Should You Push Through Pain? Knowing the Difference Between Soreness and Injury

By Empire Performance PT

Every runner, athlete, and active adult has asked this question at some point:

"Should I push through the pain?"

Maybe your knee starts aching halfway through a long run. Your shoulder feels sore after lifting weights. Your back tightens after a day of yard work. Or your calves are so sore after yesterday's workout that walking downstairs feels like a challenge.

Sometimes discomfort is a normal part of getting stronger.

Other times, it's your body's way of saying something isn't right.

Knowing the difference between normal soreness and an injury that requires attention is one of the most valuable skills an athlete—or anyone who enjoys being active—can develop.

Ignore pain that shouldn't be ignored, and a minor issue can become a months-long setback.

Stop every time you feel mild soreness, and you'll never build the strength or endurance needed to improve.

Finding that balance isn't always easy, but understanding how your body communicates with you can help you make smarter decisions.

At Empire Performance PT, this is one of the most common conversations we have with patients every day.

Let's break it down.


Pain Is Information—Not the Enemy

One of the biggest misconceptions about pain is that it's always bad.

Pain isn't your enemy.

Pain is information.

Think of pain like the check engine light in your car.

Sometimes it's alerting you to something serious.

Other times it's signaling something relatively minor that still deserves attention.

The challenge is learning how to interpret the message.

Pain exists to protect us.

Without it, we'd continue placing stress on injured tissues without realizing it.

The goal isn't to fear pain.

The goal is to understand it.


Not All Pain Means Injury

One of the most surprising things we explain to patients is that pain and injury are not always the same thing.

You can experience:

• Significant muscle soreness without injury.
• Mild pain from temporary tissue irritation.
• Severe pain from a relatively minor strain.
• Minimal pain despite a more significant injury.

Pain is influenced by many factors beyond tissue damage, including:

• Previous injuries
• Stress
• Sleep quality
• Fatigue
• Anxiety
• Overall health
• Activity level

This is why two people with the same injury may report very different pain levels.

It's also why pain should never be evaluated based on intensity alone.

Context matters.


Understanding the Pain Scale

One tool we often use in physical therapy is the 0–10 pain scale.

While it's not perfect, it provides a helpful framework.

0–2: Minimal Pain

This level usually represents little to no discomfort.

You may notice the area, but it doesn't change how you move.

In many situations, this level of discomfort is acceptable during rehabilitation and exercise.

3–5: Mild to Moderate Pain

This range deserves attention.

The activity may still be appropriate, but it's important to monitor how symptoms respond afterward.

Questions to ask include:

• Does the pain improve after stopping?
• Is it gone within 24 hours?
• Does it affect my movement?

If symptoms remain stable and improve quickly, modification—not complete avoidance—may be appropriate.

6–10: Significant Pain

Higher pain levels often suggest that the body is struggling to tolerate the current workload.

Continuing through severe pain rarely produces positive outcomes.

Instead, it's usually a sign to stop, reassess, and determine the underlying cause.

Remember:

The number itself isn't everything.

A pain level of 3 that steadily worsens over several days deserves more attention than a brief pain level of 5 that disappears immediately.

Patterns matter.


What Is Normal Muscle Soreness?

If you've ever started a new workout program or increased your training, you've probably experienced delayed onset muscle soreness, commonly called DOMS.

DOMS typically develops:

• 12–24 hours after exercise
• Peaks around 24–48 hours
• Gradually improves over the next several days

Characteristics include:

• Generalized muscle tenderness
• Stiffness
• Mild weakness
• Discomfort when stretching or using the muscle

Importantly, muscle soreness usually affects both sides of the body if both sides were trained.

For example:

After a challenging leg workout, it's normal for both quadriceps to feel sore.

That's very different from sharp pain on the outside of one knee during every run.


Muscle Soreness vs. Injury

So how can you tell the difference?


Normal Muscle Soreness

Typically:

• Appears after unfamiliar activity
• Improves with light movement
• Feels like a dull ache
• Occurs in muscles—not joints
• Resolves within a few days

Possible Injury

More concerning symptoms include:

• Sharp pain
• Pain during a specific movement
• Swelling
• Bruising
• Instability
• Pain that worsens with activity
• Pain that persists or increases over time

If discomfort consistently returns during the same activity, it's worth investigating further.


The 24-Hour Rule

One of our favorite guidelines for athletes is the 24-hour rule.

Ask yourself:


How do I feel tomorrow?

It's common to experience mild soreness after a challenging workout.

However, symptoms should generally return close to baseline within about 24 hours.

If pain:

• Continues worsening,
• Causes limping,
• Prevents normal activities,
• Or remains significantly elevated,

your body may be telling you that the workload exceeded its current capacity.

This doesn't necessarily mean you've suffered a serious injury.

It does mean your training plan likely needs adjustment.


Warning Signs You Should Never Ignore

Some symptoms deserve immediate attention.

