This is probably the number one question patients ask, and unfortunately the answer isn’t that simple…it usually DEPENDS! It is also important to clarify what exercising THROUGH pain is. We understand exercising THROUGH pain to mean as a person exercises his/her pain INCREASES. Therefore, if a person is in pain, but exercise does not INCREASE the pain then it would not be considered exercising through pain.

Let’s look at some factors to guide whether or not you should exercise through pain:

1. How acute, or long an injury has been present is important. We do not recommend exercising THROUGH pain when an injury is within the first 1-2 weeks.

2. The intensity and amount of stress applied during exercise also matters when it comes to working through pain. DAMAGE to tissue (muscle, tendon, ligaments, nerves, etc) is when the force applied to it is more than the particular tissue could withstand. The good news…it actually takes a lot of force to cause damage to human tissue!  So, if you are exercising through pain, but are performing the exercise in a SLOW AND CONTROLLED manner you are likely NOT causing any damage

3. What is the overall trend of the pain over time? If someone is exercising through pain and over time the pain is getting worse we recommend they DO NOT work through pain. But, if someone is working through pain and over time the pain is getting better we would approve working through pain.

Many people will immediately abandon an exercise if it hurts when they perform it because they think it is making them worse, or causing damage. This behavior can limit the potential to maximize functional return following an injury. Pain does NOT always equal DAMAGE. Before abandoning an exercise we should first make modifications in: form, load/resistance, range of motion, and dosage (sets, repetitions, etc) to see if we can perform more comfortably.

Another thing to think about when deciding whether to continue or modify an exercise that hurts or stopping it completely is does the exercise promote a movement that is important for YOUR function? For example the squat is a movement all human beings need throughout life, so this is definitely an exercise you should modify. On the other hand if you are doing jumping drills that cause pain in your knee, but this does not relate to how you function (or want to function) then maybe you should stop the exercise.

Plantar fasciitis is inflammation of the thick band of tissue that lines the bottom of the foot. The plantar fascia helps to support the arch of the foot and acts as a shock absorber. This structure which spans from the heel bone (calcaneus) to the toes can be irritated or damaged when excessive or repetitive stress is applied. This can happen from overuse, performing an activity that one is not used to, and/or trauma. Common impairments associated with plantar fasciitis are muscular tightness and/or weakness, or wearing inappropriate footwear.

A herniated disc is a displacement of the nucleus pulposus (inner part of the disc) through the annulus fibrosus (outer part of the disc) thus protruding into the spinal canal and potentially compressing spinal nerves. Disc herniations are quite common and sometimes cause no pain, however, there are times when they can irritate a nerve causing pain, numbness, and weakness.

Yes, research shows that herniated discs can heal with conservative treatment. The rate of spontaneous regression was found to be 96% for disc sequestration, 70% for disc extrusion, 41% for disc protrusion, and 13% for disc bulging. Regression usually requires 4 months, but surgery may be required if regression is not experienced after 10 months or if significant neurological impairments are present.

A “pinched nerve” is when there is too much compression on a nerve that can cause pain, alter sensation, and/or reduce muscle function. This compression can be at a nerve root of the spine (from a disc protrusion, bone spurring, etc) or at a peripheral nerve (ie: from a muscle in spasm). Where and which nerve is compressed can commonly be distinguished by a clinical examination including reflex testing and observing symptoms patterns, as well as by using diagnostic imaging and nerve conduction testing.

A torn meniscus is an injury to the C-shaped fibrocartilage that attaches to the top of the tibia bone. The meniscus is a shock absorber and also increases congruency/stability of the knee joint. A tear can be caused by trauma such as an excessive twisting motion, but can also be degenerative in nature. The outer portion of the meniscus has blood supply and does have healing capabilities. Meniscus tears are not always painful as there is a high prevalence of meniscus tears in the asymptomatic population.

Degenerative disc disease (DDD) is the deterioration of the spine and in particular the discs which act as cushions in between the vertebrae. Degenerative disc disease is very common and a natural part of the aging process. However, there are times when DDD can contribute to the experience of pain.

Good posture is achieved when the head is over the shoulders, the shoulders are over the hips, the hips are over the ankles, and the neck, mid back, and lower back are in their normal amount of curve when viewed from the side. It is important to note there is no single posture someone should be in all the time. We are meant to move! Posture is dynamic; meaning that it can and should change frequently – especially with situations that allow you to be in a certain position for an extended period of time.

There are many potential causes for arm numbness:

1. Occluded blood supply to the arm
2. Nerve compression including compression to the cervical (neck) nerve root or to the peripheral nerve
3. Spinal cord injury
4. Brain injury including TBI, stroke, TIA
5. Myocardial infarction