Avoid pain or gradually expose?

Should You Push Through Pain or Protect the Injury? Four Key Things to Consider

Physiotherapy has changed a lot in recent years, especially when it comes to dealing with pain during exercise. In the past, the advice was often to avoid anything that hurt, but now, we know that in many cases, it’s actually okay—and even beneficial—to continue moving and gradually increase activity, even if it causes some discomfort. However, this doesn’t mean that everyone should push into pain right away. Some people need to protect their painful area, while others may need to challenge it to help them recover.

In this post, we’ll look at four important things to consider when deciding whether to work through pain or give your body some time to heal.

1. When the Injury Happened

The timing of your injury is a big factor in deciding how to manage your pain. If the injury is recent, pain is often a protective signal from your body. For example, if you’ve just sprained your ankle, it makes sense not to run on it right away. Similarly, if you hurt your back yesterday, it’s probably wise to avoid heavy lifting for now. In these situations, protecting the painful area for a while is the right move.

However, if it’s been a long time since your injury, the approach might be different. If you injured your back a few years ago and still avoid bending over, it may be time to gently start moving again, even if it feels a little uncomfortable at first.

There are exceptions, like after surgery, where some pain with activity is expected early on. In these cases, there’s often a small window of time to get the range of motion back, so working through some mild pain can be beneficial.

2. The Type of Pain You’re Feeling

Not all pain is the same, and understanding what kind of pain you’re experiencing can help guide your recovery. For instance, if you have mechanical pain, which tends to hurt with certain movements (like back pain that flares up when you bend forward), it often makes sense to avoid those movements and adjust how you move to reduce pain.

On the other hand, if your pain is constant and doesn’t improve with movement adjustments—whether you’re sitting, standing, or lying down—it’s unrealistic to avoid all activities. In these cases, gently increasing your movement over time, even if it causes some discomfort, can help your body adapt and eventually reduce pain.

3. Fear of Movement and Avoidance Behaviors

Fear of movement and avoidance behaviors can have a huge impact on how pain is experienced and managed. If you don’t have significant worries or fear about moving, staying within a pain-free range during your activities is usually the best approach.

However, if you’re feeling anxious or overly cautious about moving because of your pain, avoiding movement altogether can actually make things worse in the long run. For patients who are fearful of doing any activity, reinforcing the idea that pain is something to be avoided at all costs can send the wrong message. Instead, it’s important to gradually reintroduce movement and build confidence, even if it causes mild discomfort, as long as serious conditions have been ruled out.

This approach, called graded exposure, helps reduce fear of movement over time and makes it easier to get back to normal activities.

4. Your Personal Goals

Your goals play a big role in determining how much pain is acceptable during exercise. For example, many people recovering from knee replacement surgery want to walk without using a cane. Achieving this goal often means working through some pain in the early stages to improve your walking pattern, build endurance, and regain the necessary range of motion.

On the other hand, some goals can be achieved without pushing through pain. For example, if a powerlifter experiences back pain when bending too far forward, learning to maintain a more neutral spine and focusing on core exercises can allow them to continue lifting without discomfort.

Conclusion

Whether to push through pain or protect an injured area is not a one-size-fits-all decision. The timing of your injury, the type of pain you’re experiencing, any fear or avoidance behaviors, and your specific goals all need to be considered when deciding how to move forward. In some cases, gently increasing movement despite discomfort can help you recover, while in others, giving your body more time to heal is the right approach.

As always, your physiotherapist will help guide you through this process and create a treatment plan that’s tailored to your unique situation.