Let’s be honest, we have all heard the phrase “no pain, no gain”, or “go big or go home”. If I am being completely honest, I’ve said this a time or two while in the gym myself and I hear it quite frequently from my patients.
So, is this slogan true in the realm of physical therapy?
The short answer, NO!
Why?
Let’s dive a little deeper.
Exercise & Pain
In general, with any activity, especially when completed by a more sedentary person there is likely to be some discomfort and/soreness. Let’s talk exercise physiology for a moment to understand what exactly is happening in the muscle when you exercise, specifically when you’re working on building muscle strength.
Muscles must have a fuel source to function properly, and when you breathe your body does a great job at distributing that oxygen to other systems, including the musculoskeletal system. So when you initially start to exercise, you use up that oxygen first. Unfortunately, the oxygen that is converted to an energy source (ATP) is used up fairly quickly and your lungs are unable to keep up with the demand, therefore your muscles begin to tap into energy that has been stored.
This happens through a process called anaerobic glycolysis; this is just a fancy way to say the muscle is making energy without the presence of oxygen. In doing so, a waste product is produced called lactic acid, and this can cause the muscles to “burn” while you are completing said exercise. Another important concept to understand is that when you are completing resistance training is that you are creating little micro tears and micro trauma to the muscle being worked- don’t worry this is supposed to happen.
Tissue Repair & the “Gains”
The body responds to these tears and this trauma by repairing the tissue and adapting the muscle to be larger and stronger. In order to create the “gains” talked about, you may be asked to perform some activities that cause muscle discomfort, to create micro tears, to then build stronger muscles.
You may be saying “okay, and? Why are we getting a science lesson?” Because if you understand this, then you will know that some discomfort and/or soreness is okay when you’re going through your rehabilitation program and this may help you distinguish between different sensations you will feel throughout your rehab journey. Discomfort, muscle fatigue, and muscle soreness is not to be confused with pain, although some will consider these sensations as such.
A Bit About Pain
While pain is mostly subjective, and we all perceive pain differently, it is associated with actual or potential tissue damage. Pain is a noxious stimuli that helps deter further injury, therefore if you push past your points of pain in all activities of daily living you may actually cause more harm than good because you are not allowing for the rest needed for the injured area to heal.
Patients that come into physical therapy with the mindset “no pain, no gain” oftentimes get discouraged that they are not healing as quickly as they would like, or their pain has not decreased. If you continue to work in, or past, a painful range of motion then you are placing undue stress on tendons, ligaments, joints, etc which affect inflammatory responses and inevitably healing. For example, you may be even more painful, more swollen, and causing more damage.
Pain, Therapy, & Recovery
The goal of physical therapy is to support healing and decrease your pain response. Of course, not all appointments are going to be “pain free” and you may be asked to endure some pain during your treatment but the increase in pain should not be long lasting. Follow the lead of your therapist, and if they are advising you not to push through the pain, trust them! We, as therapists, are here to help you get better and meet your goals as quickly as possible.
If you are dealing with pain, acute or chronic, and need some help working through it then please feel free to reach out to us here at ProActive Rehabilitation and Wellness to schedule an evaluation and learn more about how to manage your pain.
