Almost no other exercise builds muscle power as much as a well-executed squat. But it’s important to end the exercise the moment any pain is felt in the back. (Courtesy photo)

Almost no other exercise builds muscle power as much as a well-executed squat. But it’s important to end the exercise the moment any pain is felt in the back. (Courtesy photo)

When it’s time to stop

“Push through the pain.”

“No pain, no gain.”

That’s what we were told in our youth. These are outside voices, but listening to your body and knowing when to stop is the key to diminishing self-inflicted injuries and lengthening your sports career.

Pain is a sign of injury. Pain in muscles stems from the overuse of the existing muscle fibers. It’s a balance: We need just enough overuse to stimulate the body to build stronger muscles, but without tearing the muscle past the point of natural repair. Pain in the joints is often due to damage to the weight-bearing surfaces. Since we often are caught up in the excitement of our sport when the body is calling out, we fail to stop in time. We extend past the helpful pain of muscle training into the damage zone. Here are some of my personal challenges:

When I’m waterskiing …

I’m in bliss, until I notice the front of my knee hurting. This usually happens just as I am getting really tired. If I drop the handle right then, I won’t overload the patella cartilage and may avoid suffering irreparable damage. Much anterior knee pain comes from overloading — from weak muscles, poor alignment or previous injuries. Gradually building strength distributes the forces across the knee and may stop the pain.

When i’m weightlifting …

It’s my single most important gym weight-training maneuver. Almost no other exercise builds muscle power in the legs, trunk and core while also improving balance and flexibility as much as a well-executed squat. It is my go-to exercise — yet it’s one that, if done poorly, leads quickly to back pain. As soon as I feel an odd tweak in one side of my back or the other, I stop the squat. I then stretch and attempt to return with a lower weight or call it quits for the day with squats.

When I’m riding my bike …

I often notice lower back stiffness. This is a function of being on the bike for several hours in the forward-curled position of the road bike rider. The stomach muscles are not engaged, the lower back strains unequally with each pedal stroke, and the neck is awkwardly extended, with the weight of the helmet pushing against the paracervical muscles. All of this conspires to produce soreness, stiffness and pain. I’ve learned that I have to get off my bike every hour or so to stretch. I also change my hand positions frequently during the ride. Either I respect the not-so-subtle signals of muscle overuse, or I find myself dropped from the group.

When I’m stand-up paddling ...

The rhythmic motion of the paddle in the water lulls me into forgetting that if I don’t engage my core, bend my back deeply, reach out and use short strokes, many of my joints will talk to me. My arm complains of a tennis elbow-like pain if the paddle’s not truly straight when entering the water. Stand-up paddling is all about technique. If I don’t listen when pain signals me, my technique leads not to bliss but to injury.

When I’m on the mountain …

There are no sports like skiing and snowboarding. Your knees are bent and loaded for as much as six hours a day with your body weight at the mercy of gravity. The bumps on the slopes are just waiting to force rapid bending and extension, while temperatures fluctuate to heat and freeze the blood flow. Why we all think we can just go out there and ski all day on the first day is beyond reason, yet so attractive.

Listen to your body. Notice the first signs of overuse pain and change the activity just enough to avoid the second, third and then fatal signs of muscle and joint injury. When we position ourselves to stop when we need to, we will achieve our ultimate goal of dying healthy and sliding into the home plate of life all used up.

Dr. Kevin R. Stone is an orthopedic surgeon at The Stone Clinic and chairman of the Stone Research Foundation in San Francisco.

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