How to Balance Pain & Exercise

Chelmsford Physio • August 19, 2024

The fact of the matter is pain is a part of life; for some it is short lived, and for others pain becomes a full time experience. But that shouldn’t mean that exercise and looking after yourself in this way is off the table.


Did you know as many as one in four people in the UK suffer from chronic pain? If so, it won’t be a surprise to you when we say that one of the most common questions we get asked during a consultation is “can I exercise in pain?”.


The short answer to this question is yes, you can exercise in pain. To explain why, we need to investigate the complexities of pain itself. The International Association for The Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”. 


But pain is multifactorial and is not as simple as pain = damage. In fact, pain is a poor indicator of tissue integrity. Psychological, social, and biological factors all add up to the pain experience. We know that pain related fear can be more debilitating than pain itself. Therefore, to assess, understand and treat pain we must have a grasp of all these factors and not simply look at pain as something to be avoided.


Exercise can reduce chances of cardiovascular issues, help with mood and mental health, boosts energy, strengthens bones, and improves sleep as well as allowing us to be social.

In medical literature, exercise has been recommended as a treatment for chronic pain. Exercise can release endorphins ( the body’s natural pain killer) as well as helping reconceptualising pain . In short challenging our beliefs about pain and tissue state, allowing ourselves to explore movements that were once perceived as being dangerous and becoming more comfortable.

 

Despite this, some people we see in clinic find exercise particularly painful, therefore we need to further understand exercise and its relationship to pain. A recent systematic review asked this question and showed that exercising with pain can have benefits including short term significant improvements. This is our first, clear sign that pain is not harmful.


So, How Can We Exercise Safely Whilst in Pain?


Well now that we have discussed the benefits of exercise and pain, we want to delve into the practicality of it, so we have collated our top tips for exercising when in pain. But first, it’s important to remember that all people are different, as are all pain presentations, therefore, we offer these as general guidelines to follow, not injury-specific advice. For that we recommend seeing a medical professional for a full assessment.


1. Monitor Your Pain Level


We like to use a subjective scale that is personal to you to measure our pain. This scale is between 0 and 10 where 0 is no pain and 10 is the worst pain you’ve experienced. Don’t let pain go above a 3⁄10 at the time of exercising. There is evidence which supports going all out with exercise, and there is evidence which supports small amount of pain being ok. We say don’t push past a 3⁄10. This is less because we are worried about damage, and more that we don’t want your issue to flare up, all we want to do is exercise in a comfortable range that will allow progression. Your clinician may vary this dependent on where you are in your symptoms. 


2. Prioritise Sleep


We need to ensure that pain doesn’t affect your sleep after you exercise. Sleep is incredibly important for recovery, so we want to ensure a good night’s sleep of 6 – 8 hours, especially after exercise. A better night sleep can also aid with lifestyle changes such as increased activity because when you’re well rested, you’re more likely to be able to keep it up, whereas a sleep deprived person might need to opt out of exercise to continue resting. Pain can also be directly affected by poor quality sleep. Therefore, we don’t want the pain to affect your sleep. If your pain levels are doing this, decrease the intensity or load of your training and speak to a healthcare professional.


3. Ensure no Increase in Pain The Following Day


Monitor your pain levels the day after exercise, with the aim of no further intensity in your pain levels. The last thing we want to do is cause a flare up, so if this happens be sure to reduce the load/intensity the next time you exercise, and again, speak to your treating clinician if you are concerned as not all prescriptions of exercise are perfect.


4. Take it Week-by-Week


Ensure graded progression (starting off light and building up) and make exercise goal orientated. Once you’ve found your baseline, make sure you slowly increase the level, intensity and/or load week on week. Goal setting has been shown to be an effective way of ensuring adherence to a programme and can be a good motivator to progressions.


5. Try an Activity You Enjoy


There is no one perfect exercise regime. There are studies which support all types of exercises and strict exercise guidelines around pain are lacking. Evidence suggests that doing a hobby or something you love will increase your chances of sticking to the routine, so keeping exercise simple and enjoyable may be the best option for you.


6. Plan to Fail 


Have plans in place for both good at bad scenarios. As the saying goes prepare for the worst. Most of the time things do go to plan but on the occasions things don’t its good to have prepared for these potential scenarios for example exercise regressions or increased pain, this helps prevent you feeling demoralised or fall of the bandwagon of treatment. 

