When prescribing exercises, a common question we get is, "If it hurts, should I keep doing it? How much pain is okay before I hurt myself even further?" The answer depends and varies on each patient's diagnosis, pain tolerance, and functional limitations. Fortunately, pain does not always equal damage to tissues.
A few good rules of thumb to follow when trying to decide when it is okay to have pain with exercise:
1. Pain severity
The pain you experience needs to be tolerable. In general, on a scale of 0-10 on the pain scale, the pain you experience while performing your PT exercises should be a level that YOU are comfortable with. For most patients, this can vary from 0-4/10. Pain higher than 5/10 can lead to prolonged soreness, affect the rest of your day, or limit your activities, which is too much pain.
2. Delayed Onset Muscle Soreness
In general, muscle soreness should last 24 hours or less following your PT exercises. If it settles within 24 hours, you're in a good place! If it lasts longer than one day, consider decreasing the repetitions, weight, or sets with your exercise to determine what level keeps your soreness controlled. If you're not sure how to change your exercises to stay within the 24 hour rule, let your PT know and they can help you find the magic number of reps and sets!
3. Does it affect your ADL's (Activities of Daily Living)?
If the pain and soreness you experience when performing your PT exercises affects your ability to perform your daily duties, such as going to the grocery store, walking your dog, going to work, etc., then your pain levels are too high. Find a happy medium that allows you to work towards your goals, improve strength, while maintaining the ability to perform your daily activities.
4. Does it affect your sleep?
Does your recent onset of pain impair your quality of sleep? For example, if you can typically sleep on your side with minimal to no shoulder pain, but your recent exercises have exacerbated your pain and made it unbearable to find a comfortable position, then your pain levels are too high. Sleep is an extremely important aspect of health, recovery, and mental wellness and should not be affected by your pain levels
Maggie Nguyen PT, DPT