Welcome to Straight Talk on Health. I’m your host Dr. Chet Zelasko. Straight Talk on Health is a joint production with WGVU in Grand Rapids MI. I examine the practical application of health information. Nutrition. Exercise. Diet. Supplementation. I look at the science behind them, and let you know whether it’s something to consider or not. You can check out other things that I do on my website Drchet.com and sign up for my free emails.
Today we’re going to explore the difference between pain and discomfort. What started the thought process for these topics was timing. I recorded this around my 74th birthday. I said when this podcast season began that I would give you an update periodically so that’s a small part. But because it involves differentiating between pain and discomfort, I felt the need to explain the difference—mostly so that you can respond in kind when you have similar challenges.
Let’s begin with something you should never ignore: chest pain or discomfort. I have one strict rule: when in doubt, check it out. In this case, if the pain is severe and you can’t breathe, like an elephant sitting on your chest, call emergency services immediately. Don’t try to drive to your physician’s office or the emergency room alone. Call emergency services in your area and keep the phone line open until they get there. Never, never, ever ignore chest pain.
But what about discomfort? Maybe you have a pain in your left arm and you’ve heard that could be signs of a heart attack. Or you have a sharp pain in your chest or between your shoulder blades. Or maybe it’s a dull ache. We live in the age of telemedicine. If you have any type of healthcare insurance, you can be online in a matter of minutes to talk to a nurse, PA, or doctor to ask questions and get professional answers. I don’t mean a search engine with AI. I mean a qualified healthcare professional. It’s a process of elimination but you don’t know the correct questions to ask. They do. You may have strained a muscle or torn a cartilage between your ribs or have Gall bladder issues. They can guide you through it. But if you have any doubt, check it out.
If you get the sense that pain and discomfort are subjective, you’re correct. We all seem to have a different tolerance for pain, depending on the location. Here is a loose definition--and it’s as subjective as you might expect.
Pain is a physical sensation which prevents a person from living their life in a normal fashion. The pain makes it difficult, if not impossible, to carry on the normal functions of life, whether movement, sitting, sleeping, or even thinking.
Discomfort is a physical sensation that can impede a person from conducting day to day activities. The discomfort can make day-to-day activities challenging but still doable although not at the same level as normal. Discomfort is the result of deteriorating joints from arthritis but is also a part of rehabilitation from surgeries for orthopedic issues as well. Overdoing exercise can result in discomfort.
Worst pain I’ve ever experienced? Kidney stone without question. It’s probably the only thing that can come close to childbirth a man can experience, at least, that’s what I’ve been told. I can’t comment further on that one.
Discomfort? I’ve had my share and that leads to part of my update. About a year ago from when I recorded this in 2025, I developed pain in the front of my shoulders. For those familiar with the anatomy, it would be in the general region of the acromion process. That’s near where the long head of the bicep attaches. It would ache so bad that it would wake me up during the night. It wasn’t related to the rotator cuff muscles. Not only did it ache while sleeping, I couldn’t lift anything heavy above my head. And the strangest thing was that when I walked, both arms ached in that region—once so bad I had to stop walking. Unreal.
About the beginning of this year when I announced my quest to get to a normal body weight this year, I also decided to increase my upper body strength. With both long heads torn, that limits the gains that can be made. I couldn’t do a single pushup. I couldn’t bench press more than 20 pounds. 20 Pounds people!. I began with light weights 5-10 pounds, but did as many reps as I could. About 3 months ago, I decided to increase the weights to the amount I could handle for 6-8 repetitions.
It's been a grind but I’ve definitely added muscle in my upper body as well as my legs. I began bench pressing with 40 pounds and now I’m up to 85 for 3 sets of 6 reps. As for pushups, which are more like half pushups for now, I’ve gone from none to 25 on the day I recorded this. But the most important thing is that the discomfort is gone. No issues sleeping. No issues walking. It all depends on the joint or joints involved but I’ve always believed you can make things better by making the surrounding muscles stronger to compensate for muscle tears and other weaknesses. What I would recommend is that you get a professional assessment and find a PT or trainer who can get you started properly as to form and progression. I still have a long way to go but it’s been positive.
I couldn’t handle this topic without talking about DOMS: delayed-onset muscle soreness. It happens most frequently with weight training but it can happen with the current novelty of high intensity interval training HIIT as well. What is it like? If you’ve ever helped someone move, you might have experienced it. Walking down a flight or flights’ of stairs while carrying boxes or furniture. Up the ramp and into the truck. Multiply that round 100 trips. You don’t necessarily feel it that night or even the next day. But the day after—about 36 hours later? That’s DOMS.
A little kinesiology. When you decrease the angle of a joint, that’s called flexion and is a concentric movement. The muscle is shortening to produce the force to lift an object. Returning to the beginning position is called extension as the muscle lengthens. That’s the eccentric part of the movement. When you intentionally resist the lengthening by slowly lowering the weight, that can cause more muscle tearing, depending on the amount of weight. More muscle tearing means the muscle will grow back larger.
However, if someone helps you lift a weight heavier than you can yourself into a flexed position, and you resist it while extending the muscle, that creates more muscle damage and, in theory, helps the muscle grow back bigger. Can you overdo it? Typically, we have a lot more common sense than that but driven people who want to see major gains? They can overdo it. The worst example I’ve ever seen was an experienced weight lifter who did a massive chest workout. Extreme DOMS causes so many tears in the muscle tissue that it results in excessive swelling. In this case, the only way to relieve the pressure was to cut through the skin and fascia from shoulder to shoulder all across the chest. Not to gross you out, the pictures looked like a sausage had split open. To be clear, that is extremely rare. In that so few people life weights at that level, the odds it happens to you and I are small. That’s DOMS taken to an extreme.
How about the rest of my goals? I really haven’t focused on my dietary intake to have a major impact on my weight yet. As I’ve gotten on track with both weight training and resistance training, I’ll begin focus on the goal of getting to a normal body weight and more importantly, maintaining it. I’m looking forward to reporting the results from that effort later in 2025.
I hope you’ve got a better understanding of the difference between pain and discomfort as well as the purpose of eccentric exercise. Slowly returning a weight to starting position during the eccentric phase will help you stimulate muscle growth ore than you might be now. And remember, never, never ever, ignore chest pain.
That’s all the time I have for this episode. If you like this podcast, please hit the share button and tell your friends and colleagues about it. Until next time, this is Dr. Chet Zelasko saying health is a choice. Choose wisely today and every day.
