No Pain, No Gain?

What does PT stand for? Pain and Torture OR Physical Torture.     Wrong!  

I recently have had this conversation with several patients that "no pain, no gain" is not the appropriate model for physical therapy practice. Patients often come into my doors with scared emotions. They have heard stories about physical therapy being painful. They know physical therapy will make them better, but believe this healing comes at the cost of torture.

As physical therapy practitioners, we need to change this belief system. We know the pain-for-gain model should not be promoted anymore. In instances of acute pain, the brain is telling the body something is painful for a reason. Pushing beyond the point of pain can trigger an inflammatory response resulting in increased tissue injury or prolonged soreness. From a psychosocial perspective, the perception of pain has a negative connotation. Pain can lead to a fear of movement, protective guarding, and a lack of trust in the therapist. If individuals associate therapy with fear and negativity, they are likely to have a slower response to treatment.

So how can we change this belief? The information I give to many patients is that they should feel 'better, looser, or less pain' by the time they leave each session. If not, I am not doing my job. While stretching, strengthening or performing mobility exercises, I tell patients to go to the point of pain and then back off. Soreness or discomfort may arise as you are gaining back your strength and ROM, but these symptoms should be temporary. Therapy is not intended to be painful. We are doing our patients and profession a disservice if we do not properly educate people about therapy and pain. 


-Jim