Minor chest strain that hasn't been going away

Pain & Rehab Forum [Moderated]
1

So about two months ago I got a slight twinge in my left pec when doing a weighted stretch on my pecs. I then felt a slight pain when doing dumbbell bench presses on my right chest. This happened at around the same time.

There was never any significant pain on both, and I still had full ROM immediately after the movement. There wasn’t any “locking up”. I told my online trainer about this, and asked if it was serious. Unfortunately he said it was something serious and I should take a few days off, which I did.

I went to the physio within the next few days and they told me to take it easier but don’t stop doing the movements.

Fast forward 2 months, and I am about 15 pounds away from the original weight on the dumbbells. I still feel uncomfortable, as if the right pec would strain when doing the movements.

Have I just been noceboing myself? I feel like the chest strain is extremely minor and should have already gone away by now.

After reading the pain in training, what do? and aches and pains article, I’ve implemented them in my own training. However I have a few questions.

  • What is considered a symptom? I don’t exactly have pain, but I do feel more stiff on 24-48hrs after I dumbbell bench. The stiffness is similar to what you would feel when getting a pump. ROM is not affected.
  • Do we increase load if symptoms reduce/stay stable AFTER 24-48 hours? So if I felt an increase in symptoms after/during training, but a reduction after 24-48 hours, does this mean the load was tolerated?
  • I’m thinking of maybe transitioning to the barbell medicine beginner program, but since I probably can’t hit the RPE targets due to the strain, what do we do instead?

I hope these aren’t too many questions, would be greatly appreciated if replied to! Thanks in advance.

2

True muscle strains can certainly take a while to fully rehabilitate. This was discussed in the context of hip symptoms in this article.

  • What is considered a symptom? I don’t exactly have pain, but I do feel more stiff on 24-48hrs after I dumbbell bench. The stiffness is similar to what you would feel when getting a pump. ROM is not affected.

This is highly individual. Pain is the main one to consider. A sensation of “stiffness” isn’t necessarily concerning on its own.

  • Do we increase load if symptoms reduce/stay stable AFTER 24-48 hours? So if I felt an increase in symptoms after/during training, but a reduction after 24-48 hours, does this mean the load was tolerated?

No; typically we look for symptom stability/reduction in the 24-48 hour period after training. If training caused things to spike in the aftermath, we would typically adjust the programming/dosage of activity.

  • I’m thinking of maybe transitioning to the barbell medicine beginner program, but since I probably can’t hit the RPE targets due to the strain, what do we do instead?

Similar to the strategies discussed in the general pain article, you can 1) increase the target rep ranges, 2) decrease the RPE targets, 3) introduce tempo, 4) alter the ROM or exercise selection.

If you continue having difficulty with this process, our rehab team can help more through a consultation.