The 4/10 Pain Rule for Exercise

Understanding Pain During Recovery

When recovering from an injury or managing a chronic condition, it’s important to know how much discomfort is acceptable during exercise and daily activities. The 4/10 pain rule is a simple guideline to help you stay active safely while protecting your healing tissues.

What is the 4/10 Pain Rule?

The rule is simple: • Pain levels of 0-4 out of 10 during exercise are generally acceptable • Pain levels of 5/10 or higher mean you should stop or modify the activity • Your pain should return to baseline levels within 2 hours of finishing exercise

How to Rate Your Pain

0/10: No pain at all 
1-2/10: Minimal discomfort, barely noticeable
3-4/10: Mild to moderate discomfort that you’re aware of but can easily continue with
5/10: Moderate pain that makes you want to stop
6-10/10: Significant pain that you should not exercise through

Applying the Rule

During Exercise:
• Monitor your pain levels throughout the activity
• It’s okay to feel some discomfort (up to 4/10)
• If pain reaches 5/10 or higher, stop and rest
• Try modifying the exercise (less weight, fewer repetitions, smaller range of movement)
 
After Exercise:
• Some increase in symptoms immediately after is normal
• Pain should settle back to your usual levels within 2 hours
• If pain is significantly worse the next day, you may have overdone it

What This Means for Your Recovery

You CAN exercise with mild discomfort because:
• Movement promotes healing and prevents stiffness
• Complete rest often leads to weakness and prolonged recovery
• Your tissues need gentle stress to heal stronger
• Activity helps maintain your fitness and mood
 
You should NOT exercise through significant pain because:
• It may cause further tissue damage
• It can increase inflammation and delay healing
• It may lead to compensatory movement patterns
• It can increase fear and anxiety around movement

Red Flags – Stop Immediately If You Experience:

• Sharp, shooting, or electric-like pain
• Pain that gets progressively worse during exercise
• Numbness or tingling
• Significant swelling or heat
• Loss of strength or control
• Dizziness or feeling unwell

Practical Tips

Start Small:
• Begin with gentle movements and gradually increase intensity
• It’s better to do too little than too much initially
 
Listen to Your Body:
• Some days you’ll feel better than others – adjust accordingly
• Don’t push through “bad days”
 
Track Your Progress:
• Keep a note of what activities you can do pain-free
• Notice improvements in your tolerance over time
 
Communicate:
• Tell me about any significant changes in your pain patterns
• Don’t suffer in silence if you’re struggling

Remember

The 4/10 rule is a guideline, not a strict rule. Everyone’s pain experience is different, and what matters most is how YOUR body responds. When in doubt, err on the side of caution and contact me for advice.
 
The goal is gradual, sustainable progress – not pushing through significant pain.