Book Appointment
By Chelmsford Physio August 11, 2026
Chelmsford Physio uses the VALD Dynamo — the world’s most advanced handheld strength and movement testing system for patients and athletes.
By Chelmsford Physio August 11, 2026
In modern physiotherapy, clinical expertise remains fundamental, but technology is transforming how we assess, monitor and guide rehabilitation. One of the most valuable innovations is the use of force plate technology, and at our clinic we utilise the VALD ForceDecks to provide objective, reliable data throughout a patient’s rehabilitation journey. Rather than relying solely on observation or subjective feedback, ForceDecks enable us to accurately measure how your body produces and absorbs force. This allows us to identify movement deficits that may not be visible to the naked eye, track progress over time, and make evidence-based decisions regarding exercise progression and return to activity. What are VALD ForceDecks? VALD ForceDecks are dual force plates that measure the forces generated through the feet during a wide variety of movements. Using highly sensitive load cells, they capture detailed information about strength, balance, power, asymmetries and movement strategies. Common assessments include: Countermovement jumps Squat assessments Single-leg balance testing Sit-to-stand testing Isometric strength testing Landing mechanics Hop testing for return-to-sport decisions Within seconds, the software analyses hundreds of metrics that provide clinicians with objective insight into a patient’s physical performance. Why Objective Assessment Matters Traditional physiotherapy assessments rely on observation, manual muscle testing and patient-reported symptoms. Whilst these remain valuable, they can miss subtle deficits that increase the risk of delayed recovery or re-injury. ForceDecks allow physiotherapists to quantify movement rather than estimate it. For example, following an ACL reconstruction, a patient may appear to squat evenly. However, ForceDecks often reveal significant offloading of the surgical limb, reduced eccentric control or delayed force production. These hidden compensations can then become specific treatment targets. Objective measurements also improve communication between clinician and patient. Seeing measurable improvements in strength or symmetry provides reassurance that rehabilitation is progressing, even when symptoms fluctuate. Monitoring Progress with Precision One of the greatest benefits of ForceDecks is the ability to track rehabilitation over time. Instead of simply asking whether someone feels stronger, we can measure improvements in: Peak force production Limb symmetry Rate of force development Jump height Landing forces Balance performance Weight distribution This enables rehabilitation programmes to be progressed based on measurable performance rather than arbitrary timelines. Improving Return-to-Sport Decisions Returning to sport too early remains one of the biggest risk factors for re-injury. Research has consistently demonstrated that persistent strength deficits and movement asymmetries can remain long after pain has resolved. ForceDecks help clinicians identify these deficits before an athlete returns to competition. Objective testing can assist with: Assessing readiness to return to running Evaluating landing mechanics Measuring explosive power Identifying left-right asymmetries Monitoring fatigue Reducing the risk of subsequent injury Rather than relying on a single test, ForceDecks contribute to a comprehensive return-to-performance assessment that combines physical capacity with clinical reasoning.
By Chelmsford Physio August 11, 2026
As pre-season gets underway, players across all levels of football and rugby are preparing for the demands of a long and physically challenging season. Whether you’re returning after a well-earned break, recovering from injury, or aiming to improve your performance, the weeks before competition begin are some of the most important in your sporting calendar. Many athletes focus solely on fitness and technical training during pre-season. However, ensuring your body is physically prepared is just as important. A comprehensive physiotherapy assessment can identify weaknesses, movement restrictions and performance deficits before they become injuries, allowing you to enter the season stronger, faster and more resilient. Why Pre-Season Preparation Matters  Football and rugby place significant demands on the body. Players are required to accelerate, decelerate, sprint, change direction, jump, land, tackle and absorb contact repeatedly throughout a match. Following the off-season, reductions in strength, power, aerobic fitness and neuromuscular control can increase the likelihood of injury if training loads increase too quickly (Gabbett, 2016). Common injuries seen during the early part of the season include: Hamstring strains Calf injuries Groin pain Ankle sprains Knee ligament injuries Quadriceps strains Shoulder injuries (particularly in rugby) Preparing your body before the competitive season begins can significantly reduce these risks.