Training with a niggle: when to push on and when to stop

The 0 to 10 rule

Physios often use a simple pain-monitoring approach for niggles and tendon problems. Rate your pain from 0 (none) to 10 (the worst imaginable).

• During exercise: pain up to about 3 or 4 out of 10 is generally acceptable.
• After exercise: it should settle back to your usual level within about 24 hours.
• Next morning: it should not be worse than the morning before.
• Over the week: the trend should be steady or improving.

If you break those rules, you did a bit too much. Reduce the load or change the exercise next time. If you stay within them, you can carry on and gradually build back up. Our guide to whether to rest or move explains the thinking behind this in more detail.

Modify, do not just stop

There are almost always ways to keep training an area without aggravating it. The trick is to change one variable at a time until you find a version that stays within the rules above.

• Load: drop the weight by 20 to 40% and do more controlled reps.
• Range: squat to a box, press from pins, or shorten the stride on lunges.
• Tempo: slow lowering phases are often well tolerated and useful for tendons.
• Exercise: swap an overhead press for a landmine press, a back squat for a sled push, running for the bike.
• Grip or stance: a neutral grip often suits sore elbows and shoulders; a wider or narrower stance can change how a knee feels.
• Frequency: train the area every few days rather than daily, so it has time to settle.

Every well-run gym class should be able to do this. At Lycan Strength, every class is scalable and coaches adjust movements to the person, so tell your coach about the niggle before the session starts. Our guide to how exercises are scaled shows what that looks like.

Keep the rest of you training

A sore shoulder does not stop you training legs. A grumbling knee does not stop you rowing with your arms, working your upper body or doing core work. Keeping the rest of your body active maintains fitness and strength, protects your mood, and keeps the habit going so you do not lose momentum.

A simple approach is to write down what you can do rather than what you cannot. A lifter with a sore elbow might still squat, deadlift with straps, push the sled and ride the bike. Someone with a grumbling Achilles might swap runs for rowing and cycling for a couple of weeks while working on calf strength. The list usually turns out much longer than expected.

It also helps the niggle. Staying active generally supports recovery, and building strength around a problem area, done carefully, is one of the most effective parts of rehab for most common gym complaints.

When to see a physio

Many niggles settle within a couple of weeks of sensible changes. It is time to get it assessed if:

• It is not improving after about two weeks of modified training
• It is getting worse, or spreading
• It keeps coming back every time you build up
• It is changing how you move, lift or walk
• It wakes you at night or affects work and daily life

Getting it looked at early is usually quicker and easier than waiting until it stops you training altogether. Most niggles are much simpler to sort out while they are still niggles.

A physio assessment looks at where the pain comes from, what makes it better and worse, and how you move and load the area, then builds a plan to get you back to full training. Our guide to physio for gym injuries covers common problems. Lycan Strength has on-site physiotherapy with 20% off treatment for gym members.

Red flags: stop and get help

Some symptoms are not niggles and should not be trained through. Get urgent help if you notice:

• Numbness around the genitals or buttocks, new bladder or bowel problems, or weakness in both legs with back pain: call 999 or go to A&E
• A swollen, hot, red calf, especially with chest pain or breathlessness: call 999
• Inability to bear weight, an obvious deformity, or a joint that locks or gives way: A&E or an urgent care centre
• Pain with fever or feeling generally unwell: contact NHS 111 or your GP
• Pins and needles, numbness or weakness spreading down an arm or leg: see your GP or physio promptly