Good Pain vs. Bad Pain

My brother told me a while back that he is doing some kind of training regimen. You’ve all heard of the latest crazes–perhaps you are doing one or several of them yourselves. He wanted to know if the pain that he was feeling in his elbow was okay. After berating him for doing this type of training, (as I am very wary of a multitude of these programs because of the injuries I often see in my practice), I asked him if his pain was “good” or “bad” pain. In explanation I stated that good pain is the type of sensation one knows over the course of their sporting life; muscle soreness, fatigue, or tightness, which exists for less than 48 hours, and is rather satisfying. Conversely, bad pain is something different, usually new, and definitely has an ominous aspect about it that the body and mind instinctively register as injurious. As he imparted that it was new, different, and felt “bad” according to my definition, I told him to shut the activity down. When he balked at this, I explained that repetitive injuries, even when they disappear quickly, have the possibility of turning into chronic injuries, and these are often much more difficult to heal. Additionally, they often require a subsequent maneuver such as therapy, steroid injection, or even surgery, to heal them. Thus, the acute injury, even if it is not too bad and can be “played through,” should be taken seriously. And perhaps, older brothers should listen to their wiser younger brothers. Or not.