Why Pain After Exercise But Not During?

Written By Drew Coverdale

A Frustrated Question

Here’s a question that symbolises the common frustration of those who suffer from persistent pain.

Does anyone else get pain flares after but not during physical exertion? 

I have done hours of manual labour the last few days, and the pain goes down and comes back with a vengeance when I am done!

I do not understand this as my brain has to realise it didn't hurt itself when the pain goes down with heavy exertion. So why would it freak out after the fact? Each day is rinse and repeat, so even if my brain thought it was hurt, it wouldn't take the pain away during exertion the next day. As it would believe, it was injured or something.

Very frustrating

A Logical Answer

The pain flare that comes after physical exertion but not during is a response to the stress chemicals during the work and not the physical exertion alone.

It's a very subtle but significant difference to understand.

There is no pain during the match or the chase from the lion. 

As you focus on that thing involving the exertion, it triggers norepinephrine. This neurotransmitter helps you maintain your focus so that you can complete whatever task you have chosen to focus on. You may know this as tunnel vision.

This goes for things you do or don’t enjoy. Whether you want or dislike the item you are involved in focusing on, the stress chemicals of cortisol and adrenal are circulating at levels relative to the intensity of the exertion you are undertaking.

If the physical exertion is not creating any physical trauma, the pain following it is not down to any new damage. However, if the effort is not physically overloading, the pain following is not down to being physically overloaded.

However, if the person experiences pain following what they consider to be minor or routine physical exertion, as this patient is asking, then it makes no sense if there has been no physical trauma or overload.

It only makes no sense if we only look at the physical aspect as a cause of that pain.

Pain Four ways

The brain uses pain as protection in 4 ways:

1) Regulation of the biological tissues of the body through thermoreceptors, pressure receptors or chemoreceptors. 

2) Regulation of the amount of water in the body.

3) Regulation of the amount of food in the body.

4) Regulation of the amounts of stress chemicals in the body.

There are early warning systems that provide gentle nudges that become a conscious awareness to act. These must be understood correctly, and any early warning can be considered, acted upon, ignored or overridden.

Suppose the threat to a particular system remains despite that first warning. In that case, a stronger sensation is triggered, and pain is at the end of that continuum before any damage occurs.

The hand is withdrawn from the radiator before the burn happens. There is no damage to the hand.

The headache at the end of the day prompts the realisation that the person hasn't drunk enough water throughout the day.

So there Is no damage to the head.

The stomach ache from not eating reminds the person to take nourishment.

There is no damage to the stomach.

Therefore, each ‘pain’ is contextually correct to help the person consciously interpret its meaning.

The organism's survival cannot allow any further conscious overriding of the earlier warnings as there may be none left, and pain is the last chance saloon.

Beyond that, it is tissue damage, injury, organ failure and death.

Bring Out The Cavalry

Pain is the cavalry to take control when the individual has not acted upon or misinterpreted the earlier warning signals that came before pain and may be continued for a while despite the pain.

The physical pain relating to excess stress chemicals is just another example of how the brain uses its final opportunity to warn the individual that the behaviour they are focusing on is bringing their system towards a place of overload or failure.

Those stress chemicals will cause damage over the long term if that stress level is maintained beyond that organism's physiological capabilities. However, other systems cannot function in that state.

Pain is triggered when the perceived threat to the organism reaches a threshold. This threshold is based on experience, beliefs, and protective neural networks already in place.

Previous Experience Is Important

Any previous experience where the brain or body recognises that level of intensity as a predictive indicator of danger can mean a short circuit to prevent that from happening.

The previous laying down of those neural pathways and their myelination (insulation so it's faster) through repetition with high emotion makes them a rapid, unconscious survival mechanism.

So, in someone with habitual traits of ignoring how they feel, pushing past what their body is telling them, suppressing emotions, and putting others first, their brain and body have a perfect warning system to protect that person from themselves when they start to misinterpret, ignore or override danger signals.

The experience highlights a lack of self-regulation, which is not the individual's fault, so the unconscious system uses what it knows best for that context to bring the behaviour to a painful, sudden, frightening halt.

So this pain after the exercises comes because there is no physical threat. So while undertaking that activity, the person is flushed with adrenaline and cortisol, not to feel much at that moment anyway.

Focus And Intent Can Represent Danger

The focus and intent behind the exertion and the presence of the stress chemicals present a threat to the organism.

However, an extremely high stress level has likely led to danger in that organism previously. 

That is the cue for the cascade of physiological reactions, which result in the short-circuit firing of pain before any actual damage occurs. The stress system is already hypervigilant, so it only needs an occasional top-up to trigger the pain alarm. That intent during the exertions is the top-up and the trigger, but one so small that the person does not even see it.

That pain from that trigger is only experienced once the stress chemicals have been naturally metabolised, in the time that takes, and the person becomes aware of that pain.

That's the pain after exercise, the one that wakes someone in the middle of the night, or the one that is present as they wake in the morning.

And what needs to happen at that moment?

That pain must be interpreted to give it meaning.

As you focus on that ‘pain’, the same norepinephrine helps you understand its meaning. 

And how is that pain interpreted? Calmly or through a dangerous filter?

‘I do not understand this’

‘Why would it freak out after the fact?’

‘Back with a vengeance’

‘Very frustrating’

An Incorrect Association

Because you can’t associate it with any recent trauma or overload, and it makes no sense then that continued focus brings uncertainty, a lack of information on how to deal with that pain and a sense of loss of control.

These are the three elements that define the stress response in all humans.

And this stress around that pain, the adrenaline and cortisol that follow that perception, continue to be the fuel for its transmission.

That individual may not interpret the exertion as stressful because they consider it normal. They don't see the activity as consciously stressful, they don't recognise how close they are to the stress threshold to trigger pain, or they may deny that connection even exists.

Even when they understand the connection between stress levels and pain, often, there is an unconscious addiction in the brain to those stress chemicals. So whenever there is a void for them, they feel compelled to act out a stressful behaviour whenever a particular cue appears.

When you realise it's not the physical exertion but the ‘good’ or ‘bad’ stressful intent behind it and your interpretation of the effect of that, which triggers and completes the cycle, you can start to understand how to unwire and rewire that mechanism towards becoming pain-free.

What’s next?
Take Your First Step to Recovery.

Drew Coverdale
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