PAIN: How do I know when to push through and when to dial back?
An old picture of me during some “pain experiments”
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No subject involving the human body is black and white, but this one can be particular tough to navigate. It’s quite a challenge to be at your full capacity for patience and rationality when pain is involved. Most people miss the sweet spot of dealing with pain by getting lost in one (or even both) of these two compensations:
Attempting to make up for a lack of understanding with an excess of grit.
Attempting to replace hard work with hyper-intellectual theories.
The solution, as always, is in the middle. You can never replace hard work or practical understanding with more of the other. In isolation, either is prone to becoming toxic and excessive. And while we’re at it, let’s add one more: you can’t replace consistency with intensity. Focus on a process that has long-term change implications. The end goal should go far beyond just getting out of pain. Pain is often a catalyst for transformation and a call to action to finally address the weak links that have quietly held us back for years.
Let’s start by shifting some problematic paradigms. If key principles are understood, the specific action steps become clearer (even intuitive and obvious in many cases). After that, we’ll get out of theory and dig into some concrete examples.
True Danger vs Fear of the Unknown
An important place to start is that you must be able to differentiate between an unfamiliar, intense sensation and true danger. To do this, we have to rise above the emotional response of pain and adopt a more objective view in these charged moments. If you’re attempting to expand the limits of your body, unfamiliar sensations are bound to arise. New sensations are typically sharper than those you’ve grown accustom to. Your nervous system heightens nearly all new experiences, so there’s nothing unusual about this.
It doesn’t even have to be an entirely new movement pattern or skill. Let’s say you’ve been doing a forward bend stretch for some time now and eventually you begin to creep into ranges of motion that you haven’t been capable of since childhood. Now, a bundle of motor neurons that have atrophied since they last had to alert you of that particular sensation are woken from their slumber and begin firing. The atrophied line of connection between these motor neurons and your CNS is so spotty that mis-firing may be the more appropriate term.
Perhaps the muscle, joint, and fascia are all perfectly fine since you’ve been following a consistent regimen of building strength as you mobilize, but you get a sharp sensation anyway… and if it’s in a place that you don’t think you’re supposed to feel intense sensations, you slap the pain label on it. Your nervous system may have just needed more time and repetition to re-integrate these lost connections. But once you bring in the pain label, everything changes.
The word pain in itself creates problems. First off, some people use it to describe literally anything uncomfortable, some will never admit to feeling it at all, and those in between have varying degrees of tolerance. And a person’s tolerance isn’t just about how much discomfort they’re okay with, but also where and what type.
One Word… Ten Thousand Translations
A sensation you may welcome when it appears in your bicep could cause sudden panic if you feel it in your lower back. The perception of “wrongness” causes mental resistance and a negative story that only heightens the pain (your nervous and endocrine systems are highly reactive to your stories and mental states after all). Part of the problem is that the fitness industry has ingrained in us that there are places you should never feel discomfort. We also all have deep wells of psychological and emotional storage within our bodies. Different types of stress get stored in different ways. This includes anything from a rough day at the office contributing to a tension “knot” in your neck to a traumatic sexual experience causing chronic tension and sensitivity in your psoas, adductors, and pelvic floor.
Once the P-word gets involved in your story, you’re likely to go into over-reaction mode. Maybe you clench your body when you approach that sensation, or maybe you stop altogether and begin scouring the internet for answers outside of this pain-riddled body that you suddenly don’t trust (maybe that’s even how you got to this article). It’s amazing how different the experience of a sensation can be when you label it with a loaded word such as pain rather than just calling it a sharp or intense sensation and leaving it at that.
The multitude of definitions and personal relationships to the word pain leads me to compare it to another loaded and charged word: God. If people are using the same word in drastically different ways, sometimes it’s helpful to set that particular word aside for a while to ensure we’re on the same page. I don’t suggest we never discuss challenging topics — after all, that’s what we’re doing now — but if we constantly use that loaded word in a conversation about the phenomenon it points to, it’s somewhat akin to Webster using a word within its own definition.
Sooner or later, a truly growth-oriented practice of any kind is going to put you face-to-face with fear, confusion, and suffering to force you to develop important human skills. Among the most important human skills necessary to navigate an ambitious practice is the ability to assess risk in a calm and patient manner. Remember, new and unfamiliar sensations are going to arise when you challenge your body to do new and unfamiliar things. When they do, you’ll need to have many shades of grey between no-pain-no-gain and complete shutdown within your arsenal.
I don’t want to put myself in dicey legal water by advocating for self diagnoses in favor of medical intervention, but I also don’t want to fuel fear and distrust of your ability to investigate your own body. If you’ve experienced an injury that requires medical intervention (or feel you’re in danger of one), take this for what it is: a blog, not medical advice.
