An official website of the United States government
Here's how you know
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.

Local News | Sept. 30, 2024

Military Health Expert Clarifies ‘No Pain No Gain’ Workout Myths

By V. Hauschild, M.P.H., Defense Centers for Public Health–Aberdeen Public Affairs

Injuries are the leading reason for military medical visits each year.

Department of Defense active duty service members require medical treatment for injuries almost 5 million times each year (for around 1.5 million individual injuries). Injuries cost millions of lost duty and training days, and billions of dollars each year.

“Some injuries are caused by acute trauma, such as from falling or a vehicle accident, but the majority of military injuries are cumulative micro-traumatic injuries, often referred to as overuse injuries,” said U.S. Army Capt. Regis Pearson, a physiologist and chief of the Injury Prevention Branch for Defense Centers for Public Health–Aberdeen.

recent military report shows that over 75% of all injuries to active duty service members are due to cumulative microtrauma.

“Most of these overuse injuries usually involve the musculoskeletal, or MSK, system which includes bones, muscles, tendons, as well as ligaments and other joint tissues,” said Pearson. “A doctor may use a medical code for ‘pain’ in a specific body area if a more identifiable injury diagnosis is not determined. Because the pain is a result of damage to tissues in that body area, the diagnosis is still categorized as an injury.”

In a 2019 study of three years of soldier medical data, almost a quarter of all the initial service members’ injury visits were for a diagnosis of MSK “pain” to a body part.

“The back, especially the lower back, is a particularly common body area associated with injury pain codes,” said Pearson. “The knee, ankle, and shoulder are the next most frequent body areas linked to pain diagnoses. Though somewhat less common, hip pain is also a problem, especially among female service members."

Pearson said the common physiological factor of these pain codes is that they usually are associated with the complex tissues of a joint, which is not the same as delayed muscle soreness.

“There are two types of muscle pain,” he said. “Acute or immediate pain in a muscle felt during an activity is indication of a strain or tear that needs medical attention. Muscle soreness that develops a day or two after an exercise is typically referred to as delayed onset muscle soreness, or DOMS.”

Like other forms of MSK pain, DOMS is a form of tissue damage that the body responds to by increasing inflammation, said Pearson.

“Unlike joint or bone damage, however, the body is often able to repair the microscopic muscle damage that is associated with DOMS in two to three days,” said Pearson. “This is what inspired the phrase ‘no pain, no gain.’ Unfortunately, misunderstanding the “no pain no gain” concept can lead to more serious or even chronic injury-related conditions.”

'No Pain No Gain' myths

Pearson reminds everyone that this phrase doesn’t apply to joints—such as the spinal area, knee, ankle, shoulder, or hip—and corrects some common misconceptions, including:

  • Myth: Sudden sharp pain during an exercise just means you are pushing your body to improve.
    Fact: Feeling sharp sudden pain during an activity may mean an acute injury. Immediately stop activity to rest the body area and consider medical evaluation.
  • Myth: A body will adapt to muscle soreness, so it is a necessary part of training. Not feeling any pain means you are not working hard enough.
    Fact: Delayed onset muscle soreness is the body’s protective response to new or excessive exercise; it is not an indication of training effectiveness. Severe DOMS can even hinder a person’s ability to recover efficiently if the muscle is too damaged.
  • Myth: Delayed onset muscle soreness is a type of pain that the body will repair and recover from on its own.
    Fact: In severe cases of DOMS, the body’s repair mechanism may be overwhelmed, especially if high exertion activity is continued. In many cases of DOMs, it is generally advised to continue using the muscles through low exertion activity for at least a day or two to allow time for the body to recover.
  • Myth: MSK pain will go away over time.
    Fact: Continued pain, especially near joints, is a sign that the body is trying to repair some form of MSK tissue which, if ignored, may worsen the severity of the condition. This can lead to longer recovery periods or even long-term pain conditions such as chronic back pain or arthritis.

