No Pain, No Gain?


Orthopedic surgeon Gary A. Pattee explores the benefits of feeling the hurt and knowing when it’s time to curb or stop that strenuous activity.

GARY A. PATTEE, M.D. is a Diplomate of the American Board of Orthopaedic Surgery, a Fellow of the American Academy of Orthopaedic Surgeons, and a motorcycle-racing enthusiast. 

NO VICTORY comes without the risk of defeat. That is a fact all competitive athletes, whether professional or casual, must accept and embrace. But what about the expression “No pain, no gain”? Around the beginning of the second century, Rabbi Ben Hei Hei said, “According to the pain is the reward.” In the 1700s, Benjamin Franklin wrote,
“There are no gains without pains” in a book of proverbs titled Poor Richard’s Almanack. Some variation on that phrase has been drilled into many of us by coaches from elementary school through college.

But is that really true? I remember cutting my finger on a Maxwell House coffee can as a little kid and watching my dad splash iodine on the wound. Aargh!! All the adults present seemed to share the same mantra: “Of course it hurts. That means it’s working. It’s good for you.”

As odd as it may seem, pain is our friend and is there to protect us. Imagine life without pain. You’d be able to flip bacon in the skillet with your bare hands and rest them on a hot stove until your flesh burned. Not such a good idea.

But an intact and functioning nervous system allows you to reflexively pull back from danger when perceiving pain.

So what about on the pickleball court? After a couple of hours, your left knee starts to hurt. You sit out a couple of games and all is good…until the next game. The pain is then back and getting worse. Maybe you decide you will just work through it. After all, no pain, no gain. But if you finally give in and stop playing, you will have made the wise decision.

What exactly is pain? The concept has been discussed and analyzed for eons and turns out to be very subjective, somewhat dependent on one’s culture, and probably a learned response. My football coach used to say, “Pain is a state of mind!” He was right. Our brains receive signals from pain receptors via neurons and provide us with the perception of pain. No brain, no pain! It’s up to the individual to try to express that perception in qualitative terms.

While you’re exercising, there is sometimes a fine line between the sensation of exertion and pain, which is warning you to back off a bit. Pain can be mild, severe, aching, intense, sharp, stabbing, shooting, splitting, excruciating, agonizing, inescapable, punishing, gnawing, throbbing, raging, crippling, acute, or chronic. Some people describe their pain as discomfort or soreness. Then there is that player whose pain, on a scale of zero to 10, is an 11. That must be the guy who always gives 110 percent!

In my professional opinion, if your pain becomes progressively worse with repetitive strenuous activities, it should naturally stop you before serious damage occurs. Our bodies have amazing systems built in to warn us, and hopefully protect us, against catastrophic consequences. However, I would advise you to learn to assess the severity of your pain to avoid placing excess stress on your joints and muscles. Persistent or increasing pain should not be ignored but should be further evaluated to minimize the risk of serious injury.

Most of you have probably heard some variation on the joke “Doctor, it hurts when
I do this.” The doctor replies, “Well, then, don’t do that!” I believe that is actually very good advice.