The “2 Shitty Options” Dilemma
The misconception that we should never challenge certain parts of our bodies has led us down a dangerous path. The areas we avoid challenging inevitably become weak and incapable of protecting themselves under load. Eventually, it can become so weak that even basic human tasks become a problem. You’ll also reach a cap on how much you can develop your body as a whole while neglecting individual links in the chain. This is where the fork in the road comes in: if an area has become so out of balance that it begins to hurt doing practically anything, what do we do? Do we overload the area that is beginning to fail during basic tasks and risk injury or do we limit our practice and general movements more and more severely to continue avoiding the weakness?
Getting angry at yourself for not finding and addressing this weakness before it reached critical mass isn’t going to solve anything — you need to make practical decisions about how to proceed. In retrospect, I’ve often looked back at these frustrating moments and been grateful to have been forced to develop something that ended up propelling my practice to new heights.
Pursuing hard things reveals weaknesses; pursuing comfort creates weaknesses. Be sure you know the difference.
Again, the further you take your practice, the less you can hide poor habits and imbalances. If you don’t have interest in pushing your limits very far, you can hide safely from some of your weaknesses for an entire lifetime — and honestly there’s nothing wrong with that. But if you truly want to pursue physical / self mastery, you’re going to have to figure out how to work through some sticking points.
Now it’s time to set aside theory and dig into a few specific cases.
As Promised: Concrete Examples
Example 1: Knees
“Knees over toes guy” is a perfect case study on this subject. His entire rise to prominence has come from turning chronic knee injuries and general weakness in this area into his greatest strength. He was once unable to do practically anything athletic anymore because of his knees. Eventually, he switched paradigms from avoidance to going right at the weakness and strengthening it.
He’s known as knees over toes guy rather than his own name (Ben Patrick) because the focal point of his shift was questioning the old fitness paradigm that your knees should never go over your toes when you squat. Why? Because when your knees go over your toes, your put load on the knees. But here’s the problem — as discussed above, an area that is never loaded gets weak. And on a practical note, life and sports require your knees to pass over your toes constantly. This is one of the main reasons that simply stepping off of a curb has long been one of the most common causes of knee injuries.
Rather than continue avoiding these positions, Ben decided to patiently and gradually strengthen them. Load is not bad, it’s simply a matter of finding the right entry point and slowly increasing your capacity over time. If you can become strong where the injury risks are greatest, you stop being susceptible to those injuries. In his case, it was so bad that he had to start with just walking backwards. But it didn’t stop there. He didn’t just develop “rehab strength” and neither should you. He can now do outrageous and seemingly precarious things with his knees without ever being in danger due to how strong his knees are under load now (ex: he has videos where he performs single-leg, knee-dominant squats with a barbell equal to his bodyweight on his back; impressive for anyone, much less someone with a history of serious knee injuries).
As a result, not only are his knees protected, but now he can perform in ways he couldn’t before. Even in his high school and college days of playing basketball, he could never even grab the rim. Because of his knees, he was referred to as “old man” even back then. Now, in the latter half of his 30’s he can dunk easily. Let this be an important lesson: stop treating rehab like rehab. Treat it as strength and mobility training from a remedial starting point. Rehab protocols are often ineffective, or at least under-effective, because they’re performed in a way that treats the human body as overly fragile. Be patient and honest with where you need to start, but your goal should be to become extremely strong, not mildly functional. To hammer that point home, I’d recommend watching this 1min “improper alignment speech” from Ido Portal.
Example 2: Shoulders
For well over a decade, I had frequent and often painful struggles with my shoulders. They were clearly the least stable part of my body, and certainly didn’t hint that I’d be doing the type of things I now do with them. The two most instrumental things that helped me go from many years of shoulder challenges to feeling almost bulletproof in my shoulders came from Ido’s advice. One was the strict Cuban rotation exercise (note: the strict version he teaches is substantially harder than the most common variation that resembles a “muscle snatch”).
The vast majority of our largest pushing / pulling muscles are internal rotators, and yet we expect to balance this out with rehab-level external rotation strength. Ido stated that anyone pursuing advanced pushing and pulling goals should also pursue a 5 reps at half bodyweight Cuban rotation (at a 4sec down, 2sec up tempo no less). To put that into context, this is an external rotation exercise that many people need to start with single digit pounds.
When I began this pursuit, I could already do things like this and had been doing resistance band variations of external rotation for years… yet I had to really push to get 5 strict Cuban rotations with only 20lbs. I still don’t have the half bodyweight target, but now I warm up with more weight than I could initially lift for a single rep. And you can bet my shoulders feel different after multiplying the load I lift while simultaneously improving my control and range of motion.
