You have probably heard it from a coach, a teammate, or the voice in your own head: shake it off and keep going. Toughness is part of sport, and pushing through can feel like a badge of honor. But not all pain is the same, and some of it is your body asking you to stop before a small problem becomes a big one. Here is how we help athletes tell the difference.
Why Pain Is Such a Common Part of Sport
Pain is a frequent companion for athletes, and it is often linked with injury. An International Olympic Committee consensus group noted that both pain and injury interfere with athletic performance.1 The same group cautioned that managing pain usually means more than painkillers and rest. A better approach looks at what is driving the pain, including tissue damage, movement patterns, and the mental side of competing.1 In other words, pain is information. The question is what it is telling you.
Soreness Versus Warning Signs
The general muscle soreness that follows a hard session usually fades as you recover. Pain that deserves a closer look tends to behave differently. Pay attention if you notice any of the following:
- Pain in one specific spot, especially over a bone, a joint line, or a tendon.
- Pain that gets worse during activity rather than easing as you warm up.
- Swelling, locking, catching, or a feeling that a joint is giving way.
- Pain that lingers at rest, wakes you at night, or keeps returning session after session.
These are not a diagnosis, but they are good reasons to have sports related injuries evaluated rather than ignored.
What Can Happen When You Keep Playing
Stress fractures are a clear example of how playing through pain can backfire. The American Academy of Orthopaedic Surgeons explains that if a stress fracture is not recognized and you continue to play through the pain, the bone can crack or break, and ignoring the pain can lead to a worse injury and longer healing.2 Bone stress injuries develop when repetitive loading outpaces the bone's ability to repair itself.3 Location matters too. A large review found that injuries at certain sites, such as the femoral neck and the navicular bone in the foot, were linked with more complications and a harder return to sport.4 Overuse problems in tendons, cartilage, and the meniscus can follow a similar pattern, where continuing to load an irritated structure may allow damage to progress.
The Hidden Risk of Masking Pain
Many athletes reach for anti inflammatory medicine before a game to stay ahead of the pain. A review of this habit found that the scientific evidence for taking these drugs preventively is lacking, and that they can carry gastrointestinal, cardiovascular, kidney, and musculoskeletal side effects.5 Masking pain may also make it harder to notice when an injury is getting worse. If you rely on medication just to get through practice, we want to hear about it.
Training Load Matters More Than Grit
Toughness does not protect you from overload. An International Olympic Committee consensus statement identified poor load management, including rapid jumps in training or competition and crowded schedules, as a major risk factor for injury.6 Smart planning, gradual progression, and adequate recovery are often more protective than simply gritting your teeth. Our approach to return to sports and injury prevention builds on that idea.
How We Help You Get Back in the Game
Getting evaluated early does not automatically mean sitting out for months. Many problems respond well to non surgical treatments, activity modification, and structured rehab. When tissue damage is more significant, options may include meniscal surgery, knee ligament reconstruction, or articular cartilage restoration. Our focus on joint preservation and regenerative sports medicine aims to protect your joints for the long run. Experts describe return to sport as a continuum that runs alongside recovery and rehab, ideally decided together by you and your care team.7 Research to guide those decisions is still limited, so we tailor the plan to you.7
Frequently Asked Questions
Is it ever okay to play through pain?
Mild, general soreness that eases as you warm up is often a normal part of training. Sharp, localized, or worsening pain is a signal to stop and have it checked by us.1,2
How can I tell if my pain is a stress fracture?
You cannot be sure without an evaluation, but pain focused over a bone that worsens with activity is a common warning sign. Diagnosis usually combines your history, an exam, and imaging.2,3
Should I take anti inflammatory medicine before games?
We generally advise against using it preventively. Evidence for that approach is lacking, and these medicines can have real side effects.5
Will seeing a sports medicine specialist mean I have to stop playing?
Not necessarily. Many injuries can be managed with modified training and rehab, and our goal in sports medicine is to return you to your sport safely.7
How do I know when I am ready to return to sport?
Readiness is a shared decision that depends on your injury, your recovery, and the demands of your sport. We weigh those factors with you rather than relying on a single test.7
Make Your Next Move a Smart One
Being tough is valuable, but being informed keeps you playing longer. If pain is changing how you train or compete, you can book an appointment with us to find out what is going on and build a plan that gets you back to doing what you love.
Reference Links:
- International Olympic Committee consensus statement on pain management in elite athletes - British Journal of Sports Medicine
- Stress Fractures - OrthoInfo
- Bone stress injuries. Nature Reviews Disease Primers - Nature Reviews Disease Primers
- Return to sport following low risk and high risk bone stress injuries: a systematic review and meta analysis - British Journal of Sports Medicine
- Prophylactic use of NSAIDs by athletes: a risk/benefit assessment - The Physician and Sportsmedicine
- How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury - British Journal of Sports Medicine
- Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. - PubMed
AUTHOR:Kai Mithoefer, MD – Orthopedic Surgeon & Sports Medicine Specialist
Kai Mithoefer, MD is a board-certified orthopedic surgeon with dual certification in orthopedic surgery and orthopedic sports medicine. He is an internationally recognized specialist in sports medicine, joint preservation, and regenerative orthopedics with more than 15 years of clinical experience. Dr. Mithoefer is dedicated to helping athletes and active individuals return safely and efficiently to sports and work through advanced, patient-centered musculoskeletal care.
Credentials & Training
After completing medical school in Germany, Dr. Mithoefer trained in the Harvard Orthopedic Residency Program. He went on to complete a fellowship in Orthopedic Trauma at Harvard, followed by the prestigious Sports Medicine and Shoulder Surgery fellowship at the Hospital for Special Surgery in New York.
Dr. Mithoefer has been recognized as a Top Doctor by Castle Connolly and Boston Magazine every year since 2019 and continues this distinction through 2026. He has published more than 100 scientific articles and book chapters and is a frequent invited speaker at national and international orthopedic conferences.
Clinical Expertise
Dr. Mithoefer specializes in minimally invasive surgical techniques, joint preservation strategies, and regenerative orthopedic treatments designed to accelerate recovery and restore function. His expertise includes state-of-the-art biologic therapies and comprehensive musculoskeletal care tailored to each patient’s specific needs. Drawing from his own experience as a competitive and recreational athlete, he understands the demands of sports participation and prioritizes safe, efficient return to activity.
Medical Disclaimer: This information is for educational purposes only and does not constitute medical advice. For diagnosis and treatment recommendations, please consult with Dr. Kai Mithoefer or another qualified orthopedic specialist.
Content authored by Dr. Kai Mithoefer, MD and verified against official sources.