What can you do?

Pearson said though the long-term conditions that result from MSK pain are common and often unavoidable, their severity can be reduced.

First, reduce your chances of injury by addressing leading risk factors of injury:

  • Maintain a healthy body weight and keep body fat percentage with the DOD limits. Evidence shows that personnel with excessive body weight and high body fat are at a higher risk for MSK injury. In addition, service members who are underweight are also more likely to get injured.
  • Maintain a regular exercise routine to achieve fitness levels. Those who don’t regularly maintain high levels of fitness are more likely to get injured. Exercise should include a balance of activities like aerobic conditioning and anaerobic training, such as strength, power, and balance activities. Service members can enhance their fitness through individual physical training but should balance the amount and types of exercise with unit training activities. The U.S. Army offers online guidance for safely training for its fitness test.
  • Stop smoking or using tobacco products. In addition to increasing risk of MSK injury, tobacco is a leading risk factor for heart and lung disease and cancer. Tobacco use has been found to increase chances for hospitalizations, missed workdays and impaired vision. Cessation services are available to service members through TRICARE.
  • Eat a healthy diet in addition to maintaining a balanced exercise regimen. The military is making it easier for service members to find high-quality foods and drinks to boost fitness, strength, and health as part of the Go for Green® initiative. Information and good food choices at dining facilities or galleys help service members make smart choices.

Second, seek medical evaluation of problematic MSK pain early on, and follow medical guidance for recovery time and restricted duty or activity. Otherwise, you may develop chronic pain.

Chronic pain, which is pain that lasts longer than six months, can impact your mood and make it difficult to work and participate in everyday activities. Some examples of chronic MSK pain are back pain, arthritis, and other joint problems.

Pearson said that maintaining a healthy body weight and fitness levels can increase your resilience against injury; it is critical to stay in tune with your body’s pain feelings.

“Trying to ‘tough it out’ can make things worse in some situations,” he said. “It is important to differentiate between mild DOMS and a more serious pain. Stop activity for more serious conditions and follow your provider’s recovery guidance.”

Additional information sources

The Defense Health Agency supports our Nation by improving health and building readiness–making extraordinary experiences ordinary and exceptional outcomes routine.

Note: The mention of any non-federal entity and/or its products is for informational purposes only, and is not to be construed or interpreted, in any manner, as federal endorsement of that non-federal entity or its products.
 

DHN-NCR Enrollment Graphic

The Defense Health Network – National Capital Re...

Local News
Nov. 21, 2024

The Defense Health Network – National Capital Region is proud to announce the launch of the Defense Health...
Read More
Senior wearing face mask leans over and types on keyboard.

Section 508 Accessibility Empowers Patients To M...

Local News
Oct. 31, 2024

Defense Health Agency Section 508 digital accessibility and usability law update given by office program...
Read More
Medical mannequin lays on table while two conference attendees talk over it.

Medical Leaders Provide Update on DOD's Health C...

Local News
Oct. 15, 2024

All service members and their families deserve quality care, better access to treatment centers, health care...
Read More
U.S. Army Lt. Gen. Telita Crosland and U.S. Air Force Chief Master Sgt. Tanya Johnson stand on a stage in front of a table and address audience.

Defense Health Agency Leaders Empowered to Lead ...

Local News
Oct. 08, 2024

DHA Network directors and leadership teams from military hospitals and clinics from across the globe, along...
Read More
Airmen prep a cargo net on the floor of a warehouse before putting it onto a aircraft sized cargo pallet at Incirlik Air Base.

Defense Health Agency Medical Logistics Team Mai...

Local News
Sep. 12, 2024

MEDLOG is a premier shared service provider promoting uniformity, efficiency, and joint interoperability of...
Read More
Graphic of reminders that "Mental Health Matters" with a logo that reads "Ask the Doc" in the corner.

Ask the Doc: What Are Ways To Protect My Mental ...

