Understanding Pain During Exercise: When to Stop and When to Push Through

The Moment of Doubt: Assessing Pain During Exercise

It’s 6:15 a.m., and you’re just five minutes into your first run in weeks. The temperature is perfect, the sun is rising, and the sky looks like a stained-glass masterpiece. Then, as you step onto a curb, you feel a twinge in your knee. Was there a click? The ache is slight but noticeable. You wonder: Is this just a sign of being rusty, or could it be the start of something more serious, like a meniscus tear? In an ideal world, you’d consult a doctor immediately, but in reality, you must make quick judgment calls. Most of the time, minor aches can be pushed through or walked off. But sometimes, ignoring them can lead to real injury.

Deciding whether to stop or keep going is tricky because everyone’s perception of pain is different. Pain experts like Beth Darnell, a pain psychologist at Stanford University and a former ultramarathoner, emphasize that the choices you make in the moment can determine whether the discomfort remains temporary or evolves into a persistent problem. “It might not have been a big deal, but suddenly we’ve created a big deal because we pushed through an additional five miles,” she explains.

Spotting Red Flags: Signs of Serious Injury

When pain strikes during exercise, there are specific warning signs that indicate it might be more than just minor discomfort. First, pay attention to any unusual sounds. If a sudden pain is accompanied by a crack, pop, or snap, stop immediately. While not every sound means a snapped ligament or tendon, it’s better to err on the side of caution.

Next, assess joint stability. Joints are particularly vulnerable because they rely on soft tissue that can lead to long-term issues if injured. If a joint feels unstable, wobbly, or unable to support your weight, it’s a strong indication that something is wrong. Swelling is another critical factor. If noticeable swelling develops within 10 minutes of the pain starting, it often signals a more severe injury.

Changes in movement are also a red flag. If your gait shifts or you find yourself favoring one side, even subtly, it’s time to stop. A friend can help you assess your movement for changes. Finally, monitor your range of motion. For example, a healthy knee should bend to about 130 degrees, but a meniscus injury might limit this movement or cause it to catch.

The type and intensity of pain matter too. Sharp or throbbing pain often indicates a more serious injury, while a dull ache is more likely to be temporary, like muscle soreness. However, intensity can be a better indicator than the type of pain. If the pain worsens over time, it’s a sign you need to take it seriously.

Tracking Pain Over Time: When to Seek Help

Pain is unpredictable, and no single rule applies to everyone. That’s why experts recommend observing how your pain changes over time. Pain should generally improve with rest or treatment. If it doesn’t, or if it shifts locations, it’s time to consult a professional.

Mallory Fox, a movement specialist, suggests tracking your pain levels from 1 to 10 each day for a week after an incident. Note any changes in swelling, loss of movement, or the development of new symptoms. For example, soreness after a new workout is normal and may peak a day or two later, but this type of pain shouldn’t be sharp, swollen, or limit your range of motion. If pain persists or worsens despite rest, it’s a red flag. Even experts sometimes misjudge their own symptoms. Conor O’Donovan, a physical therapist, once ignored worsening back pain and swelling after a soccer game, only to discover he had dangerous blood clots requiring ICU treatment. “If it’s getting progressively worse, something’s going on,” he warns.

Chronic Pain: Navigating Exercise with Pre-Existing Issues

For people with chronic pain—whether it’s a “trick knee,” lower-back issues, or another condition—the rules change. The advice isn’t to stop moving entirely but to approach exercise with care. Setting clear goals and boundaries is essential. If you’re running a 5K or playing with your kids, plan rest breaks in advance and stick to them, even if you feel fine.

If you have pre-existing pain, most experts caution against pushing through without professional guidance. Instead, start slowly, gradually increasing intensity, and regularly check for changes in pain quality or location. One sign you’ve overdone it? A “pain hangover” the next day, which can disrupt sleep, leave you fatigued, or limit your range of motion.

That said, movement is still highly beneficial for chronic pain. Exercise reduces stress, improves sleep, and boosts mood. “You don’t want to do too much, but you also don’t want to stop,” Dr. Darnell says. Small increases in pain are acceptable and even expected, as long as they don’t lead to long-term worsening.

When It’s Okay to Push Through

Not all pain is a sign to stop. Delayed onset muscle soreness (DOMS), for instance, often appears a day after trying a new exercise and can last up to a week. This type of pain is usually dull and improves with movement, though it may worsen for a couple of days before subsiding. As long as it doesn’t cause sharp pain, swelling, or limited mobility, it’s safe to push through gently.

Even with chronic pain, gentle movement can be therapeutic. The key is to listen to your body and avoid activities that cause sharp, worsening pain or mechanical issues like catching or locking joints. Pushing through pain is not about being tough; it’s about being smart.

Balancing Movement and Injury Prevention

Exercise is essential for overall health, but so is avoiding unnecessary harm. The goal is to find a balance that allows you to stay active without risking long-term damage. For most people, this means paying attention to warning signs, resting when needed, and gradually increasing intensity. It also means seeking advice from professionals when unsure.

Dr. O’Donovan, who works with chronic pain patients, puts it simply: “Your body’s built to move. It’s healthy to move.” Movement strengthens muscles, improves joint health, and enhances overall function. But it’s equally important to respect your limits and take care of your body. With the right approach, you can enjoy the benefits of exercise while minimizing the risk of injury.