The funny thing is most clients come to me wanting to DECREASE their pain, not add to it. And yet I still hear time and time again the message that seems to have been drilled into people – “You can’t gain without pain”.
Now I have spent my professional career challenging this. I do believe you can gain without pain. And I’ve had great results with my clients for 13 years doing this. Sure sometimes you can’t avoid some discomfort. Think of things in life where we have grown from, and there was often a degree of discomfort. But do we need to have severe excruciating pain?
Maybe this is one way to gain. But its not the only way. I always believe in trying something that is NON-PAINFUL first. If that isn’t working I may have wasted a little time, and I can always try something else then. But 99% of the time I find the non-painful technique works very well.
In fact I would argue causing pain first is a very poor way to get good results. Think of an injured animal. Do you think they’ll be very receptive to anything if we cause them more pain? I sometimes joke to my clients our bodies are much like injured animals. When we cause pain we go into fight or flight response, release hormones such as adrenaline and our bodies tense. This often makes it much harder for client and therapist to get results.
I’ll give you an example. I had a client who saw another therapist initially after a shoulder operation. Now this client had hurt the shoulder quite badly and it wasn’t moving the way it should have at the post-op stage he was in. There was significant stress going on for him as well about whether he was able to get back to his job. Now the therapist (who by the way was a very experienced shoulder specialist) immediately did one of the most painful techniques you can do to gain range in the shoulder. The client actually screamed when this occured and asked the therapist to stop. The therapist didn’t and kept going. End result the client (I think understandably) didn’t want to go back to this therapist. Now the interesting thing is that I spoke to the therapist and they said that the client got 90 degrees of shoulder flexion. I had this same client in the pool. In the warm water we massaged around the area, and I told the client he was very much in control of how far I would move his arm. We did some exercise to get the endorphins flowing (natural painkillers released when exercising). I did some breathing exercises, showed movement with the other shoulder, and made the first movement very small, so he could get used to the feel. Each time we went a little further. Then we had a break did some other things and came back to it. End result? Shoulder flexion 140 degrees, 50 degrees more than the painful technique.
I found this the first time I worked in the Wesley Hydro pool on clients who had had total knee replacements. I would see clients on the ward hate the sight of physios walking towards them because they knew it would hurt. I would read in the chart Knee flexion 95 degrees with 7/10 pain (Visual Analogue Scale) And then I would have same clients laughing in the pool getting 110 degrees without pain. I’ve seen it countless times since.
For me the no pain no gain doctrine is just that. Its a belief, not backed up by research or results with clients that I have seen. Quite the other way in fact. I can’t tell you how many clients I’ve had who’ve found physio painful and didn’t get great results. I find often when I first see them that they are guarded in body and mind because they expect I’m going to hurt them.
Once I can get through this, assure them that THEY ARE IN CONTROL an amazing thing happens. They relax, and then they are often amazed how much more movement/improvement in function they get with the techniques I use. Finch therapy in particular that I use is great because it gets great results without pain, with very small and simple movements. Hydrotherapy is the same. In warm water you can move easier without pain. Even something as simple as doing a little massage to get the body used to touch first can make all the difference.
So next time you find yourself or someone else saying “no pain or no gain” just stop and think for a moment.
Is that the only way? Do I think that just because you’ve heard it so many times? It may be true for some people and some therapists who don’t know any other way. But there may be a better way. I’m not saying you can’t gain with pain. Enough people swear by hard deep tissue massage and other painful techniques that I’m sure they are right. But there may be a way to get equal or even BETTER results with non-painful techniques, at least if they are tried first before a painful technique. Don’t take my word for it. Give it a try and see for yourself.
There is an old saying If you think you can you can. If you think you can’t you can’t. For me painful therapy is like this. If you think it has to be painful you’re right. If you think you can gain without pain you’re also right. Both valid. But I like people to have the choice.










