By Dr. Colleen Aubrey, PT, DPT

“No pain, no gain” is a phrase most of us have heard at some point in our lives, but what does it really mean? And more importantly, is it beneficial when it comes to your health, fitness, or rehabilitation process?

As a physical therapist, one of the most common questions I hear from patients is: “How much should I push into the pain?” or “If an exercise doesn’t hurt, does that mean it’s not working?” The short answer: no, that’s not true.

Pain vs. Muscle Activation

There is an important distinction between pain and muscle activation. Pain is your body’s way of signaling that something may not be right. When you experience pain during an activity, it’s important to listen to your body. That might mean modifying the movement, trying a different variation, or adjusting your form.

On the other hand, if you’re performing an exercise and feel your muscles working in a way that’s simply uncomfortable—especially if those muscles haven’t been used in that way before—that’s completely normal. This type of sensation often means your muscles are being appropriately challenged and are learning to activate more effectively.

So, how can you tell the difference between a “good” working muscle sensation and actual pain? It can be tricky, which is why working with a physical therapist or physical therapist assistant can be so helpful. One question I often ask my patients is:

• “Does it feel painful in a way that makes you want to immediately stop the movement, or is it more of a gradual build-up of fatigue that you could push through, even though it’s challenging?”

If it’s the latter—fatigue or soreness that you can tolerate—it’s likely safe to continue. But if the pain is sharp or causes you to stop suddenly, it’s a sign that the movement should be modified.

Does this mean you should feel no pain at all throughout your health, fitness, or rehabilitation journey? Not necessarily. Some discomfort is normal, and in some cases, healing can even involve pain at rest. However, pain should never be the goal of exercise—it’s not a requirement for progress or effectiveness.

This is a great opportunity to highlight the importance of advocating for yourself when navigating healthcare. While healthcare providers offer a wealth of knowledge, experience, and guidance that can be incredibly valuable, it’s essential to remember: they can’t feel what you feel.

You know your body best. If something doesn’t feel right—whether it’s pain, discomfort, or just a sense that something is off—it’s important to speak up. Open communication with your provider fosters a stronger therapeutic relationship and allows your treatment to be better tailored to your specific needs, ultimately leading to better outcomes.