Seek evaluation promptly if you experience:


Sharp or Sudden Pain

Pain that feels like:

• A pop
• A snap
• A tearing sensation

should never be ignored.


Significant Swelling

Rapid swelling often indicates tissue injury.

Early evaluation helps determine the next steps.


Loss of Strength

If you suddenly cannot push, pull, lift, or bear weight normally, something more significant may be occurring.


Persistent Night Pain

Pain that consistently wakes you from sleep or prevents restful sleep deserves medical evaluation.


Numbness or Tingling

Symptoms involving burning, numbness, tingling, or weakness may indicate nerve involvement and should be assessed promptly.


Pain That Changes Your Movement

If you're limping, compensating, or altering your running form because of pain, continuing to push through usually creates additional problems elsewhere.

The body always finds a way to move.

Unfortunately, compensations often lead to new injuries.


The Difference Between "Good Pain" and "Bad Pain"

Athletes often ask us:

"Is there such a thing as good pain?"

We prefer to think of it differently.

Certain sensations are expected during rehabilitation.

For example:

• Muscle fatigue
• Mild stretching discomfort
• Controlled muscular effort
• Temporary soreness after strengthening

These experiences are part of adaptation.

Concerning pain includes:

• Sharp pain
• Increasing pain
• Joint pain
• Instability
• Pain that significantly alters movement

The goal isn't to eliminate every sensation.

The goal is to recognize which sensations are productive and which require modification.


Should You Finish the Workout?

The answer depends.

Ask yourself:

Is the pain changing your movement?

If yes, stop.

Is the pain getting progressively worse?

If yes, stop.

Is the discomfort mild and stable?

You may be able to continue while monitoring symptoms carefully.


Does the pain disappear after warming up?

Some stiffness improves with movement.

However, if pain consistently returns after every run or workout, it deserves further evaluation.

Ignoring recurring symptoms often prolongs recovery.


The Athlete's Biggest Mistake

One of the biggest mistakes athletes make is waiting too long before seeking help.

Many runners tell us:

"I thought it would go away."

Sometimes it does.

Sometimes it doesn't.

Small issues become large problems when athletes continue training through worsening symptoms for weeks—or even months.

Early intervention often means:

• Faster recovery
• Less missed training
• Fewer compensations
• Better long-term outcomes

Seeking help doesn't mean you're weak.

It means you're being proactive.


When Should You See a Physical Therapist?

You don't have to wait until you're unable to walk.

Consider scheduling an evaluation if:

• Pain has lasted longer than one to two weeks.
• Symptoms keep returning.
• Running or exercise no longer feels normal.
• You're avoiding activities because of discomfort.
• You've tried resting without lasting improvement.
• You're unsure whether it's safe to continue training.

Physical therapy isn't just for severe injuries.

It's also one of the best ways to prevent minor issues from becoming major setbacks.


The Empire Performance PT Approach

At Empire Performance PT, we don't simply ask:

"Where does it hurt?"

We ask:

• Why does it hurt?
• What caused it?
• How is your body moving?
• What goals are you trying to achieve?
• How can we help prevent this from happening again?

Every evaluation includes a comprehensive assessment of:

• Strength
• Mobility
• Balance
• Movement quality
• Training habits
• Lifestyle
• Recovery strategies

Our goal is to provide clarity.

Sometimes we'll reassure you that it's safe to continue training with minor modifications.

Other times, we'll recommend temporary changes that allow healing while maintaining your fitness.

Either way, our objective is the same:

Keep you moving whenever safely possible.


Trust Your Body—But Learn Its Language

Your body constantly communicates with you.

The challenge isn't whether it's sending messages.

The challenge is learning how to interpret them.

Pain doesn't automatically mean stop.

But it also shouldn't automatically be ignored.

The healthiest athletes develop the ability to recognize:

• Productive soreness
• Temporary discomfort
• Warning signs
• Injury signals

That awareness allows them to train consistently while avoiding unnecessary setbacks.


Looking Ahead

Pain is only one part of staying healthy.

Long-term success comes from building habits that reduce injury risk before pain ever begins.

Next week, we'll explore exactly how to do that in Week 8: "The 5 Habits of Injury-Resistant Athletes."

We'll discuss the daily habits that consistently healthy athletes share—and how you can apply them to your own training and active lifestyle.


Ready for Expert Guidance?
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If you're wondering whether your pain is normal soreness or something that deserves attention, you don't have to guess.

At Empire Performance PT, we help active adults, runners, and endurance athletes understand what's happening, identify the root cause of their symptoms, and create personalized plans that support long-term recovery and performance.

Whether you're preparing for your next race, returning from an injury, or simply trying to stay active without pain, we're here to help you move with confidence.

Schedule your physical therapy evaluation or running assessment today and let us help you train smarter, recover faster, and stay healthier for the miles ahead.