Run Smart: Why the ‘No Pain, No Gain’ Mindset Will Likely Lead to Injury

A physical therapist explains why this common motivational phrase is actually quite harmful


No pain no gain?

For as long as I can remember, I’ve heard this phrase over and over again. While it may hold true for muscle strengthening or work-outs, when it comes to injury and rehabilitation, it is definitely a myth.

First, running through pain (aside from the pain of fatigue aforementioned) can be detrimental not just to your eventual healing, but to your running career.

When you run in pain, or do anything with any soft tissue or joint pain, your body comes to recognize this feeling. If you continue, you slowly teach your body that this pain is acceptable. The more this happens, the longer it will take for your body to let this pain go. Thus, in trying to heal from an injury, the more time that has elapsed since you continued to run in pain, the longer the injury will take to heal.

You may deal with many injuries before you come to terms with this, as many of us will stubbornly run through an injury because we don't want to stop running. But the quicker you start resting, the quicker the injury will go away.

Pain is a sign of inflammation and the chemical reactions that ensue. If we keep this cycle of chemical reactions going, it’s harder and harder to stop it. The brain slowly begins to assume this is the new normal. It can often become a chronic problem, or in many cases, the problem can keep coming back to haunt us, and over time end our running career.

I often get patients who figure this out after 4 to 8 weeks of therapy for a chronic condition. The next time they have any injury whatsoever they immediately come in the week they begin experiencing pain. They have figured out that if they do this, they often need only 2 to 3 treatments in total, instead of months of therapy.

The quicker you catch the problem the quicker we can get rid of it. I think of it this way: you can either run at 100 percent in a matter of weeks or spend months training at 70 percent. Or as many of my patients who refuse to stop running through injury, you can be 80 percent for years and likely to keep being forced to spend time off throughout your career.

'No pain, no gain' is also a myth of rehabilitation programs. If a therapist or doctor gives you exercises and stretches that hurt when you do them, a word of warning, you are not going to heal! As I tell my patients, the only thing that is allowed to hurt is when I manually work on the soft tissues. Therefore anything you do for yourself should not hurt at all.

To an extent, the massage and manual work we do to you can hurt, but must be done by someone who knows exactly what they are doing. The hurt will be the 'good pain' as we call it at DASH. It hurts but it works. Even during the hurt it often 'feels necessary' or 'feels like it's fixing the problem' as my patients often remark.

There are, of course, some exceptions to this rule. Take for example the non-acute phase of adhesive capsulitis or 'frozen shoulder', or post-surgical patients behind in their range of motion (pray you don’t ever end up in these categories.) However, exercises, weights, stretches and homework that causes pain, is for the most part, not helpful.

The goal will always be to get back to running as quickly as possible. But trust me, you will get back and stay back longer if you catch an injury earlier, get treatment right away and don't run in pain.

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