyms have got very good at screening people by giving them questionnaires. In some cases, depending on how you answer the questions, they won’t allow you to use the gym until you’ve been screened by your doctor.”

Many people have concerns about their knees. “When you get them checked out, you won’t necessarily need an X-ray. Scans are only indicated if looking for something specific. MRIs are very good for picking up ligament injuries.”

For people looking for advice on exercise, the message seems to be “no pain, no gain”.

But if the pain experienced during or after exercise is more than just delayed onset muscle soreness, then the advice is to visit your doctor or a physiotherapist.

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