Yes, you should do physio if it hurts, but the type and intensity of pain matter; mild discomfort (3/10 or less) during movement that eases quickly is often okay, but sharp, increasing, or lingering pain (longer than 24 hours) signals you're doing too much and should stop and tell your physio to adjust the plan, as physiotherapy aims to improve movement, not cause significant harm. Ignoring severe pain risks further injury, so communicate with your physio about all discomfort to ensure safe progress.
However, physio exercises are not designed to hurt. If you experience any pain during physio exercise, it is important that you contact your physiotherapist or healthcare professional right away so the issue can be addressed and resolved as soon as possible!
Here are a few examples of when physiotherapy might not be recommended: Acute Infections: If you have an active infection, especially in the joints or bones, physiotherapy may need to be postponed until the infection has been treated. Movement or manipulation during an infection can worsen the condition.
Physiotherapy may be right for you if you have persistent pain, particularly in your muscles and joints. A physiotherapist will evaluate your condition and recommend a course of treatment based on your needs. They will consider factors such as your age, gender, and medical history.
If you're experiencing more than mild discomfort during or after therapy, we strongly recommend speaking up immediately. Don't push through severe pain, and don't avoid future physical therapy appointments. Your therapist can modify exercises or switch techniques.
If eight or more minutes are left over, you can bill for one more unit; if seven or fewer minutes remain, you cannot bill an additional unit.
In physiotherapy, red flags are signs and symptoms indicating a potentially serious underlying condition (like cancer, infection, fracture, or neurological issues) that requires urgent medical investigation beyond typical musculoskeletal treatment, such as severe night pain, unexplained weight loss, fever, bowel/bladder changes, numbness/weakness in both limbs, or a history of cancer/trauma. They are clinical clues that prompt physiotherapists to refer patients for further tests (imaging, bloods) rather than just starting treatment.
The 80/20 rule (Pareto Principle) in physiotherapy means 80% of results come from 20% of actions, focusing rehab on key contributors to recovery, like identifying the true underlying cause (e.g., movement patterns, stressors) rather than just treating symptoms, and prioritizing exercises done at home, while in sports, it often means 80% low-intensity training and 20% high-intensity for sustainable performance. It helps therapists and patients prioritize high-impact interventions for better, more efficient outcomes, reducing wasted effort on less effective tasks.
In fact, you may find the movements and exercises incredibly challenging. However, if physical therapy crosses from discomfort to pain, you should talk with your physical therapist and your physician about that pain. Try to be as specific as possible about exactly what you're feeling and where.
If you're not sure if you could benefit from physiotherapy, here are some signs that suggest it could help you.
Patients sometimes feel worse before getting better in physical therapy because the treatment involves mobilizing injured areas, breaking down scar tissue, and strengthening weak muscles, which can cause initial discomfort. This effect generally subsides after the first 2-3 weeks of treatment.
Also if you have back pain with changes in bowel or bladder control, this is a more serious sign, and its best to bypass the physiotherapist and get more urgent medical attention. These types of problems are best dealt with at the minor injuries unit where they have the facilities to X-ray you.
If you skip PT appointments, your injury or surgery may not heal appropriately. If that's the case, you're at risk for future injuries because you can't improve strength and mobility around the injury.
Most workouts are supposed to involve a degree of discomfort for your body to benefit from them. But the “no pain, no gain” mantra only extends so far and if you push past the point of severe discomfort you are likely asking for trouble down the line.
If you continue your usual exercise regimen even when you're sore, you're not giving your muscles enough time to heal. In fact, pushing yourself during a bout of soreness can eventually lead to an overuse injury. Overall, you're at risk of causing harm to your body by not resting.
Successful Outcomes: Evaluating Physical Therapy's Impact
The success rate of physical therapy typically ranges from 68% to 72%. This means that most patients experience significant improvement in their condition following treatment.
Should Physiotherapy Cause Pain? You may experience temporary discomfort during the treatment process. However, physiotherapy should not cause pain. While it may seem counterproductive, there are several reasons why physiotherapy might result in symptoms such as mild aching, stiffness, or tenderness.
Exercise – Regular exercise is an effective natural pain reliever for chronic pain. It helps to reduce inflammation, improve mobility, and release endorphins, which are natural painkillers produced by the body.
Generally speaking, rest works well for injuries or pain that are associated with repetitive strain. It also works well for most ordinary injuries, such as muscle sprains or strains. Simply reduce the amount of activity and the issue will normally resolve itself.
In physiotherapy, red flags are signs and symptoms indicating a potentially serious underlying condition (like cancer, infection, fracture, or neurological issues) that requires urgent medical investigation beyond typical musculoskeletal treatment, such as severe night pain, unexplained weight loss, fever, bowel/bladder changes, numbness/weakness in both limbs, or a history of cancer/trauma. They are clinical clues that prompt physiotherapists to refer patients for further tests (imaging, bloods) rather than just starting treatment.
Jennifer Aniston's 80/20 rule is a balanced approach to wellness, focusing on healthy, nutrient-dense foods 80% of the time while allowing for indulgences like pizza, pasta, or martinis (the 20%) without guilt, promoting consistency and sustainability over perfection. It's about moderation, enjoying life's treats, and getting back on track with healthy choices at the next meal or workout, emphasizing that no food is inherently "bad".
Resolution of Symptoms:
If your injury or condition has fully recovered – that is your pain is gone, and you have full mobility and are not reminded of your injury during your activities, you probably aren't getting anything more from your rehab exercises.
Louis Gifford introduced the "PINK FLAGS – ABCDEFW initiative"[7] - these are the "positive" flags that suggest that an individual will do well with their treatment or rehabilitation.[1] A = Attitudes and beliefs B = Behaviours C = Compensation and financial D = Diagnostic and treatment E = Emotions F = Family W = Work ...
The vast majority of patients stop physical therapy once they reach maximum medical improvement, even if that doesn't mean that they are back to a pre-injury level of fitness. If you've made the strongest recovery possible, it may be time to put an end to your PT services.