When are painful exercises / training sessions valuable?
“No pain, no gain” is so over sold that people easily assume it means that your undiagnosed pain will do well from pushing on… Sometimes this pays off and sometimes it backfires in spectacular fashion! But how would you know which one you’re headed for? And when are you wasting your time by avoiding pain?
Avoid these 5 pains:
- Progressive increases in pain (be that within a training session, outside of training or from one day to the next)
- Pain limiting your ability to perform or complete a task or an exercise
- Undiagnosed pain, because your specifics response to different pains are essential
- Pain demanding medication to keep your sanity (especially if you’re mixing medications, increasing medication strengths or ignoring maximum dosages)
- Pain that persists and/or doesn’t progressively settle over any 3 consecutive days (tendon rehab being a very special exception to this last rule)
Pain can be a warning sign, sometimes a false alarm, and most certainly may have value in being produced intentionally in several specific scenarios. We often need our patients to produce very precise pain when their condition requires that to resolve the problem, but this is where a skilled health professional’s guidance comes in.
Gain from these 5 pains:
- Regaining functional movements and range of motion post operatively often require a level of pain but we need to balance that between the risk of disrupting the surgical repair and the requirement of rehabilitating your required function.
- In centralising referred pain, the production of the more centrally located pain is an excellent cue to confirm you’re being effective – but this pain is typically not the one which brought you to us in the first place.
- Pain-free tendon rehabilitation is a complete waste of your time (let’s not even talk about the money wasted on massage, needles or strapping for tendon problems) but education on when which level of pain should be present is vital to have you approach this rehabilitation correctly.
- Gaining strength and gaining fitness (increasing your capacity for load) may involve some pain and you can expect it to be equal on both sides of your body and you may never break rules 1-4 above while doing so.
- Bonus repeat because it’s so often misunderstood: Proper tendon rehab will require regular (and at times persistent) production of your painful condition within a bona fide tendon rehab programme under the guidance of a skilled professional.
Your health and wellbeing deserve informed, personalised care. For tailored support, please discuss any questions or concerns with your physiotherapist of choice.
Image credit to IG @cottonbro