Monday, November 18, 2013

The No Pain, No Gain Principle - 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 be dangerous. Just ask Tiger Woods. Rather than take some time off & rehab the cartilage injury in his knee, he decided to keep on playing "through the pain". You can see him clutching his knee in agony after this unwise decision.

Here's another 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 tendinitis 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, we 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 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 "Rule of 3". Following this rule can help you avoid injury during exercise or everyday life. Here's how it works:

The Rule of 3

During any activity, rate your pain on a scale of 0 - 10, where "0" is no pain, and "10" is the worst pain you've ever experienced in your life. As long as you keep your pain rating at 3/10 or lower, you're almost always safe. If your pain reaches levels of 4/10 or higher, either modify the activity to bring it down to a "3" or lower, or simply stop the activity. (NOTE: This rule does NOT apply to "exercise discomfort" -- the burning feeling in muscles from straining during exercise.)

And, if you find yourself having to modify or eliminate activities on a regular basis, it's time for you to meet with a 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.

So, let's change the old saying, "No pain, no gain" to a new one. It's safer, it's more comfortable, and it's an easier motto to live by: "No pain, no pain!". Listen to your body -- it knows what it needs!

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