"No Pain, No Gain" Fallacy

I've had new patients (and potential patients) ask me if physical therapy treatment will hurt. I explain to my patients that our first goal is to reduce their pain levels before we restore any lost functionality. Many times I will start with hands-on techniques to reduce pain, restore tissue pliability, and generally prepare the patient, so they can advance without hindrance through exercise and activity training toward their ultimate goal.

Depending on the patient’s needs, we may spend considerable time in our gym or workout area. When I show a patient how to use a certain weight machine, I emphasize that while the exercise may feel uncomfortable, the patient should never experience pain, particularly in the tendon and joint areas. With the first hint of pain, my patient stops lifting that particular weight, and we adjust the joint angle of the movement to a pain-free range. In some cases, the patient may need to stop and work on joint and tendon lubricating exercises before the strength training is resumed for that session.

If you injure yourself, especially as a beginner, you may give up on strength training, fearing that you will hurt yourself again. So, it is important that you know the proper form to avoid injury and that you listen to your body's pain signals. If something hurts, stop and review that your form is correct. If it is, you may need to lower the weight or adjust the movement you're making to put less stress on your tendons and joints in particular. You may want to hire a professional weight trainer so that you can be sure that you are lifting properly and avoiding potential injury. They may also help you adjust certain lifts to put less stress on your joints and tendons.

The Talk Test

At Aptitude Physical Therapy, we are constantly encouraging our patients and social media followers to walk more, mostly because it’s one of the easiest and cheapest forms of exercise to adopt. The CDC recommends 150 minutes or 2 1/2 hours of moderate-intensity aerobic activity per week. We recommend working toward that goal, for example, by walking for 10 minute intervals a couple of times per day. But how do you know that your walking is considered exercise and not just going for a stroll?

According to the CDC , one of the best ways to determine the intensity of your workout is to use the “Talk Test.” If you are able to talk but not sing during any physical activity, you are performing a moderately intense activity. If you have trouble saying more than a few words without pausing to catch your breath, then you are doing a high-intensity workout.

The more you walk every day, the easier it will become. So, going up a hill by your house may at first be a high-intensity workout for you. You may want to find a flat surface to walk on and slowly increase your speed until you notice that walking has become easier.  At that point, if you try the hill again, you may notice the hill isn’t as daunting as before, and you may be able to carry on a conversation going up the hill.

As always, be sure that your physician approves of any physical activity and your exercise plan before you begin. You may also want to ask a friend to join you on these walks so you can test the intensity of your workout with the “Talk Test.” Having a friend along may also help pass the time more easily.

For more information and guidelines for exercising, we recommend the following links.
Exercising with High Blood Pressure
CDC Measuring Physical Activity Intensity