At Altius Physical Therapy, one of the most common questions we hear from patients recovering from tendinopathies—like shoulder, elbow, hip, knee, or Achilles tendon pain—is:
“Should I stop if it hurts?”
The answer? Not always. In fact, some pain during rehab is normal—and even helpful—as long as it’s within safe boundaries.
Here’s what you need to know about working through discomfort safely and effectively.
Modern research and clinical guidelines now support a symptom-guided approach to tendinopathy rehab. That means it’s okay to feel some pain—as long as it checks the following boxes:
1. Mild to Moderate Pain (Up to 4/10)
Pain during exercise that stays at or below a 4 out of 10 is considered safe. A little soreness or tightness is part of the process—your tendon is responding to load and adapting.
2. Pain Should Return to Normal Within 24 Hours
It’s okay if you feel sore after your session, but that discomfort should settle by the next day. If pain lingers, gets worse overnight, or affects your sleep, that’s a sign we may need to adjust the program.
3. Progress Over Time Matters Most
Don’t worry too much about day-to-day fluctuations. Instead, track how you’re feeling over a week or two. If you’re moving better, feeling stronger, and tolerating more activity, you’re making progress—even if some soreness remains.
Some pain is not okay to push through. Call your PT or modify your exercises if you notice:
Worsening night pain or pain at rest
Loss of range of motion or strength after a session
Sharp, stabbing pain with light activity
New or increased swelling around the tendon
These are signs that your tendon is too irritated and needs a bit of a break or a lower load.
Tendons don’t heal by resting alone—they get stronger through gradual, progressive loading. In the past, rehab often avoided pain completely. But now we know that completely pain-free rehab can underload the tendon, slowing your recovery.
With guidance from your physical therapist at Altius, we’ll help you load your tendon safely, without overdoing it.
Keep pain under a 4 out of 10, and make sure it returns to normal within 24 hours.
At Altius, we specialize in helping patients move confidently through the healing process. You’ll get:
A personalized, progressive rehab plan
Clear guidance on what pain is safe
Strategies for building long-term tendon health
Ongoing support every step of the way
Our new office will be open to patients on January 2nd, 2023
Please contact us at evan@altiusnj.com or at (201) 391-8932 for more details!