Local News
Sep. 04, 2024

Our mental health expert, U.S. Public Health Service Capt. Meghan Corso, chief of behavioral health clinical...
Read More
New text service offers military healthcare updates, information

Defense Health Agency Launches New App for Provi...

Local News
Aug. 29, 2024

Defense Health Agency develops important new tool for assessing and managing mild traumatic brain injury, also...
Read More
Man wearing beanie and green t-shirt that says "G TEAM" stands in front of yellow moving truck.

How AFMES Members Balance Duty and Community

Local News
Aug. 29, 2024

At the Armed Forces Medical Examiner System, the dedication to service transcends the lab coats and sterile...
Read More

Nov. 21, 2024

Launch of New Model of Care and Enhanced TRICARE Prime Enrollment in the National Capital Region

The Defense Health Network – National Capital Region is proud to announce the launch of the Defense Health Agency’s innovative New Model of Care, starting with My Military Health Scheduled Virtual Visits. Alongside, we are also excited to reveal significant expansions in TRICARE Prime enrollment capacities across our facilities. The My Military Health care model ushers in a transformative era in healthcare delivery within the DHN-NCR. This groundbreaking approach is person-centric, utilizing cutting-edge digital tools to improve health outcomes and make healthcare more efficient and accessible.

Oct. 31, 2024

Section 508 Accessibility Empowers Patients To Manage Care

Defense Health Agency Section 508 digital accessibility and usability law update given by office program manager Ghoston.

Oct. 15, 2024

Medical Leaders Provide Update on DOD's Health Care Focus

All service members and their families deserve quality care, better access to treatment centers, health care providers and mental and physical well-being, the director of the Defense Health Agency said.

Oct. 8, 2024

Defense Health Agency Leaders Empowered to Lead Transformative Change to Improve Patient Experience

DHA Network directors and leadership teams from military hospitals and clinics from across the globe, along with DHA headquarters subject matter experts—participated in the symposium, designed to provide health care leaders with realistic solutions to their local challenges.

Sept. 30, 2024

Military Health Expert Clarifies ‘No Pain No Gain’ Workout Myths

Department of Defense active duty service members require medical treatment for injuries almost 5 million times each year (for around 1.5 million individual injuries). Injuries cost millions of lost duty and training days, and billions of dollars each year.

Sept. 12, 2024

Defense Health Agency Medical Logistics Team Maintains Supply Chain Ensuring Quality Health Care Delivery

MEDLOG is a premier shared service provider promoting uniformity, efficiency, and joint interoperability of defense medical materiel programs and products required for Military Health System institutional and operational elements in support of the full range of military operations.

Sept. 4, 2024

Ask the Doc: What Are Ways To Protect My Mental Health?

Our mental health expert, U.S. Public Health Service Capt. Meghan Corso, chief of behavioral health clinical operations at the Defense Health Agency, answers a Dear Doc question on ways to protect your mental health.

Aug. 29, 2024

Defense Health Agency Launches New App for Providers to Assess and Treat Traumatic Brain Injury ‘Anytime, Anywhere’

Defense Health Agency develops important new tool for assessing and managing mild traumatic brain injury, also known as concussion, with the Warfighter Brain Health Provider Toolkit application.

Aug. 29, 2024

How AFMES Members Balance Duty and Community

At the Armed Forces Medical Examiner System, the dedication to service transcends the lab coats and sterile environments of their daily responsibilities. These men and women are committed to something greater than themselves—both within the walls of their workplace and outside in the communities they serve.

Aug. 27, 2024

Military Health Information Technology Focus of DHITS 2024

The 2024 Defense Health Information Technology Symposium kicked off in Dallas, Texas, with Patrick (Pat) Flanders, chief information officer for the Defense Health Agency, touching on the Department of Defense’s efforts to modernize health care, providing enterprise intelligence and data solutions, and looking to the future.