Training Through Pain

Life plays rough. Injuries are going to happen. In May, I suffered a partial AC joint separation in Judo. But not because of judo. I was training without a partner. I just miscalculated and hit the ground wrong executing a move I have practiced thousands of times over the past forty-six years. Only this time, I messed up. Ouch.

It was fairly debilitating, as serious shoulder injuries tend to be. It’s not my first shoulder injury. The rehab process is long and painful. And while I have most of my range of motion back, there are still a few movements that are painful, such as the bottom of a pushup or ring dip.

Now, there is something that I understand about pain that most people get wrong. Though they entered my life together, pain and injury are not the same thing. Injury is tissue trauma; pain is a signal. And because this is not my first rodeo, I know that they do not always recede together. In fact, my experience with both back and shoulder pain is that it long outlives the injury that triggered the pain signal in the first place.

Fear can exacerbate this. So can resuming training prematurely. I’ve read many hypotheses on why pain persists even after an injury has healed. I don’t know which one is true. But I do know that it is a thing. I have a lot of firsthand experience with it.

Why Rest Isn't Always the Answer

My shoulder is healing. It isn’t healed. But it is getting stronger quicker than the pain is receding. Before my Chicago trip, the first weekend of June, things were actually going pretty well. I had recovered most of my strength and range of motion, and the pain was minimal. During our six-day trip, I did not train. Mostly this was a logistics thing pertaining to the schedule. But I am also guilty of the oh so common misconception that maybe a few days off training would give my body time to heal.

It never works that way. Your body heals through movement. Because returning from six days of rest and recovery in Chicago, my shoulder was screaming at me, much worse than when I left. Instead of getting better, I had lost range of motion and strength. Could not even hang from the pull-up bar without pain.

Pain Isn't Always Telling the Truth

Here is where most people go wrong. They mistake pain for the truth. Yes, I separated my AC joint in early May. The injury was real. The emphasis, though, must be on was. I did not do anything during my stay in Chicago to re-injure my shoulder. So, the increased pain I was experiencing on my return could not possibly be associated with the actual physical condition of the shoulder. This kind of potentially debilitating pain should not be allowed to interfere with your activities.

As painful as it was, I forced myself to hang from that pull-up bar and practice deep breathing until my nervous system, reassured that everything was in fact okay, stopped sending pain signals and allowed my shoulder to open up and relax into the hang. Yes, I had to physically turn off the false pain signals. They were false alarms from a nervous system recalling past trauma. They did not correspond to my present reality.

How do you know which is which? If my shoulder was still injured, the pain would have worsened after the bar hang, telling me that I had aggravated the injury. The fact that the pain receded after hanging and that my pain-free range of motion actually increased tells me that the pain was purely neurological.

A quick clarification: neurological does not mean psychosomatic. Neuropathic pain is not all in your head; it is very real and very physical. Even if there is no actual injury to justify the pain signal.

A Return to Action

Here is what my return workout after Chicago was:

10-9-8-7-6-5-4-3-3-2-1
Floor Press
Chest-to-bar pull-ups

You may remember this one.

As painful as hanging from the pull-up bar had been, I was concerned about the pull-ups. But to my surprise, after a bit of bar hanging to open up my shoulder, it was not the problem. The problem was I could not press a 95lb barbell. Even 50lb dumbbells felt too painful.

Lifting lighter is one option. But at a certain point, the weights become too light to be meaningful. So, instead, I chose to attack pressing strength from a different angle, turning the movement upside down using ring push-ups in place of floor presses.

These weren’t easy, but while my nervous system refused to allow me to press up through the weak point in my injured shoulder, it proved willing to allow me to lower myself down through that range. And learning it was safe there, it let me push back up as well. I went very slowly and carefully so as not to aggravate the tender tissue.

I was uncertain about how many pull-ups and push-ups my shoulder could take. My practice reps set off all the pain signals. But the pain didn’t worsen after movement. If anything, it eased off slightly. But a set of ten reps of push-ups or pull-ups with that amount of pain seemed daunting. So, I inverted the rep count, beginning with the round of ones. This proved an effective strategy. As my body adjusted to the movement demands, and successful early rounds reassured my nervous system that these were indeed safe movements, the shoulder gradually opened up and the pain signals calmed down.

Progress Through Persistence

If it had gotten worse as the rounds went on, I would have stopped, but despite fatigue, it felt better the further into the workout I got. I still went slowly, taking good breaks between sets. I never performed more than five reps in a row, making sure I did not execute with sloppy form or while fatigued.

And by the end of the workout, twenty minutes in all, my shoulder felt looser and more relaxed than when I started, and the pain had dialled down several notches. And though I feared the possibility of overdoing it on my first workout back, the shoulder felt even better the next day. Sometimes you have to work through pain. Slowly, persistently, progressively. Not every pain signal is the truth. Especially the pain signals that hang around for weeks or months after the initial injury from which they originated.