NO PAIN, NO GAIN: Fact or fiction?

We’ve all heard this expression.  But is it true?

This motto was first aired in 1982, when actress Jane Fonda produced a series of workout videos (you know the ones!), in which she used phrases like “No pain, no gain,” and “Feel the burn” to encourage her fat-burning viewers to work harder during exercise.  And it’s still used today.  Thousands of personal trainers repeat this mantra to their clients daily, reminding them that there is no meaningful reward without sacrifice.

There’s only one problem. Pushing yourself through pain can actually be dangerous.

Here’s a quick example.  A young woman came in to our office with pain in her right hip.  She had been training to run a marathon, and her speed and endurance were improving nicely.  Out of the blue, her hip started hurting when she ran – even during the first few steps.  The pain progressively worsened, eventually preventing her from running at all.

Her doctor had told her that she had a tendonitis in her hip, and said she should be fine after a little stretching, rest & ice.  That didn’t seem to help.

After performing an exam & x-ray of her hip, i suspected a stress fracture.  An MRI confirmed this.  Less than two months of rehab later, we had her running again, and her hip was healthy.

Here’s the take-home point.  If this young woman had followed the “No pain, no gain” theory and continued to run, she could have developed avascular necrosis (AVN) of the hip, which could lead to a catastrophic fracture of the hip, and then required her to have a total hip replacement surgery.  Not a very pleasant experience.

In fact, joint pain is never normal.  Pain is like the red light on your dashboard, telling you when something is going wrong & needs attention.  If your engine was overheating, would you keep on driving?  Would stomping on the accelerator solve the problem?

We have a simple pain rule for our patients, called the “wincing” rule.  Following this rule can help you avoid injury during exercise or everyday life.  Here’s how it works:

The "Wincing" Rule
During any activity, if you have enough pain to make you "wince" (like the guy in the picture!), that means you may be doing actual damage to yourself.  Immediately stop what you're doing and see if your pain subsides.  If it does, resume your activity but at a lower intensity that allows you to work comfortably.  If you're running, for example, try running at a slower speed, or a shorter distance, or on flat ground instead of an incline.  Anything lower than a wincing  level of pain is generally okay to work through -- like an exercise "burn", or stiffness, tightness or soreness.

And, if you find yourself having to modify or eliminate activities on a regular basis, it’s time for you to come see me or another qualified health professional.  Pain that occurs routinely, or pain that becomes more frequent or severe, is a sign that some underlying problem needs to be corrected.  And with many conditions, the sooner you get the proper treatment, the easier it is to correct.

In summary, pain high enough to make you wince means STOP.  Pain levels below that are generally okay to work through.  And remember: Your body is pretty good about telling you what it likes and doesn't like.  Listen to it!

-Daniel Bockmann, DC

To see a list of the causes of joint pain, click here: http://www.mayoclinic.com/health/joint-pain/MY00187/DSECTION=causes

To learn more about avascular necrosis of the hip, click here: http://www.mayoclinic.com/health/avascular-necrosis/DS00650

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