A good friend of mine recently asked her clients a question – No pain, No gain….agree or disagree? The results were interesting with 43% saying agree and 57% saying disagree… how would you vote?
Well it certainly got me thinking – about the phrase, about people’s perception of pain and about how a widely used phrase like this can influence each of us very differently, in both positive and negative ways.
The phrase appears to have become popular in 1982 when Jane Fonda used to say it in her aerobic exercise videos, to encourage people to keep going when they started to feel the ‘burn’ from their muscles working hard. As an athlete myself, I understand this feeling and know that one can certainly exercise through this feeling without getting injured, even though, at the time, you think it hurts so bad that you need to stop when really you probably don’t!
My thoughts around this are that over the years this phrase seems to have been taken out of context and people tend to use it as a way of proving to themselves or maybe to people around them, that they are tough somehow because they did something even though it was painful.
For example, someone tells you they went and had a massage and it was SO painful and proceed to show you the bruises that are left from it, like they are trophies because hey ‘no pain, no gain right?’ hmmmm!
Or, you go to the gym after not being for a while and you’re not sure where you’re at but you want to try hard and you’re halfway through your session and your arm or leg or back starts to hurt like you’ve never felt before, but you don’t say anything because you don’t want to seem weak so you tell yourself ‘no pain, no gain, you’ll be right, keep going!’ hmmmm!
These are examples of when the pain you are feeling, is your body warning you that tissue damage may be happening, or could potentially happen if you don’t do something about it. These are the times when you should listen to your body and change something about what you’re doing so the pain comes back to a tolerable level of discomfort.
It is basically impossible for me to accurately describe the difference between discomfort and pain, simply because, if nothing else, it is going to be vastly different for everyone. Not only this, but as you learn to tolerate discomfort, your level of tolerance starts to increase, so what is tolerable for you now will most likely be very different to if you practice this for the next 6 months and then retest it.
These are actually changes that happen in our brain and we can have a lot of control over it, if we practice. Where this is important and very relevant from a clinical perspective is on return to normal activity and sport after an injury or any kind of trauma really i.e. an accident, surgery, injury, chronic pain, you name it. In the past, rehab has really been pathology focused rather than people focused, but we are now learning that when the person doing the rehab is more involved in the process, changes occur much quicker. For example, in the past when someone got injured and they took themselves off to their clinician of choice, they would generally leave with a few exercises they were told to do because ‘these will strengthen whatever and because this is what the research says is best for this particular injury at this particular set and rep scheme, you should do that’.
What we now know is that client adherence to this old kind of rehab plan is very minimal due to a number or reasons – it may hurt them to perform the exercise or after doing the exercise, so they stop. They can’t fit it into their day, so they stop. They aren’t sure if they are doing it properly, so they stop. They don’t see the benefit in it, so they stop. And there are probably other reasons too.
What has been found to achieve better adherence is when the clinician involves the client in planning the rehab plan. So discussing options for when you can fit it in, making sure there isn’t too much so it’s not overwhelming and doesn’t take up too much of your time. Taking the time to go through each exercise to find the perfect number of reps that are tolerable for you and leave you feeling positive about your plan. Having a plan to check and track your progress so you can see the positive results. These things are going to set you up for success.
The common question that comes up with any exercise therapy I give to my clients is: should it hurt? This is a great question and I love that people ask it. The right answer is what is your tolerance level at this very point in time. It might be different today then it is tomorrow but as long as you know what is tolerable for you, you will always be able to achieve it. So, while my client is in the clinic, I would get them to perform the exercise until they feel pain and I would tell them that if they feel that at home they need to stop and back it off a bit. That may mean doing less reps so they don’t get to that pain point or it may be not holding on as long or going less deep, whatever it is, do less so that you don’t reach that same pain point. Now if they say they are still ‘feeling something but its not pain as such, they are just aware of it’ I say that is fine, as long as they are happy to tolerate it. If they feel this sensation at home, they can be happy that they are still safe and not doing anything that is hindering their progress. This positive reinforcement is actually training the brain to recognize the difference between pain and discomfort and the more you do this, the faster the brain will recognize that you are actually not in danger and don’t need a pain response. Who would’ve thought we could train our brains like that!?! Amazing!
Our bodies are so incredible and especially our brains and neurological system but boy are they complex! Lets work with them, not against them.
Keep moving and stay positive because –
“A pain free body is a functional body!”