The Shock of Pain
One of the most stressful moments during a workout is when pain suddenly appears. A pinch in your back, a sharp sensation in your knee, or shoulder pain during an exercise can make you freeze, stop your workout immediately, and think: “Did I just damage something?”
Deciding What to Do Next
But what should you actually do when pain appears during exercise? Do you need to stop everything and rest, or can you modify the exercise and continue moving safely? In this article, we’ll look at what can influence the experience of pain during physical activity, how fear of movement can affect the nervous system, and 3 practical steps you can take when pain appears during a workout.
Misleading Information About Pain and Exercise
Spreading Fear on Social Media
Some of our fear around movement doesn’t necessarily begin with the sensation itself. Sometimes it begins with the information we receive about it. Online, we can find many confident statements about pain and exercise that may cause us to interpret normal body sensations as signs of damage.
The Damage of False Information
Not long ago, I came across a social media story from a movement professional who told her audience that if they experienced a “stabbing” sensation in their knee or back, it was a sign that inflammation was beginning. She then warned that if they didn’t continue exercising and strengthening their muscles, a previous injury or disc herniation could “flare up” again. The problem with statements like these is that they turn a single sensation into a definite medical interpretation. A brief stabbing or pinching sensation, by itself, cannot diagnose inflammation or tell us that tissue has been damaged. Pain also does not necessarily mean that new tissue damage has occurred. Pain is an experience involving the brain and nervous system, and it can be influenced by many factors, including information coming from the body, previous experiences, expectations, attention, emotions, and context.
How Can Fear-Based Information Affect Pain?
When we repeatedly receive messages that portray the body as fragile or movement as dangerous, we can begin to interpret ordinary sensations as signs of threat. Fear increases. The body becomes more guarded. We may tense our muscles, hold our breath, or start avoiding movements that used to feel natural. This can contribute to a cycle: Pain → fear → increased guarding and avoidance → less confidence in movement → greater sensitivity to pain.
Fear of Movement (Kinesiophobia) and the Nervous System
To understand why pain can appear during exercise, it helps to understand an important principle in modern pain science: pain is not a direct measure of tissue damage. Pain is part of the body’s protective system. The brain and nervous system process information from many sources and evaluate whether protection may be needed. This is one reason the exact same movement can feel completely different on different days or in different circumstances.
What Happens When We Exercise While Afraid?
If you come into a workout worried that your disc herniation will return, that your knee is “worn out,” or that an old injury is about to reopen, your nervous system may become more alert and protective. You may start paying close attention to every small sensation, holding your breath, tensing your muscles, or unconsciously changing the way you move. And the pain? It is real. It is not “just in your head.” But it also does not necessarily mean that tissue damage has occurred. Understanding this distinction can help us respond to pain without automatically becoming afraid of it.
How Should You Respond to Pain During Exercise?
Not every painful sensation during a workout means you need to stop all activity. At the same time, it isn’t a good idea to ignore every painful sensation and simply push through. Instead of asking only: “Does it hurt?” You can also ask: “What happens when I change the movement?”
Pain or Discomfort You Can Monitor and Modify
Mild to moderate pain or discomfort that does not significantly worsen and still allows you to breathe and move with control may be something you can pause, assess, and modify. You can reduce the range of motion, decrease the load, change the angle, or move to a more supported version of the exercise.
When Should You Stop and Get It Checked?
If you experience sudden severe pain, a new injury following trauma, sudden or significant weakness, loss of function, a limb giving way, significant numbness, unusual burning or electrical sensations, substantial swelling, or symptoms that continue to worsen, stop the activity and seek appropriate assessment. These symptoms do not tell us exactly what the diagnosis is, but they are reasons not to simply push through the pain.
What to Do When Pain Appears During a Workout: 3 Simple Steps
If pain or discomfort appears in the middle of a set, try not to react immediately with fear. Instead of freezing or abandoning the entire workout, try these three steps.
Step 1: Pause, Breathe, and Reduce the Sense of Threat
Pause the exercise for a moment. Take a few slow, comfortable breaths. Relax your jaw and shoulders and notice what is happening in your body without trying to fight the sensation. You can remind yourself: “I noticed a sensation. I don’t have to panic. I can pause, assess, and choose what to do next.” The goal is not to convince yourself that “everything is fine” in every situation. The goal is to create enough calm and space to respond thoughtfully rather than automatically.
Step 2: Scale Down and Modify the Exercise
Instead of immediately abandoning the exercise, see whether a small modification makes it more comfortable or manageable. Reduce the range of motion: For example, squat less deeply or use a smaller range of movement. Reduce the load: Remove weight or resistance, or move into a more supported position. Change the angle: Move your arm or leg slightly and see whether another angle feels more comfortable. Slow the movement down: A slower pace can give you greater control and allow you to notice how your body responds. The goal is not to “beat the pain.” The goal is to find a way for the movement to feel safe, controlled, and appropriate for your current capacity.
Step 3: Return to Movement Gradually
Have you found a more comfortable version of the exercise? Try 3–5 slow repetitions while breathing naturally. Pay attention to how your body responds. If the sensation settles or remains manageable, you may be able to continue gradually. If the pain keeps increasing, becomes sharp or significant, or new concerning symptoms appear, stop and reassess rather than forcing yourself to continue. Over time, experiences of gradual and manageable movement may help reduce fear of movement and rebuild confidence in your body.
Why Can Complete Avoidance of Movement Become Part of the Problem?
When pain appears, one of our most common automatic reactions is to stop exercising. Sometimes rest or temporary activity modification is exactly what is needed — particularly after a new injury or when symptoms are significant. But when fear of pain leads to prolonged avoidance of movement, it can create a cycle that becomes difficult to break. The more we avoid movement because we are afraid, the more we may gradually lose strength, endurance, and confidence in our ability to handle physical activity. Most importantly, we may reinforce the belief: “Movement is dangerous for me.” The goal is therefore not to ignore pain. But it is also not to avoid every movement that creates a sensation. The goal is to find a gradual, appropriate, and manageable level of activity that allows the body and nervous system to rebuild confidence and capacity. You don’t have to choose between “pushing through the pain” and “doing nothing.” There is a middle ground.
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