One of the most common phrases I hear as a physical therapist is “no pain/no gain, right?” When I hear this, I take a nice deep breath, straighten out my shoulders, and climb right onto my soap box. Are you ready? My goal today is to use this platform to shed some light on this outdated idiom and perhaps help save you future pain in the pursuit of those elusive “gains.”
The general answer is no, this is not an accurate sentiment, however there are some exceptions. Later in this article, I’ll provide some general guidelines to help you determine what “pain,” if any, is appropriate for the goals you are attempting to achieve. But first, let’s explore what “pain” is. Pain is a natural and biological process which has been developed as an internal security system. When we encounter something potentially dangerous, aka a noxious stimulus, a signal is sent to our brain warning it of a possible threat. In fact, our body is so good at attempting to prevent harm, the pain signal only needs to travel the distance from the noxious point of contact to our spinal cords before triggering a withdrawal reaction. Have you ever accidentally touched a hot stove or curling iron to find you’ve jerked your hand away before you noticed any sensation or pain? If so, this is a prime example of this efficient system at work. Now pain is an extremely complex system and its complexity deserves an article or two all its own. This includes complex pain conditions, which are special and outside of the goals of this article.
Alright, so back to no pain/no gain. We’ve learned that pain is a natural process meant to protect the well-being of the individual. Therefore, let me pose a hypothetical: if your “one of its kind,” shiny new Porsche is making unnatural grinding noises and jerks with every gear shift, would you keep driving it in an attempt to fix it? Obviously, NO. So often, and yes, even I have been guilty of this, people just “push through the pain” while they exercise, ignoring what their bodies are trying to communicate. Which is usually, “hey, I’m letting you know that something feels wrong and you might be in danger of injury if you continue. Please stop.” So, let’s quit treating our cars better than our bodies and stop to figure out what is going wrong. I promise our bodies are not trying to trick us; pain is NOT a sign that everything is going well!
Before you start protesting, you are correct, there are many different types of pain and not all are inherently bad. The application of this article is in reference to independent exercise and activity. There are certain conditions for which pain IS “gain,” but these circumstances should be supervised and guided by a qualified healthcare professional. Muscle soreness is the type of “pain” which first inspired this catchy phrase but even muscle soreness is only healthy in moderation. I’m looking at you, rhabdomyolysis. In fact, I don’t even really like categorizing muscle soreness as “pain.” Soreness is a signal from your body informing you that it is time for those muscles to rest and repair. If you want to make efficient strength gains, it is crucial to rest those muscles to rebuild them stronger. Exercise is like prescription medication (actually it is one of the best prescriptions for nearly every medical condition), the dose is important. Just like medication, too much can be and for you, and too little will not have the desired effect.
Now for the how to/application portion. There are always exceptions, but for the most part, I try to refrain from telling my patients that any specific exercise or activity is completely off limits. Instead, I give them applicable guidelines to make sure they are exercising in the safe zone. One useful tool I teach my clients when approaching an exercise is to categorize it as either a red light, yellow light, or green light exercise. An activity categorized as a redlight occurs when you feel pain during a movement and the pain continues once you’ve ceased the activity. If the pain lingers, possible negative tissue changes and/or inflammatory response could be occurring. And again, pain here is characterized as discomfort that feels abnormal and apart from the normal sensations associated with muscle use. Yellow light exercises are those where you may feel something “off” or uncomfortable, but the discomfort dissipates once you stop the activity. These exercises are “proceed with caution.” The tissue may simply need to warm up before the symptoms are relieved, but if they continue or worsen, then the exercise turns into a red light. Last and most obvious, green light means go! Green light exercises have zero discomfort associated with them and can be enjoyed freely.
No matter your current lifestyle or exercise/activity goals, medical history, or degree of pain, we are experts in healing and helping you get back on track towards health and fulfillment! If you find yourself experiencing some discomfort you can’t shake or missing an activity you love due to pain, don’t hesitate to call and schedule today!
In health & happiness,
Dr. Kinzie Munar, PT