So far I’ve mainly discussed the mental side of pain, but what do you actually do in the gym if you’re hurting?

Generally, persistent joint or muscle aches is a sign that a deload/low-stress week is in order. A week with reduced weights and overall workload can help relieve a lot of small aches and pains (e.g. mild knee discomfort, bicep tendonitis, etc.) that may’ve accumulated after many weeks of hard training.

If pain continues to persist after deloading, it’s useful to reassess the following:

• Technique
• Weekly Training Volume
• Average Intensity
• Training Frequency
• Exercise Selection
• Tempo

We can modify one or more of these to ensure our training sessions are still productive while staying under an acceptable (not a lot) pain threshold. Solutions will vary from person to person, and this is another case for tracking your training if you’re not doing so already. A structured training approach is all about monitoring trends and patterns, seeing what works well and what doesn’t, and that applies to pain management as well.

To give a real-life example, @the_quadgirl Sarah was experiencing hip and knee pain while performing Low Bar Squats. My initial response was to slightly lower volume, but that didn’t really do much since she didn’t have a lot of volume to begin with (relative to her BW, strength level, etc.).

The changes I made to her training are on the 2nd slide (below).

The slower tempo naturally limits the load (intensity) she can use. Slowing things down gives her time to think, allowing her to focus on maintaining technique, practice staying braced under load, and it just helps with pain sometimes.

The front squat also limits load and places less torque on the hips, which can be helpful. It also allowed her to go much deeper than her back squat, which is something I occasionally find can be helpful when it comes to knee pain while squatting.

I didn’t think squat frequency needed changing, but if there wasn’t any improvement, I would’ve definitely considered it.

She experienced less pain every week until she was completely pain-free at the end of the cycle. She even PB’d her squat by 5kg despite training being not as specific as usual.