There are inevitable things in life: summers in Florida are hot, winters in New England are cold, and people do silly things on social media (the Milk Crate Challenge is one recent example). If you’re active, especially if you lift weights, you’ll likely feel some pain during exercise. After a tough squat your knees might feel a bit cranky, or your shoulders could be sore after weeks of benching. Rehab after an injury can also be painful and frustrating, like sitting on a cactus. Pain isn’t pleasant, but the big question is this: should you train through pain when it’s present?
Should you train through pain? It depends. If you have a knife in your thigh, then no—you should go to the ER. But for the scenarios mentioned earlier, I’d answer with a clear “yes,” with some caveats.
To make progress, you need to move. Movement triggers mechanotransduction—that’s the nerdy way of saying tissue starts to heal. Pain, when it’s dosed properly, can actually be helpful during training. Pushing into a bit of pain often yields better short-term results than staying completely pain-free. When I work with clients or athletes who feel pain during training (especially in rehab), I use a pain-threshold scale. On a 1–10 scale (1 = no big deal, I’ve got this; 10 = something terrifying), aim for about 2–3.
A helpful stoplight analogy from my friend Tim Latham of Back Bay Health goes like this:
0–3 = green light — go.
4–5 = yellow light — proceed with caution and adjust ROM, technique, sets/reps, etc.
6–10 = red light — stop and revisit later.
Let’s put this into action. Suppose a client had ACL surgery a few months ago and has been cleared by their doctor and physical therapist to start more aggressive strength work. I don’t expect them to walk in on day one feeling perfect; there will be some discomfort. But I won’t shy away from it or avoid it at all costs. A little pain is okay, and often it’s part of driving progress. A common hurdle in rehab is underloading—doing so little that the body never has to adapt. Tendons, muscles, and bones need appropriate load to heal and come back stronger.
In guiding an ACL patient through this process, I might start with a deadlift. As long as pain stays in the 0–3 range, we’re good. If it climbs to 4–5, it doesn’t mean we quit the exercise. We adjust:
– Modify ROM — lift with less knee bend (bar higher off the ground).
– Change tempo — slow down, which can be surprisingly effective.
– Fine‑tune technique — experiment with foot position or stance for more comfort.
– Reduce volume — build up more gradually.
If pain reaches 6–10, we stop that exercise and regress. It’s not a perfect system and there’s some subjectivity, but the goal is to use pain as a guide, not a reason to bail out. Pain can be an important part of the healing process.
