Should I still be exercising while in pain?
Many patients are hesitant to ask whether they should exercise while in pain, fearing that they’ll be told to stop. However, it’s rare that I advise patients to stop exercising altogether, unless they’re only interested in performing a specific exercise that could cause further harm. I remind my patients that there’s always something they can do, even if it involves modifying the exercise or substituting it with another activity that still benefits their sport or overall health.
Most of the time, it’s about regressing the exercise, adapting it to minimize or eliminate discomfort, and then rehabilitating it back to its original form. There are several ways to regress an exercise rather than progressing it, and sometimes, it’s more beneficial to take a step back and focus on other aspects. The main challenge is the mindset; patients often struggle with the idea that their exercise isn’t progressing. I try to explain that taking a step back allows them to invest in other aspects of their exercise, such as strength or proprioception training, so when they return to their sport or desired activity level, they’ll have gained additional benefits.
I often use a pain scale from 0 to 10, with 0 being no pain at all and 10 being the worst pain imaginable. Exercising with pain levels at or below 4/10 is generally acceptable, as some discomfort can be expected. However, if the pain exceeds 5/10, I recommend regressing the exercise, as this could signal that the nervous system is warning of potential danger or further damage. Patients sometimes forget that the nervous system serves as a safety mechanism, signaling when something isn’t right. The saying “no pain, no gain” is, in my opinion, misguided and suggests that pain equals progress when, in fact, my years of study have shown the opposite to be true.
The outdated RICE (Rest, Ice, Compression, Elevation) method for injury recovery is another misconception. Instead, the focus should be on optimally loading the injured tissue and returning to exercise as soon as possible. I hope this explanation, along with the chart I’ve created, will help guide you in making informed decisions about exercising while in pain.
