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What does no pain, no gain really mean?

Melissa Felder, P.T., D.P.T.

As a physical therapist, I often educate patients regarding diagnoses as well as how to manage their condition.  This might include information about posture, using heat or ice and how long certain activities should be performed.  I may recommend doing things like sitting or gardening for shorter periods of time to prevent making the pain worse.

Often my patients are confused about whether they should “work through” pain during exercise or activities.  Many have heard the saying, “no pain, no gain,” and remember Jane Fonda using that phrase on her workout videos in the 1980s.  No one is watching those videos anymore, but the words live on.  As a physical therapist, I tell patients that the pain for which they came to see me should be avoided.  When they feel that pain, it could be a sign of swelling or other damage to their body.  Instead of “working through” pain, I tell patients to pay attention and only do the number of exercises to their limit – before they develop pain. 

Part of learning how to get over an injury is to develop awareness between the “bad pain” of an injury and the “good pain” of hard work and improvement. The only time “no pain, no gain” might be appropriate is when the discussion is about muscle pain – the pain that occurs from the muscles working hard. We know that to build muscle tissue, tiny tears of the tissue must occur.

Pain that leads someone to seek help from a physical therapist may be an indication of inflammation or swelling which can interfere with activity and limit the ability to build muscle. In fact, working through that pain may lead to more problems and defeat the gains made with an exercise program. Part of my therapy is to teach people to listen to their bodies – to get stronger, faster or more flexible. I want them to be able to reach their goals without causing more harm.  I want them to have an active and pain free tomorrow.

I have specific instructions for different problems. If someone has an injured, they should avoid pain that moves deep into the shoulder. Someone with low-back conditions should avoid any pain that goes down the leg. If someone has neck problems, I tell them to stop if they notice pain in the arm or shoulder blades. I teach my patients how to exercise in a pain-free manner to strengthen without hurting themselves.

Do you have an injury preventing you from doing your job or other activities? Maybe you have nagging back, ankle, neck, shoulder or any other pain that just won't go away, consider making an appointment with a physical therapist. Physical therapists do more than just help you get over the initial injury and pain, they teach their patient how to take care of themselves, so they are less likely to get injured again.

Melissa Felder, P.T., D.P.T., has been a physical therapist since 1997. She has extensive training in manual therapy and worked as an inpatient physical therapist at FMC for five years, before turning her focus to outpatient physical therapy at FMC for the past four years.