Benjamin Franklin once said, “There are no gains without pains.” More recently, the phrase came to be known as “no pain, no gain” and “feel the burn” from the Jane Fonda exercise videos of the 1980s. The statement “no pain, no gain” refers to the belief that pushing yourself harder will yield better results, but is it true?
A Dangerous Motto to Follow
Many trending workouts like boot camps and interval classes involve high-intensity movements like plyometrics, which can be stressful to the body. Competition workouts emphasize high-timed workout volumes, which can lead one to push through the pain. Historically, personal trainers and even Olympic coaches would encourage their athletes with “no pain, no gain” to be successful. Yet injury can result when we push ourselves to do those 10 more pushups or five more burpees.
Generally, the average person has difficulty distinguishing between soreness, pain, and injury. In physiotherapy, these conditions can be sequential: Normal soreness can evolve into chronic pain and eventually lead to injury. Many overuse injuries are just that; if you don’t allow yourself adequate time to recover from strenuous activity, the micro-trauma from workouts can lead to an injury.
Further fueling the idea of “no pain, no gain” is that it must first break down to gain lean muscle. We have allowed ourselves to feel “pain” after activity and accept this as standard when better training techniques involve the gradual buildup of exercise tolerance.
Does Physiotherapy Have to Hurt?
Many of our patients joke as they enter into a program that physiotherapy stands for “pain and torture.” While the vast majority of our patients are seeking relief from the pain associated with injuries or chronic conditions, the adage that “it has to hurt before it gets better” follows us into the rehab process.
This belief can often lead people away from physiotherapy as a treatment option. When you’re already in pain, the thought of being stretched out can make a patient feel uneasy. Those fears may have been more legitimate years ago, but by applying the knowledge we have today, our physiotherapy techniques can be easier on the body and more impactful.
Decades ago, immobilization periods were more prolonged, leading to more significant deficits in joint motion and strength. Subsequent physiotherapy sessions would often be painful because of the need to regain joint motion. Combining decreased immobilization time with a greater understanding of which tissues limit a specific range of motion allows us to restore mobility with less pain.
In addition to the effective therapeutic results we can produce with specific tissue targeting, we can also develop a strengthening routine to help progressively improve your condition. These exercises typically do not hurt because we focus on gradually introducing exercises at the injury site and working other joints to optimize function. We allow the tissues to heal rather than pushing the body too much too soon.
Keep in mind that everyone has a different pain tolerance. After prolonged immobilization, there may be some initial discomfort. We tell our patients to focus on frequency over intensity to combat this. Especially post-surgically, your body will likely respond better to gentler at-home exercises performed more frequently than less often at a higher intensity. If you push too hard before your body is ready, you could end up in an inflammatory cycle that’s hard to break.
Since pain is subjective, the idea of “no pain, no gain” can play a role in recovery, but those who allow this to be their guiding principle for training or rehab head down a slippery slope.
Physiotherapy as an Adjunct
The ultimate goal of physiotherapy is to increase your mobility and stability. Mobility accounts for muscle flexibility and joint movement, while stability helps to steady and balance our joints during everyday movements.
We prescribe at-home exercises on a specific schedule for a reason. When patients do their at-home recovery exercises too much or not often enough, it can impede progress. If your body lacks mobility or stability during physical activity, you could end up doing more harm to the body than good. We teach people how to move and carry themselves smarter to achieve their recovery goals safely.
Do not fear the benefits of functional physiotherapy. To restore a normal range of motion to your joints and stabilize them with progressive strengthening exercises, you will feel restored and have a freedom in your body that you didn’t realize you had lost. There is potential to be your physical best, which will also promote your emotional well-being. Physiotherapy is a win-win that does not have to involve pain.
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