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Massage Today
October, 2001, Vol. 01, Issue 10

"No Pain, No Gain"

By Ben Benjamin, PhD

True or False: The phrase "No pain, no gain" is an important axiom to follow when using exercise to rehabilitate an injury.

Answer: False.

If pain is felt during rehabilitative exercises, it means that further damage to the tissues is occurring.

It is often thought that rehabilitative exercise is used solely to rebuild muscle strength. In fact, it is intended to do several things at once: minimize scar tissue in the healing process; re-establish and maintain flexibility; and rebuild strength.

Full-range movements serve to restore flexibility and prevent the return of adhesive scar tissue, during and after therapeutic interventions. An effective exercise regime rebuilds strength in the surrounding muscles, tendons, ligaments, and joint capsules -- in short, all of the tissues stressed and atrophied by the precipitating injury.

When injury occurs, many structures can be weakened. For example, if the ankle is sprained, the primary injury is most often in one or several ligaments. When this occurs, the ankle swells and the joint structure is stressed. If the ankle is swollen, painful adhesions form in the joint capsule and flexibility is dramatically reduced. The person may not walk for several weeks, causing atrophy of the muscles, tendons, ligaments and so forth. A combination of hands-on treatment to restore motion, eliminate unwanted adhesive scar tissue and increase circulation, along with rehabilitative exercise, will restore strength and flexibility.

When the axiom "No pain, no gain" is followed, the person begins strong movement before the body is ready. This activity keeps re-injuring the structures that are already damaged. There are many young athletes and dancers who followed this path to early retirement by not listening to their body's pain. Pain is the body's signal to stop. When any kind of exercise is painful, the body is trying to tell us something. That message is "Stop! You are hurting me."

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