Feburuary 2, 2026

I Interviewed a PT About Pain Signals. Then I Tore My ACL...

By Lylah Ruparel

I’ve been thinking a lot lately about the unspoken rules that govern how my team and I approach training. These aren’t things coaches explicitly tell us. They’re beliefs we absorb from training culture, from each other, from the pressure to always be getting better.

When I tore my ATFL last spring, I started questioning some of these assumptions. So I sat down with Dr. Ali Ross, a physical therapist who works with athletes, to put our team’s most deeply held training beliefs to the test.

Here’s the ironic part: between recording this interview and publishing it, I tore my ACL. Turns out I’m still learning how to listen to my body and recognize the difference between pain that’s part of training and pain that’s a warning. So I’m writing this from the other side of exactly what Dr. Ross was trying to teach me.

MYTH #1: Rest Means Doing Nothing But Lying on the Couch

What we believe: Rest days are looked down on in our training environment. If you’re not moving, you’re falling behind. We either go hard or do nothing. There’s no in between.

What Dr. Ross says: “I think a lot of high-level athletes think that rest means to stop, and so rest gets a negative connotation. But rest is an active, intentional piece of training.” Dr. Ross frames rest as the three R’s: restoration, recovery, and relaxation. “You can’t just keep going and never rest. You have to take time to give your body recovery.”

The science: Research shows that rest is when adaptation actually occurs, not during training itself (Kellmann et al., 2018). When we train, we create micro-damage in muscle fibers. The body repairs and strengthens during rest through a process called supercompensation.

Dr. Ross emphasized sleep: “Are you getting eight to ten hours? That’s a big piece.” Sleep deprivation increases injury risk in adolescent athletes by up to 70% (Milewski et al., 2014).

MYTH #2: Training Through Pain Builds Mental Toughness

What we believe: Pushing through discomfort is a badge of honor. Stopping because something hurts is perceived as weakness. There isn’t always a distinction made between the pain of effort and pain that something is genuinely wrong.

What Dr. Ross says: “There’s a difference between mental toughness and physical toughness. Pain is a signal. Pain doesn’t always mean something is wrong, but it’s a signal that something needs attention.” She explained there’s muscular pain (the fatigue during a hard workout) and then there’s pain indicating you’re pushing too hard. “When you always push through pain, you don’t learn what your limits are.”

What this means (and what I’m learning): Mental toughness isn’t about ignoring pain. It’s about being smart enough to recognize when pain is a warning.

I’m still learning this. When I interviewed Dr. Ross, I thought I understood the difference. But clearly I didn’t because I missed the signals my body was sending before I tore my ACL. Looking back, there were signs. Discomfort I pushed through. Instability I attributed to fatigue. Dr. Ross told me: “Sometimes girls are not taught how to listen to their body’s feedback. Having good communication between the athlete, their parents, and the coach is really important instead of just having them keep their head down and pushing until something snaps.” Something snapped. And now I get it.

MYTH #3: More Training Is Always Better and Can Be “Banked”

What we believe: When we’re healthy, every session should be maximized because you never know when injury might sideline you. We overload during good stretches, thinking we’re storing fitness.

What Dr. Ross says: “Think of your physical capacity as a piggy bank. You can put coins in (that’s your training) and you can fill it up. But what happens if it cracks and drops? Think of that as an injury. You don’t lose all your coins. They’re still there. But now you have to regroup, maybe buy yourself a new piggy bank.” She continued: “Those coins are not just training. They’re rest, recovery, fueling yourself with good food, good relationships.”

The science: Research on training load management shows that when athletes’ acute workload (this week) exceeds their chronic workload (4-week average) by more than 150%, injury risk increases 2 to 4 times (Hulin et al., 2016).

MYTH #4: If You’re Young, Your Body Will Just Bounce Back

What we believe: Young athletes feel invincible. This is the window to build a massive fitness base, so there’s urgency to maximize training now.

What Dr. Ross says: “Kids do bounce back faster. Their tissues are more pliable, they have more stem cells, their brains are more neuroplastic. But they’re also more susceptible to chronic stress, which makes them more vulnerable to overtraining.” She explained pediatric sports injuries that only happen in kids, specifically growth plate injuries. “In kids, bones are softer, so they bend rather than snap. But those growth plates can get fractured, which can be dangerous.” 

The long-term consequences: Dr. Ross brought up RED-S (Relative Energy Deficiency in Sport): disordered eating, irregular menstruation, and decreased bone density. “For girls, if they don’t have their period by 13 or lose their period, that’s a sign they’re not getting enough to eat. And bone density? You only have until your mid-twenties to establish it. If your bone density peaks low, you’re more prone to osteoporosis and fractures for the rest of your life.” Female athletes with menstrual dysfunction in adolescence had significantly lower bone mineral density decades later (Loud et al., 2007). Athletes who specialized before age 12 were 70% more likely to suffer serious overuse injuries (Bell et al., 2016).

What I’m Taking Away

This conversation with Dr. Ross fundamentally shifted how I think about training. The myths my team and I believed weren’t just wrong. They were dangerous. But here’s the harder truth: even after this interview, even knowing all of this, I still tore my ACL. I still missed the signals. I’m still learning.

Smart training isn’t about doing more. It’s about doing what your body can adapt to.

• Rest is part of training, not a break from it.

• Pain is information, not a challenge to overcome.

• You can’t bank fitness. You can only build it sustainably.

• Being young doesn’t make you invincible. It makes you vulnerable in different ways.

The goal isn’t just to survive adolescence as an athlete. It’s to build a body (and a relationship with your body) that lasts. I’m working on that relationship now. From the other side of injury, with a lot more humility than I had when we started this conversation.

Sources & Further Reading

Kellmann, M., et al. (2018). Recovery and performance in sport. International Journal of Sports Physiology and Performance, 13(2), 240-245.

Milewski, M. D., et al. (2014). Chronic lack of sleep is associated with increased sports injuries. Journal of Pediatric Orthopaedics, 34(2), 129-133.

Hulin, B. T., et al. (2016). The acute:chronic workload ratio predicts injury. British Journal of Sports Medicine, 50(4), 231-236.

Bell, D. R., et al. (2016). Prevalence of sport specialization in high school athletics. American Journal of Sports Medicine, 44(6), 1469-1474.

Loud, K. J., et al. (2007). Correlates of stress fractures among preadolescent and adolescent girls. Pediatrics, 119(4), e1393-e1398.​​​​​​​​​​​​​​​​