“No Pain, No Gain” when it comes to Physiotherapy?


Have you ever heard the popular phrase “no pain, no gain”? It is a phrase I hear often by physiotherapy patients during their treatments. I thought it would be beneficial to discuss this expression and hopefully alleviate some fears patients have when coming for treatment.

Should Physiotherapy be painful?

Experiencing pain with physiotherapy is not quite black or white because there are times when physiotherapy can cause discomfort and times when a patient should not have any discomfort with treatment. Discomfort can sometimes increase with manual therapies and exercises prescribed, but it is temporary and should not make the pain from your injuries worse. The therapies provided are used to increase healing and mobility.

When should patients NOT be pushed past their pain in physiotherapy?

During the acute phase of a patient’s injury, they should not be pushed beyond the pain they may already be feeling. During this phase the brain is telling the body it is in pain for a reason. Pushing beyond this pain can cause an inflammatory response resulting in increased tissue injury or prolonged soreness. At this phase of a patient's injury which is usually the most painful time, part of physiotherapy treatment is focused on decreasing swelling and pain.

When is it OK to feel pain?

For some injuries or conditions, it is necessary to relieve stiffness and increase tissue mobility with increased stretching, range of motion exercises, or passive manual therapies which may cause some pain in order to prevent or eliminate adhesions and scar tissue build up. This will enhance overall movement. It is the extra “push”, tissue or joint manipulation the therapist will need to do that may cause relative ‘pain’ but it is short lived and often patients report feeling better at the end of treatment.
During an initial assessment, some testing may be used to mildly provoke pain to help determine the diagnosis, what is causing the pain or makes it feel better and what course of treatment will be required.

Our goal for each physiotherapy session at Fortius Physiotherapy, is that you leave us feeling better. During your treatment we may have you stretch, strengthen or perform mobility exercises. These are performed to the point of pain; we are not trying to push past the pain. Discomfort can be felt while gaining back strength or range of motion but it should only be temporary. The discomfort felt after physiotherapy is usually due to strengthening weak muscles, which is similar to what someone would feel after a workout at the gym.

During your Fortius Physiotherapy appointment we want to know when you are feeling pain and how it feels, for example is it sharp, dull, throbbing etc. This will help us to determine another treatment course that will not irritate or exacerbate your symptoms. Open communication with the therapist is very important for successful outcomes.

We look forward helping you reach your success at Fortius Physiotherapy and Wellness.


Karen Evers RKin, OTA and PTA