Rehabilitation Principle #1 – No Pain, All Gain
Rehabilitation (unlike athletic training) requires that you perform your exercises within a completely pain-free zone; essentially a zone of safety.
Exercising in a manner that causes pain develops abnormal neuromuscular patterns that may lead to further injury. Conventional rehabilitation strategies commonly do not succeed because they do not address the underlying neuromuscular problems. They are often designed to make you work through your pain (as in work- hardening programs). This only causes you to create or reinforce the abnormal motor responses which in turn continues to keep you in pain.
In addition, if you work through pain caused by tissue damage you run the risk of central sensitization. This is a nervous system process which causes you to become more sensitive to pain. The only way to break this pattern is to perform your exercises in a pain-free zone.
We commonly have patients come to our clinic who have exercised through their pain for years! They are always amazed at how, by exercising within a pain-free zone, we were able to help them break their pain cycle in just a few short weeks.
What works will vary from person to person so listen to your body and adjust the routines accordingly.
Never work through injury pain. If you have an injury, and the exercise hurts during certain motions, or if you feel pain when resting, then restrict the range of motion of the exercise to lie within your pain-free range.
In addition, avoid the exercises that currently cause you pain, until your body is ready for them. To truly rehabilitate your injuries, you must work within a pain-free zone.
This is quite different from training to improve your performance where you may have to endure some degree of muscle pain (not injury pain) to improve strength and endurance.