Pain tolerance Vs Pain sensitivity & Flexibility

‍

Allow me a little clinical anecdote before moving on to the flexibility content.

As a new Physio, I found it frustrating when I asked a client to rate their pain out of 10, if 10 was the worse pain they could imagine, and they replied that their pain was 11/10. This after driving to the appointment, walking in and having a calm conversation with me. (I now realise that 11/10 pain really means, previously, my concerns haven’t been taken seriously enough or my needs aren’t being met).

I noticed that clients that rated their pain highly also tended to describe themself as having a high pain tolerance. I thought, ‘I have a high pain tolerance’ further emphasised the level of their pain. Often these clients experienced longstanding pain, multiple diagnoses, and several specialists involved in their care. 

This is an example of me confusing pain tolerance and pain sensitivity. 

Pain tolerance Vs Pain sensitivity

Think of pain tolerance as the ability to cope with pain. To sit with it, rather than avoid it at all costs. To accept pain as an inevitable, but unpleasant part of life. People who experience chronic pain usually do have a high pain tolerance. This is because they are experienced in dealing with pain and can get things done despite their pain.  

On the other hand, pain sensitivity reflects a state of nervous system hypervigilance. Inputs (like moving a joint or pressing on skin) that are not usually painful are painful, and things that are often painful (like stretching) become more painful. A person with high pain sensitivity has an extra protective system, often because they are more vulnerable or susceptible to illness, injury or stress. It’s normal to have increased pain sensitivity when tired, sick or injured. 

Pain and Flexibility training

Pain is a normal part of flexibility training. Stretching hurts because you are challenging yourself to move further into range than usual and pain is part of how your body reduces the risk of harm to your tissue. Learn more here.‍

Accepting and sitting with pain when you stretch is pain tolerance. Pain tolerance involves learning from experience that you can cope, and despite pain, you are safe. Increasing pain tolerance is probably the most significant mechanism for increased flexibility, for most people.

Pain tolerance often increases with reduced sensitivity as it’s easier to tolerate less intense pain. As your body becomes more familiar with a stretch, it becomes more comfortable because it’s less likely to be interpreted as potentially harmful.

The interaction between pain tolerance and pain sensitivity will impact flexibility training.
‍

How to increase pain tolerance:

• Progressively increase the intensity of stretching and learn from experience that you are ok and can cope.
• Frequent, consistent training.
• Learn about pain and flexibility, so you understand why stretching hurts.
• Learn and practice mindfulness techniques, especially when you stretch. 
• Stretch with a curious, non-judgmental mind.
• Stretch with others with similar goals.
• Find intrinsic motivators.

How to reduce pain sensitivity:

• Sleep and rest well
• Commit to your recovery as much as to your training. 
• Good nutrition and hydration.
• Manage stress.
• Look after your general health.
• Train consistently.
• Move in meaningful ways.
• Don’t push through increasing pain.

‍

Help, The more I stretch, the worse it feels, and now I can’t stretch as far as I used to?

This can be a sign of an overload/ overuse injury, reflect an increase in the intensity and/or frequency of your training, highlight an issue with under-recovery or be a sign of an underlying health concern. Don’t continue to push through with your training program. You will become more and more sensitive until you can’t tolerate or suffer an injury that stops you. Instead, visit a knowledgeable health professional, deload and increase your active recovery.

‍