30 Seconds Summary
- Physical therapy is sometimes painful because the body isn’t used to the activities you’re performing in the PT clinic.
- Muscle soreness is different from pain. Understanding that can help you stick to your PT exercise routine.
- Physical therapy shouldn’t be too painful although it can be uncomfortable for some people.
- You can avoid post-PT pain by following the prescribed exercise program at home. That can help your body adjust to the movements faster and you won’t lose the progress you make in the PT clinic.
- Too much pain after physical therapy means you need to talk to your therapist to adjust your treatment regimen.
Is this going to hurt? – That’s usually one of the first questions I get when I prescribe an exercise program to my physical therapy patients.
No matter how much we claim that physical therapy (PT) isn’t painful, the reality is that some patients complain of pain or discomfort when they’re starting physical therapy.
They’ll come in for their second or third session and put up some resistance during the treatment session because they had pain after the last PT session and they believe it’ll happen again.
So in this article, I’ll explain why physical therapy hurts (sometimes) and how much pain is too much pain after a treatment session.
Don’t Confuse Soreness With Pain
Anytime you put your body through a harsh workout or undergo physical therapy after an injury, chances are you might experience soreness. The problem arises when some people consider this soreness as pain. (Reference)
Post-exercise soreness can be of two types:
- Acute – happens during or immediately after an exercise session
- Delayed onset muscle soreness (DOMS) – comes on a day or two after your session.
Torn muscle tissue, connective tissue microdamage and lactic acid accumulation are some of the reasons for this soreness. (Reference)
So how do you know if it’s soreness that you’re experiencing after physical therapy or pain?
Well, soreness doesn’t come with redness or swelling but a painful tissue or joint injury does.
Also, soreness is generally not too intense or sharp but pain can be. If your muscles are sore, they’ll feel tight. But with pain, the muscles might hurt to touch, it might be difficult to put weight on them and do activities.
Research has found that massage and a warm shower or a hot pack helps soreness, but pain not so much.
Time is also a great differentiator between pain and soreness. Pain will increase or stay the same over time but post-exercise soreness tends to go away with rest.
Why Does Physical Therapy Hurt?
Physical therapy might hurt for the same reason why exercise can sometimes hurt – because you’re putting stress on your muscles in a way that isn’t usual for your body.
The key is to know how much stress is enough, and when it’s too much.
If you’re standing up for the first time days after surgery, then it might hurt. If your physical therapist is stretching your overly tight muscles, that’s going to be uncomfortable or borderline painful as well.
Pain is a natural response of the body to let you know that something is wrong.
If your physiotherapist is putting you through a semi-vigorous exercise session – which might be necessary – then you’ll feel some pain because your body will be trying to heal microtears in your muscles that happened during the treatment.
It’s good to remember that these microtears are not a bad thing. It’s our body’s way of healing an injury or adapting to change.
How Painful Should Physical Therapy Be?
Ideally, physical therapy should only cause discomfort and not pain. But if you do experience pain, then it should be mild enough to still keep you functional around the house.
Your mind is a powerful thing. Once it associates physical therapy or exercises with pain, it can be really challenging to break that thinking and bring you back to a physical therapy session.
Also, pain is a subjective feeling. We all feel pain differently and each of us has a different pain tolerance. (Reference)
So if anyone tells you that your pain should only be a 3/10 on the visual pain scale or something like that, I suggest you don’t pay attention to them.
Just remember, discomfort or soreness is okay after PT. But your physical therapy exercises should not cause you so much pain that you are restricted to your bed afterwards or can’t perform your daily activities.
For most people, the soreness and pain after physical therapy lasts for a few hours or a day or two. If you experience it for longer, then you need to inform your physical therapist about it.
One thing you should never ever do is tolerate intense pain thinking that it’ll fix you faster. You could be causing further injury that way and reversing your recovery.
What Should You Do if Your Physical Therapy Is Painful?
You can start by understanding why exercising or physical activity is painful.
As I’ve said above, our mindset plays a big role in how much pain we experience. If you can understand and accept that the discomfort you’re feeling is helping you recover, then that can help you feel less pain and motivate you to continue your treatment. (Reference)
Hence, educating yourself is the first thing you should do if your physical therapy is painful.
Also, communication is important. Talk to your physical therapist about the pain you’re feeling and be as elaborative about it as possible.
Tell them when it hurts during the day, what kind of activities aggravate your pain, how much it hurts and point out the painful area.
It could be that your exercises are a bit too much for you at that stage of rehab. And you telling your physiotherapist about it can help them adjust the exercises for you.
A change in the way you do PT can also decrease soreness or pain. For instance, if it hurts too much to exercise on the ground, your physiotherapist can move you to aquatic therapy. Or they can modify the frequency or intensity of your exercises.
Learn to perform the movements properly. If your physical therapy is hurting you, then that could be because you’re doing the exercises wrong.
How Can You Avoid Pain After a Physical Therapy Session?
Follow the instructions that your physical therapist gives you, especially the home exercise program, to decrease your physical therapy related pain.
Exercising at home and maintaining the required level of physical mobility can help your body adapt to the new range of movement over time. Consistency on your end is a key ingredient for physical therapy success. (Reference)
PT appointments are generally between 30 to 45 minutes long. And most patients see their physiotherapist twice or thrice a week.
That’s not enough time for your body to get used to the new activities. That’s why the home exercise plan plays a big role.
Physical therapy requires active participation from patients. If you’re not following the home exercise program, then chances are you’ll be in pain the next time you do the exercises with your physiotherapist.
Icing and heating the painful areas can also help you recover faster after a painful PT session. (Reference)
The Takeaway
I know many patients jokingly say that PT stands for physical torture and not physical therapy. It’s easy to laugh off such statements but pain is a serious issue that demands our attention.
Both the patients and their physical therapists need to take pain seriously and reevaluate their approach as necessary. If your PT sessions are causing you too much pain, then you need to talk to your physical therapist about that.
Just remember, you have to endure some discomfort in order to get better. Training your body to manage load again, or perform the movements you used to do comes with its fair share of soreness and mild pain.
If you have any questions regarding what post-exercise soreness is or how much pain is too much pain, then feel free to contact us to get your answers.
Disclaimer: This article is for informative purposes only. We provide well-researched and authentic information. Do not consider this personalized health advice. Please contact a licensed healthcare professional for medical issues and health concerns.
