Should You Exercise Through Pain Or Rest?

Advice is often conflicting and confusing. Medical professionals and soft tissue therapists often recommend rest or avoiding certain activities whilst in pain, whereas other sources say it's best to keep moving.

Who's right?

Previous studies have shown that avoidance and fear of movement is associated with longer recoveries from injury and less favourable outcomes. But there's less research into whether persistence affects pain...until now.

A 2024 study looking at patients with acute low back pain has found that persistence with anxiety was associated with increased pain intensity. 

So, if both avoidant and persistent behaviour hinder recovery, what's the answer to finding relief from pain long-term?

What Science Says About Behaviour and Pain

As mentioned above, previous studies have shown that avoiding movement leads to kinesiophobia and other maladaptive changes that prevent recovery from pain.

But there's been very little research about the effects of pushing through pain.

A 2024 study aimed to answer that question by following 165 participant with acute back pain over a period of 12 months (see the study link at the bottom of this blog post).

The research team assessed:

• pain intensity
• tendency to engage in avoidant or persistent behaviour 
• psychosocial variables, such as fear and depression
• the presence of motor control impairments

Results

• Pain intensity and avoidant behaviour decreased over the course of the year, whilst persistent behaviours tended to stay the same.
• Persisting with physical activity combined with feelings of anxiety or distress was associated with increased pain intensity.
• Both avoidant behaviour and persistence without anxiety didn't significantly affect pain intensity.

The researchers concluded that pushing through pain whilst feeling anxious may make you more likely to develop chronic low back pain.

It's important to note that the evidence presented by this study could be considered low quality because of some significant limitations. Nevertheless the results are interesting and support a common-sense, individualised approach to rehabilitation protocols.

My #3 top tips for managing pain and recovering successfully from injury:

1) Find your personal optimal balance between activity and rest, taking into account the demands of your lifestyle and work

Pacing yourself so you're not moving too little or too much will help you maintain function without stressing your body. Remember to take into account how you live and whether your job is physically demanding or sedentary. 

This balance will be different for everyone. There's no one-size-fits-all strategy.

2) Address beliefs and personality traits that may lead to avoidance or persistence, such as fear, anxiety or exercise addiction

The 2024 study demonstrated that as pain intensity decreased over time, so did avoidant behaviours. This makes sense as moving less is a natural mechanism to protect the damaged tissues in response to an acute injury.

However, the finding that persistence remained constant over the duration of the study suggests that this behaviour is habitual. It's likely to be linked to a person's approach to activity, which may be more automatic and inflexible.

This inability to adapt to a new situation, such as an injury, is often driven by deep rooted beliefs and personality traits that show up as excessive exercising, reluctance to rest and having an extremely active or busy lifestyle.

Acknowledging and addressing unhelpful behaviour patterns and obsolete beliefs using any combination of CBT, EFT, bodywork, Somatics, and energy healing is a key component of pain relief and recovery.

3) Develop a regular movement practice that you can easily adapt to how your body's feeling and won't aggravate or overwork sensitive tissues.

Somatic movement is the core of The Befriend Your Body (BYB) Method, with influences from Clinical Somatic Education (Hanna Somatics). Feldenkrais Method (Functional Integration), Ida Rolfe Method of Structural Integration, and the teachings of my personal mentors.

The exercises of The BYB Method are derived from the body's natural movements and childhood reflexes. They are safe movements that the human body is designed to be able to do.

They should not hurt. If you find them painful, or pain levels increase afterwards, you're likely trying too hard. Repeat using half the previous effort. If that's still painful, try again with even less effort.

The aim of the BYB Method is to learn how to move efficiently with less effort and strain on your muscles and joints. In this case, less is definitely more!

None of the exercises require special equipment or a big room. A Yoga mat, rug or carpet to lie down comfortably on the floor is ideal, but you can also do your practice in bed, sitting in a chair or standing. 

Tips to create an effective movement practice for pain relief:

• Be consistent with your practice - what the brain does frequently, it does well.
• Practice in a quiet space with no distractions. Your brain takes in all the information from it's environment. Minimise external stimuli so the sensory feedback from the exercises can be processed more effectively.
• Keep it short and simple - 3 to 4 exercises done slowly with full concentration will be more effective than a long, complex practice where you get bored and distracted halfway through.
• Remember that all the movements are meant to be non-painful. If pain increases, repeat with half the effort. Notice if you're naturally inclined to push harder - this is a valuable personal insight.
• If you find staying consistent difficult, attending regular group classes will help you get into a routine and establish a regular practice.

WAYS TO GET SUPPORT WITH CHRONIC PAIN

1) Pain Relief At Home Classes

These are online classes that you do in the comfort of your own home - turn up the heat, turn down the lights, create your own relaxation zone, whilst I guide you through a restorative movement practice designed to reduce pain and improve mobility and ease.

There will be 2 classes a week to choose from - do 1 or both!

This option is ideal if....

• you already come to one of my in-person classes but want a top-up,
• have done 1:1 coaching with me and now simply need a consistent maintenance routine, or
• you're new to my unique approach and looking for a gentle introduction to the world of movement for pain relief.

2)  1:1 Coaching

If you're ready to get help with finding long-term relief from chronic pain and stiffness and are looking for a more personal experience, a good place to start is my Unlock Your Body breakthrough session.

This is a one-off powerful 1:1 session where I'll help you understand the root triggers behind your persistent pain, and how to begin reversing them. This breakthrough session is ideal if you have a specific pain or injury that you're struggling to resolve, even if you've already tried other treatments with limited success.

We'll work together to find new ways of moving without pain. You'll leave with a deeper knowledge of what's triggering pain in your body, and a clear action plan to gain lasting relief. 

For some of my clients, a single session is enough to reset their body out of pain. For others, this is their first step to learning how to move their body without pain after months or years of struggling.

Apply HERE  and I'll be in touch to arrange an initial complementary consultation to discuss the various 1:1 coaching options I offer, and which would be a good fit for your circumstances.

Other ways you can find help with managing pain or an injury are:

• Book into a Stretch or Pilates class with me - these are a good introduction to some movement explorations from The Befriend Your Body (BYB) Method for pain relief and relaxation. This is my signature framework that I use to help my clients get out of pain and back to the activities they love.
• Come to my new class "Restorative Movement" at Field Place, Durrington, which will introduce to somatic movement. This runs on Thursday from 7.15pm to 8pm.  
• Subscribe HERE to receive "The Movement Chronicle", a free weekly e-newsletter delivering movement and pain relief truth bombs directly into your inbox every Monday morning,

You can connect with me to get help with chronic pain or injury through any of these channels:

• Email at norma@unicornhealthandfitness.com
• Follow me on Facebook and DM me on Messenger https://www.facebook.com/norma.pearsonfitness
• WhatsApp message to 07801 867361.

Study Link

Hotz-Boendermaker, S., Surbeck, U., Morf, R., & Pfeiffer, F. (2025). Persistence, not avoidance, is associated with low back pain—An observational cohort study. European Journal of Pain, 29, e4728. https://doi.org/10.1002/ejp.4728