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Should My Physio Treatment be Painful?

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Our Bristol Manager and physio Leanne Plenge clarifies whether there is actually any truth in the ‘no pain no gain’ cliché, and whether the exercises your physio prescribes should be painful. 

In the years I have been practising as a physio I have heard the statement no pain no gain many times.  Sometimes from behind the curtain as another physio suggests this to a patient, sometimes from a patient expressing a tight grimace when I have asked how their exercises are going or how a particular treatment feels!

It’s one of those statements that everyone will have heard before. We apply it to ourselves when we push hard towards a sporting goal or tighten the purse strings to save for a holiday. It’s a powerful statement but with regards to physio, it can be sometimes be misleading and sometimes harmful.

Every person is different. Every treatment is also unique. I would say that the vast majority of treatment techniques should not be painful. Sustaining pain in muscle tissues for often and long enough will ultimately risk sensitising those tissues to pain sensation and therefore risk a situation where chronic pain may develop. This is why I suggest that in my experience, exercise should on the whole be relatively pain free. This enables maximum muscle unit recruitment and building without inhibition, whilst also avoiding sensitising that person to pain.  Any physio that tells you that the exercise will be excruciatingly painful is being lazy – there are always alternatives!

Some hands on treatments can be uncomfortable, maybe even mildly painful when performed. A good example of this is trigger pointing or deep tissue massage for a tight or overactive muscle. The therapist might use their elbow even to press deep and hard into the centre of the painful muscle where it is felt to be most tight to release it off.  What you do see though is almost immediate improvement in flexibility at the joints affected by this muscle, or reduction in the tenderness and tightness when the muscle is next touched. This pain is short lived and useful.

So, when you next see a physiotherapist or a chiropractor, osteopath or therapist, make sure they are explaining to you how you should feel during the treatment and why it will feel like that.  Make sure you understand what that particular treatment is trying to achieve for you. That way you will gain the best from the therapy and not risk further harm.