Do I Need To Be Concerned? Soreness Versus Pain

A question that comes up often among patients and non-patients is “should I be concerned about this discomfort I am feeling?”  This question may come up during rehabilitation from an injury or surgery as strengthening is progressed (examples include starting to walk without crutches or starting plyometrics), at the beginning or middle part of a season, or during a period where activity level and/or its intensity increases significantly over a short period of time. In this blog post, I hope to provide some insight on what pain is, why it commonly occurs in athletes, how to differentiate between soreness and pain, and whether or not you need to be concerned about the pain or discomfort experienced.

What is Pain?

Simply put, pain is your brain’s interpretation of a stimulus that occurs to your body. The nervous system experiences a sensation and that information is then sent to the brain to interpret whether there is something wrong (such as an injury) and if your body needs to react in order to protect itself. In order to experience pain, our brain has to process the input received from our nervous system and decide whether it may be harmful to us. 

However, to make things a little more complicated, pain doesn’t always mean there is an injury and an injury doesn’t always mean there will be pain. Our brain is powerful and influences how we experience something like an injury. Each individual experiences pain differently and may also be influenced by factors such as:

• Expectations

• Emotions/mood

• Stress

• Beliefs about pain

• Attention

• Environment

• Culture (includes the culture of sports or activities)

• Prior experiences

As already mentioned, pain doesn’t always mean there is an injury or something wrong. Sometimes an individual’s pain doesn’t match the extent of stress to the body and the system can get out of balance. While this extends past the scope of this specific blog post, it is worth noting and an important part of the pain experience. 

Why Does Pain Occur?

Pain can occur for many different reasons. As mentioned above, it may be due to an actual injury to the body. The body’s response to pain may be protective and beneficial, especially immediately after the injury. In sports, this may look like a fall or being hit by another player or object. However, other times there isn’t always a specific moment when the pain occurs. Instead, one might recall that it started gradually over time or may not even be able to recall when it started. This is especially common in sports or activities that require lots of repetitive movements with not a lot of rest. In these cases, pain may occur because of:

• Poor technique 

• Altered technique possibly due to fatigue

• Overuse and the inability of the body to adequately recover

• An imbalance between different muscle groups

• Inadequate rest, hydration, or nutrition

Do I Need To Be Concerned or Seek Professional Recommendations?

Now that we’ve discussed what pain is and why it often occurs in athletes, let’s talk a little about the difference between soreness versus pain, and when we need to be concerned. Most of the time, after further inquiry, discomfort that an athlete experiences can be broken down into two subcategories: soreness and true pain because of a potential injury. Let’s talk a little about the difference between these. 

Soreness

Soreness is common and occurs often in athletes, highly active individuals, or even in those individuals who perform a new activity that they are not conditioned or used to (this may be someone who hasn’t been able to perform their usual activities due to an injury or surgery or someone who has taken time off from an activity). Soreness is often expected in athletes at certain parts of their season including as the season starts, in the mid-portion of the season or during a period of intense training, and after a break from training.

Key elements that help us determine whether discomfort is soreness include:

• Typically occurs in a generalized area of your body (example: your entire shoulder)

• Improves after 24-72 hours

• Comes on slowly after an activity

• Commonly described as “tightness”

• Improves with movement or an increase in activity, but worsens with periods of inactivity or periods of prolonged sitting/lying down

When experiencing soreness, it is typically okay to continue training or performing your activities. However, it is important that you are still ensuring you are receiving adequate rest, hydration, and nutrition to allow your body to fully recover and prevent this soreness from turning into something more concerning. 

Pain

In contrast, discomfort that does not behave like soreness may be considered pain that is more concerning. It is not expected at any point in a season and may be a warning sign of an injury or potential future injury. 

Key elements of this include:

• Typically occurs in a specific location and you can point to the area (example: the top of your shoulder)

• May be accompanied by swelling

• Lasts longer than 24-72 hours and does not improve with rest

• Discomfort is constant

• Occurs quickly during an activity or immediately after an activity

• Described as “sharp” or “throbbing”

• Improves with rest, but worsens with movement

• Causes you to change how you perform daily activities such as carrying your backpack or washing your hair

• Forces you to change your technique, alter the intensity at which you perform a task, or modify parts of your activity

When experiencing this type of discomfort, it is best to seek the advice of a sports medicine healthcare provider to receive further examination, diagnosis, and treatment recommendations. It may require some modifications or rest from your activity as well. Sports physical therapists are excellent resources and can help you if you are experiencing any of the above symptoms.

If you are looking for a quick checklist to help you determine whether you need to be concerned about the pain you or your child is experiencing, check out my free resource that you can download. 

Get Your Free Download Here!

If you ever want to talk further about any discomfort you or your child may be experiencing, please don’t hesitate to reach out. I am here to help keep you strong, healthy, and injury-free! 

Disclaimer: The information provided in this blog is for educational purposes only and does not substitute for professional medical care. Please seek the care of a physical therapist or sports medicine physician if you are concerned about the discomfort you are experiencing.