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Should we be pushing into pain with rehabilitation or not?

Many therapists have different opinions regarding this matter. Some therapists always instruct patients to push into pain when doing their rehab exercises. The opposite is also true where therapists are telling patients to avoid doing any movements that hurts or to move only in pain free ranges. It is also true that some patients should most definitely avoid painful movements, but there are also cases where we should encourage moving into pain. it is also true that certain conditions call for different approaches. Listed below are guidelines to assist with this.

Do not move into pain if:

  • There are any signs of serious pathology
  • Acute trauma like surgery, muscle tears, injury/damage to the cartilage, or a ligament sprain
  • If pushing into pain has not helped improve things so far

Push into pain if:

  • There are no concerns that doing so will do harm or damage
  • It is done at a tolerable level
  • The pain does not last too long after doing the exercises or interfere with sleep
  • Avoiding pain, resting, and reducing activity for an extended time hasn’t helped

These are just guidelines I use to guide myself when dealing with this dilemma and so far they have worked well for me.

Your PTX team.

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