• Samuel Spinelli

No Pain, No Gain? A Myth Bust Monday

“No pain, no gain.” No doubt if you are reading this, you have heard it. You might have even said it. But what does this mean, and more importantly, is it true? Well, like any statement, it depends.



The expression “No pain, no gain” (NPNG) dates back all the way to the second century, written in The Ethics of the Fathers 5:23 as “according to the pain is the gain”. Its next interpretation appears to be in 1650, in a two-line poem by Robert Herrick titled “Hesperides”, he states


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“If little labour, little are our gains: Man’s fate is according to his pains.”


Moving forward, in the persona Poor Richard (1734), it is none other than Founding Father Benjamin Franklin who mentions “there are no gains, without pains”. And finally, the actual term “no pain no gain” was made popular in the 1980’s by none other than fitness guru Jane Fonda .


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Jane started using the phrase during her aerobic workout videos to describe the burn associated with working out past the muscle aches. Regardless the progression of the phrase, I think we all can agree physical pain is not a necessary component in making gains toward rehab or fitness goals.


Soreness is Not the Same as Pain.


Merriam Webster defines no pain no gain as “used to say that it is necessary to suffer or work hard in order to succeed or make progress”. In certain realms of rehabilitation, especially strength and conditioning, I’d say working hard is mostly true, but not suffering in the physical sense. One should not be feeling like they suffered through their PT session. Lets face it; your body requires a certain level of stimulus big enough to drive adaptations. We must work hard to make progress. Physical Therapist Scot Morrison, uses the term “sloptimal load” (ref?), a dosage sufficient to elicit the majority of the desired effects without wrecking the individual; the idea of moving forward as soon as you get something that satisfices. To make gains, you need to get your body out of homeostasis, and you do this by ensuring demands are met, and intensity and dosage are adequate to drive adaptations (gains) in the system (your body). But experiencing soreness from exceeding demands is not the same as pain. We can push through soreness; we should not (in majority of circumstances) push through actual pain. And on the clinical and rehabilitation side, pain, physical “ouch”, joint related pain, should be avoided.




DOMS

How sore is too sore?


Muscle soreness (DOMS) enables the individual to reflect on the exercise or workout. It allows us to know we experienced a stimulus satisfactory enough to create micro trauma, which in turn will stimulate repair and growth in the muscle. DOMS lasting 48-72 hours that is strictly in the muscles and gradually subsides, is OK, and a green light to continue. This is not the same as pain, or a feeling of concern experienced during the exercise. That feeling should be at minimum a yellow flag, a signal of caution, in which one should reflect, take a step back, re-assess form, load, intensity, and make a decision to move forward or stop. Physical pain is not a normal. The hard part is people need to be able to distinguish the difference between discomfort and pain. Often times, sharp acute pain that occurs quickly indicates potential injury, and the person should stop what they are doing. However, a slow, gradual build that is more of a dull burn or subtle (1-3/10) ache is more of the “hard work” that we endure to make progress and gains in strength.


Why is being sore a good thing? Some may have heard the term ‘envelope of function’ which Scott Dye describes as “that torque which can be safely withstood and transmitted by the system without damage (2005)”. Without going into too much depth, he is basically describing the amount of force in which a person is able to accept, transfer, and dissipate without injuring themselves. Think of this as your current baseline for exercise. The dark (middle) line, and everything under, is the envelope of function, and the persons current capacity to tolerate loads. The goal is to shift that line to the right, increasing the area under the curve, which equates to increasing the ability to withstand forces (increased resiliency in the system, ie, your body) and making the body more robust. The way a person does this is through working in the supraphysiologic overload zone, in which DOMS is likely. The beauty of this concept is it applies to both the rehabilitation setting as well as the strength and conditioning setting. However, work too hard, and you end up in the structural failure zone, ie, injury. This is why we do not want pain, and thus why “no pain no gain” does not hold up.




Some pain, Some gain, most of the time.


The gym is (usually) not the clinic. The majority of patients we treat are not going to be experienced bodybuilders, nor will many have ever lifted a barbell. They likely will not have hard deadlines to meet for competitive sports, or be familiar with pushing their body to max failure. This is why no pain, no gain is only applicable in very rare situations. Instead, I like “some pain, some gain”, with a clear understanding between pain and discomfort. When thinking of muscle development, and injury rehabilitation, discomfort may be beneficial in some instances, detrimental in others. Choosing to push through your pain can increase the severity of your injury and will likely delay the time to recovery. This is why consulting a healthcare professional is so important. When in doubt, contact your local Physical Therapist, get a consultation, and get the education you deserve to keep you on the right track.



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Zachary Fox PT, DPT, ACT, CSCS


References


Morrison, S. 2019. http://physiopraxis.co/


Dye, S (2005) The pathophysiology of Patellofemoral Pain; A Tissue Homeostasis Perspective, Clinical Orthopaedics and Related Research. 436, 100-110.

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