What kind of pain is it? Is it just a bit of ache or stiffness after a heavy session? That’s usually fine. Or is it something sharper — a sharp, shooting pain? Because if you’re getting sharp, shooting pains, that’s not something you push through with exercise. Dull ache after training, usually okay. Sharp or shooting, stop.

Is it actually stopping you doing anything? If you’re trying to run and the pain is changing the way you run, or you’re lifting and actively avoiding certain movements because they hurt too much, that’s a sign. Having to dodge and adjust around the pain isn’t something I’d recommend pushing on with, certainly not without getting it assessed first.

What’s the reaction the next day? Do you get really bad soreness in your lower back the day after training — not just normal stiffness, but properly sore? If the day after is consistently bad, that’s usually a sign there’s a bit more going on than normal training load.

Is the pain travelling anywhere? Any associated hip or groin pain? Any pain referring down into your legs? Once the pain starts spreading — into the hip, the groin, down the leg — that’s not one to keep exercising on. That needs looking at.

Are you relying on painkillers to do it? If the only way you can get through training is by managing the pain with painkillers, that’s a clear sign you shouldn’t be exercising on it. Painkillers mask the pain, they don’t fix the problem — and exercising through masked pain is how you turn a small issue into a big one.

There are two more things to factor in, because they change everything.

The first is the trajectory — which direction is it heading? Is it gradually getting better week on week, or staying the same, or getting worse? Pain that’s steadily improving is a good sign, and usually okay to keep gently moving with. Pain that’s getting worse, or stubbornly not budging, is telling you something different.

The second is how long it’s been there. A bit of soreness for a few days after a hard session is one thing. Back pain that’s been hanging around for weeks, or longer, is another. The longer it’s been there, and the less it’s improving, the more it deserves a proper assessment rather than just training through it.

This one is really important. If you’ve got an active under-18 with back pain, you have to be extra careful. Young, sporty teenagers can develop stress fractures in the spine — and here’s the dangerous part, these often get missed. A lot of them don’t even show up clearly on a standard MRI scan. So with active teenagers, you don’t just push through back pain and hope. That one always needs proper assessment. Don’t take a chance with it.

So let me pull the whole thing together. Is the pain a dull ache, or sharp and shooting? Is it stopping you doing things, or making you avoid certain movements? How bad is the soreness the next day? Is it spreading into your hip, groin or leg? Are you relying on painkillers to get through it? Is it getting better, or worse? And how long has it been there?

If it’s just a bit of ache, it’s settling, it’s not stopping you, it’s not spreading, and you’re not popping pills to manage it — then gentle, sensible exercise is usually absolutely fine, and often good for it. But if you’re ticking the other boxes — sharp pain, avoiding movements, bad next-day soreness, referral into the leg, relying on painkillers, getting worse, or dragging on for weeks — then back off and get it properly assessed first. And with under-18s, always err on the side of caution.

Joe Sharp
BSc (Hons) Physiotherapy