Most everyone has heard the saying “no pain, no gain” when it comes to exercise. This may be true in terms of a healthy individual and when it refers to the muscle burn sensation that accompanies exercise. It may also be true in terms of the two days of soreness that follows the start or progression of a strengthening exercise program, or that follows the performance of an activity that has not been performed in a while. This soreness is better known as “delayed-onset muscle soreness” and is a normal part of the adaptation process of muscle breakdown.
“No pain, no gain” is not true when one has been injured. When one is recovering from an injury it is not wise to exercise with pain. When one is performing their rehabilitation program, one should only exercise in a pain-free range. If there is always a bit of pain present, as it is true after an injury or surgery, then you should never do exercise that creates more pain or increases your pain response. The increase of pain perception is the body’s way of letting you know you are overdoing things and that some tissues are not able to handle the stress that is put on them. The soft tissues (tendons, ligaments, muscles, and fascia) involved become weak and over-stressed.
Pain is a subjective feeling that we all have experienced at one time or another. We expect that we are going to experience pain after an injury or trauma. However, if there is no presence of pain during exercise we may think that there is nothing to worry about. This may not always be the case. Pain during exercise is the body’s way of telling us whether we are exercising too hard or overstressing our bodies. But just because pain is not present, does not mean that we may not be doing harm. For instance, a sedentary or deconditioned individual may not experience a pain response during exercise. However, they may find in the future they have back pain or neck pain due to a lack of muscle endurance or some other musculoskeletal problem. For this reason, many people move into pain patterns without any apparent reason or trauma.
In summary, exercise should be performed without any increase in pain. Therapeutic exercise is utilized to promote healing, increase metabolism, and introduce gentle controlled loads so that the soft tissues can adapt to normal forces. Periodic maintenance through exercise can prevent non-traumatic pain patterns from occurring. It is important to give plenty of feedback to your physical therapist or other health professional so he or she can monitor and make any adjustments to your exercise program.