How to get back to movement after an injury

When pain increases slightly during or after a session, or the next day, it’s not necessarily a warning sign. Here are three key questions to ask yourself:

• Is the pain less than 4/10 during the activity?
• Does the pain decrease within 72 hours of the activity?
• Is it still better than before the activity?

If the answer is yes, we can generally conclude that the body is adapting. In this case, it’s possible to take advantage of a concept widely used in rehabilitation: progressive desensitization.

Progressive desensitization is a method based on the body’s adaptation mechanisms, particularly at the nervous system level. It improves tolerance of a painful movement or stimulus by gradually increasing the load or exposure, while respecting a safe pain threshold.

This is a fundamental principle in the treatment of persistent or post-injury pain: rather than completely avoiding a painful movement, it is gradually reintroduced in a controlled manner until it becomes tolerable, or even painless, again.

Let’s take a concrete example. A person consults for shoulder pain, felt when raising their arm above their head.

Raising the arm without a weight causes pain rated at 2/10.
Adding a 2-pound weight to the same movement increases the pain to 3/10.
In both cases, the pain remains below the 4/10 threshold, which is considered safe in the context of rehabilitation. This level of pain is generally tolerable and does not pose a risk of worsening the condition.

Example of a proposed plan:
Perform the movement (arm raised above the head with two books) for three sets of 10 repetitions, every other day. The goal is for the pain during the exercise to gradually decrease over the weeks, until it reaches a level close to 0/10.

When the pain decreases under the same conditions (same weight, same movement), we can conclude that the desensitization process is working. And we can assume that the movement without weight has also become pain-free.

The mechanisms behind this improvement include:

An adaptation of the nervous system: the body learns that this movement is no longer dangerous.
A gain in muscle strength: the structures are better supported.
An improvement in joint stability: movement becomes more fluid and better controlled.
All of these factors contribute to reducing hypersensitivity and improving function. The goal is not just to eliminate pain, but to restore the ability to move with confidence.

• Mild pain during exercise isn’t automatically a bad sign.
• As long as it’s stable, decreases over the next few days, and remains below 4/10, it can be part of the healing process.
• Progressive desensitization is a powerful strategy for regaining your mobility and independence.
• It’s essential to respect your limits and follow a tailored plan, often developed with the help of a healthcare professional.

Our Hexa Physio clinics, located in Montreal and on the South Shore, offer personalized support to help you resume physical activity at your own pace, with rigorous and supportive monitoring.

Schedule an appointment with our team to develop a treatment plan that respects your pain while helping you progress toward your goals.