The 2nd recommendation from Ido, which he recommends to all people who live in bodies and have arms: hanging. I had already been practicing hanging for years by the time I began using the Cuban rotation, and honestly that was one of the main reasons my shoulders were able to handle my training up to that point. Any time I’ve neglected hanging for even a short time, my shoulders tell me. For anyone who has shoulder pain of any kind, I highly recommend this short book by John Kirsch, MD. The man has done more research on this subject than anyone else and was much of the inspiration behind Ido’s recommendation.
In a nutshell, hanging passively from a bar (or rings, a tree branch, etc), is vital to the structure of our shoulders. And I do mean structure, not just musculature. Hanging prevents (and reverses) a skeletal constriction in the overhead position that is responsible for the vast majority of shoulder pain — it literally (un)bends a bone that otherwise slowly infringes upon the humerus over time when we don’t hang. Remember, we’re just hairless apes and our structure developed in the trees. I could go on about the vast strength, mobility, and decompression effects of hanging, but let’s move on.
My shoulders aren’t the only area that has given me trouble in my training. It’s time to address possibly the most common pain issue in the modern world: lower back pain.
Example 3: Lower Back
This is something that I never thought I’d experience personally, so it was a humbling experience when I did. Though it was quite debilitating for a while, I’m thankful that it happened for two reasons:
I’m now better equipped to teach from experience when helping others with this.
It has become a catalyst toward flipping a weakness into a strength in an area that I didn’t realize was preventing me from unlocking certain skills.
This was quite recent, and it snuck up on me because it showed no signs of even being weak. After all, how could a weak lower back do the things I was doing? I certainly hadn’t avoided loading my back, or my posterior chain in general (essentially the entire backside of the body, especially the glutes, hamstrings, and lower back). But, I had focused more on stretching than strengthening them — and not by a small margin. An imbalance which I certainly knew better than to create, but I suppose I had some delusions of invincibility because of how resilient my body (and mind) had felt in the face of intense, outrageously high volume training over the prior couple of years.
Explanations aside, my back was now so bad that it was an ordeal every time I had to bend over. I couldn’t even do gentle forward bending stretches anymore. When back issues arise, the most common modern advice is to simply “strengthen your core.” More specifically, the generic advice suggests that back pain is usually just the result of tight hip flexors and weak abdominals. Neither were true for me by a longshot after years of addressing past deficiencies on both counts. Technically, your entire lumbo-pelvic hip complex is part of your core, which includes your glutes and lower back, but the people giving such generic advice often use the word synonymously with “abs” — this is why I add the word “core” to the list of abused and confused words right along with God and pain.
So what was Ido’s prescription for my lower back pai—err, sharp and intense sensations? A high volume of posterior chain strength work that loaded my lower back in a wide array of angles. And not the “gentle rehab” type of work. The prescriptions and 6-week goals were much more aggressive than I expected. One of which was the old school approach of GHD / roman chair back hyper extensions to go straight to the source (despite the name of the exercise, the primary goal is hip extension, not lumbar hyper extension). Contrary to my fears from within my weakened state, it was overwhelmingly effective… and to my surprise, didn’t cause any particularly sharp sensations. I was, however, perpetually sore for weeks while I continually challenged my weakened areas to rebuild themselves.
Fittingly, knees over toes guy also advocates heavily for this exercise. Not just rehab and prevention, but also for flat out strengthening. He goes as far as to say here that this is such a necessity that anyone who owns a couch should own a back extension machine. I don’t personally own a couch, but given my experience I can’t argue with the sentiment.
Keep in mind that none of these examples cover the full spectrum of how these issues are to be addressed. The point is the principle that pain is often a signal of weakness, and thus the solution is usually more about building new strength than about avoidance of “bad” movements. The weaker you get, the more movements and positions suddenly become “bad” for you. Scale back certain culprits as necessary in the short-term, but don’t wait to be out of pain to start the rebuilding process.
The Talent Paradox
I’d like to wrap this up with a thought that is paramount to the path I’ve chosen in life: the things we’re most effective at sharing with the world are not the things we’re naturally good at, but rather the things we’ve struggled with, devoted ourselves to overcoming, and turned into our greatest strengths.
I believe that a “talent” usually shows up first as a weakness. Specifically, a weakness that triggers hardwired desires to address a feeling of emptiness in an area that feels inherently meaningful. But since this isn’t how the word is usually used or understood, talent goes on my God, pain, core list. How many billions of people have historically not followed their calling because they were led to believe that a talent is something that comes easily?
The experience of overcoming a deficiency prepares us to help others who struggle with similar deficiencies, gives us a deeper appreciation for being strong in that area, and fuels a passion that must have been somewhere in us all along for us to have been willing to put so much into it in the first place. Many of the greatest in the world at their crafts were particularly challenged in their craft in the beginning. That initial challenge is often vital to lighting a fire. Your starting point is NOT an indicator of your potential. Plus, the lower your starting point, the better your story.
If something matters enough to you to pursue excellence, you can count on one thing:
