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Well, first things first, I do want to say that it's hard to define hurt and pain, because everyone has a different pain tolerance. What's mild discomfort to one person might be pretty bad on someone else's pain scale.
But, physical therapy is not supposed to cause sharp pain by any means. Of course, you're probably using body parts that are injured or parts that have had chronic pain for a long time. But the pain from physical therapy should be more soreness from stretching those muscles and joints, from getting them massaged, from electrical nerve stimulation pads, etc. It can be difficult, and you might experience a type of pain or soreness that is unfamiliar, but definitely let your physical therapist know if it's overwhelming!!
In a blog post on Athletico's website, one of their physical therapists Sarah Clough says, most of her patients have come to the first session with the idea, "Is physical therapy supposed to hurt? YES, because, no pain, no gain."
Clough talks about how "no pain, no gain" can actually be a dangerous view. After all, that view is what causes many injuries in the first place!
She says that some patients have come to her terrified, while others encouraged her to go harder on them (one called her a "physical torturer") or else they didn't think they were going to make any progress. But she specifically says, she doesn't want her patients "pushing through pain." She says that research shows it's best to do exercises that test motion and strength of the injured area, while NOT making pain worse, even in cases like frozen shoulder where researchers used to believe that progress was only be made with painful aggressive stretching techniques. She says that nowadays, therapists know better, and that it's very possible to heal the injury AND avoid pain.
I did some research myself in order to figure out which study she was talking about specifically, and I found a study that talked about how frozen shoulder (which, in case you don't know what that is, it's any condition where shoulder motion is difficult without a known diagnosis).
This study showed that it was very helpful for physical therapists working with patients with frozen shoulders to stay within their tolerated range, such as by doing small pendulum exercises oh, and by applying heat and ice packs before therapy even starts. The study backs up the idea that "going beyond the pain threshold can result in inferior outcomes" and pointed out how this had happened to athletes.
Well, I recommend that you talk to your physical therapist, doctor, etc. about your own personal situation…but overall, they should not have a "No pain, no gain" mentality. Research doesn't support the idea of any benefits of pushing through significant pain as a physical therapy patient!
As someone presently in PT for shoulder surgery, I can relate. The first few weeks the therapist had to do massage and pressure points near the scapula. My surgery was arthoscopy on the bursa but some pain radiated to the back of the shoulder. The ROM was becoming good in the Anterior but the posterior needed slower work. And all this because I was communicating the pain levels. I am doing much better and they have added some strength the final four sessions. Communication is key in getting optimum results and doing the exercises at home. Happy healing!