exercise therapy, informative, research evidence

How to train through pain: why ‘sometimes’ it should hurt.

We all experience pain in our training. For some of us it is what keeps us returning to the gym. For others it keeps us away. But how much pain is good for us? And how can we tell when the pain is an indicator to take a step back?

We can use our own perceived pain levels to evaluate how our body is reacting to a given training load (also referred to as Rate of Perceived Exertion or ‘RPE’). RPE uses a scale (see Figure 1) from 0 to 10 to determine the effort exerted by the athlete when performing a given exercise.

RPE
Figure 1. Adapted scale for RPE used in study by Day et al., 2004 (4)

Although initially constructed to help those training in aerobic activities (1-2) such as running and cycling, the Borg rating of perceived exertion (3) has since been adapted and shown to be highly effective in monitoring intensity in resistance training (4-6). In essence, there is strong evidence to show that monitoring and adjusting training programmes using RPE can be as reliable and valid as using maximal testing. Unlike using a percentage of a percentage of a one-Repetition Maximum Test (1RM), RPE does not require repeated testing to determine the resistance needed for each exercise.

Now, you might be wondering why I’m chatting on about RPE training principles how does this relate to injury and PAIN? Please bear with me…

A study by Day et al. (6) showed that the resistance exercises (Squat, Bench, Overhead Press, Bicep Curl, and Tricep Pushdown) performed at intensities of 50, 70, and 90% 1RM were consistently associated with average RPE scores of 4, 6 and 7, respectively. This is GREAT news for those of us who can’t afford to exert excess energy (or frankly, don’t have the time!) to re-test for the correct load to work at a specific percentage of our 1RM in each exercise or percentage Heart Rate Maximum (HR max) during each training session (6-7). This system enables us to be responsive to our body’s reactions to a training stimulus – we can adapt our training load based on how hard the work feels.

Now, you might be wondering why I’m chatting on about RPE training principles how does this relate to injury and PAIN? Please bear with me…

The RPE scale is also being used increasingly in the field of injury rehabilitation. It is a useful tool to ensure that rehab exercises are performed by injured athletes and individuals at an intensity is appropriate for their level of recovery. There are so many different variables that can influence the path to recovery after injury. A small setback or impairment in performance can have a relatively large impact on the ability of a recovering athlete to perform their prescribed exercises. Therefore, an athlete’s RPE can vary day by day depending on these variables. For example: caffiene consumption has been suggested to have a possible impact on RPE during resistance training (8).

RPE scale is also being used increasingly in the field of injury rehabilitation

So, of course, when it comes to prescribing exercises in the clinic I frequently refer to the RPE scale. I encourage my clients to work within intensities that don’t exceed a 6 out of 10 or fall below a 4. It is worth noting that any method that encourages monitoring and evaluation of training volume is likely to help an athlete (or any other person with a training goal) to spot risk factors for injury and therefore create opportunities to reduce injury risk.

Looking for some help with shoulder injury and pain issues?

If you are interested to know more about methods to prevent and manage pain and injury then the following events and workshops maybe be of interest to you – we will cover theory and methods of monitoring and adjusting training volumes and programming to ensure injury risk and pain are minimised, so that optimal performance can be achieved!

‘Move Well Clinic Workshop: Preventing and Managing Shoulder Pain and Injury’ on November 30th 2019 at Strength Lab 1.0 (Northampton) BUY TICKETS.

8-week Small Group Shoulder Conditioning Programme’ Starts on October 30th 2019 at Strength Lab 1.0 (Northampton) REQUEST INFORMATION.

 

References:

(1) Herman, L., Foster, C., Maher, M.A., Mikat, R.P. and Porcari, J.P., 2006. Validity and reliability of the session RPE method for monitoring exercise training intensity. South African Journal of Sports Medicine18(1), pp.14-17.

(2) Eston, R.G. and Williams, J.G., 1988. Reliability of ratings of perceived effort regulation of exercise intensity. British journal of sports medicine22(4), pp.153-155.

(3) Borg, G., 1998. Borg’s perceived exertion and pain scales. Human kinetics.

(4) Gearhart, R.E., Goss, F.L., Lagally, K.M., Jakicic, J.M., Gallagher, J.E.R.E. and Robertson, R.J., 2001. Standardized scaling procedures for rating perceived exertion during resistance exercise. Journal of Strength and Conditioning Research15(3), pp.320-325.

(5) Gearhart, J.R., Goss, F.L., Lagally, K.M., Jakicic, J.M., Gallagher, J.E.R.E., Gallagher, K.I. and Robertson, R.J., 2002. Ratings of perceived exertion in active muscle during high-intensity and low-intensity resistance exercise. Journal of Strength and Conditioning Research16(1), pp.87-91.

(6) Day, M.L., McGuigan, M.R., Brice, G. and Foster, C., 2004. Monitoring exercise intensity during resistance training using the session RPE scale. The Journal of Strength & Conditioning Research18(2), pp.353-358.

(7) Ritchie, C., 2012. Rating of perceived exertion (RPE). Journal of physiotherapy58(1), p.62.

(8) Hudson, G.M., Green, J.M., Bishop, P.A. and Richardson, M.T., 2008. Effects of caffeine and aspirin on light resistance training performance, perceived exertion, and pain perception. The Journal of Strength & Conditioning Research22(6), pp.1950-1957.

 

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