Ask a PT: Is the statement true, “No pain, no gain”?

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Nathan Swan, DPT

Should PT hurt?While I love the fearless attitude of this statement, it is not always true. The assumption made in the case of “no pain, no gain” is that more is better. This is not the case. We certainly know more is not better when it comes to medication. It would be silly to take a whole bottle of blood pressure medication and expect better results. We call this an “overdose”. In the same way, your body can be overdosed by over-loading your tissue. This is what causes overuse injuries. An exercise done with excessive loads or repetitions can actually do more harm than good.  Pain is your body's warning sign that immiment danger is ahead, so stop what you are doing! 

While you may have muscle soreness for a day or two after exercise, exercising should not be painful. On the flip side of the this, we should acknowledge the truth driving this statement – inactivity leads to weakening and dysfunction of your body. Disuse is not a good thing. Your body thrives under the right conditions of movement and exercise. Do not use the first paragraph to justify not exercising at all. It’s all about getting the right “dose”.

Is this true in physical therapy? Specific techniques utilized by your physical therapist can create some limited pain; however, if there is ever more than a little pain, you should let your physical therapist know right away. Slight pain is sometimes necessary when working to change dysfunctional soft tissue, breaking adhesions in the joint capsule to improve motion, or when performing specific exercises involving mobilizing the nervous system. Generally though, exercises that you perform in physical therapy and as part of your home exercise program should never be painful, as this may increase swelling by taxing the joint or muscle too much, resulting in prolonged and delayed recovery. Besides, an over-stretched muscle or joint that causes you to clench in pain instead of relaxing won’t create any lasting result anyway. So the pain will not even result in any gain.

So to fully answer the question: when exercising, pain does not improve your work-out or your condition, rather it is an appropriate warning from your body that injury may be imminent. Slight pain during physical therapy sessions may result in some benefit, but remember to keep every exercise pain-free when performing your exercise program at home.