Can You Really Strengthen Your Pain Away?
Why getting healthier may matter just as much as getting stronger
I’ve always been a thinker and enjoyed asking why.
In most cases, people seek physiotherapy because they’re in pain. I’ve worked in one of the biggest and busiest NHS physiotherapy departments in the country, and over the years, as I’ve walked past clinic rooms, there’s been a consistent message delivered:
“You need to get stronger.”
So people do what they’re asked.
They start a strengthening programme.
They load the tendon.
They stick with the exercises.
Often, they do get stronger.
But the pain they hoped would ease… doesn’t always follow.
That disconnect has intrigued me for a long time. Why do some people respond, and not others?
If you’ve been told this in the past, it’s important to know:
That doesn’t mean you’ve failed — and it doesn’t mean exercise isn’t working.
A quick clarification
What follows reflects both my clinical experience and how current thinking around pain and rehabilitation is evolving.
This discussion is about ongoing or persistent pain, not the immediate pain that follows an acute injury.
If you pull a muscle, sprain a ligament, or sustain a clear injury, some short-term pain is expected and often settles as healing takes place.
The ideas in this blog are more relevant when pain lingers beyond that early phase — when things haven’t settled as expected, despite doing “all the right things”.
Strength Helps — But Pain Is More Complicated
Strength training is valuable.
It supports the body, improves function, helps build physical robustness and enhances performance.
But pain doesn’t always respond in a simple, predictable way.
Increasingly, research — and clinical experience — is questioning the idea that pain improves simply because muscles or tendons get stronger. Across many common joint and tendon conditions, people often improve without major strength changes, while others gain strength without a clear reduction in pain.
Both experiences are real — and both are valid.
Why a Narrow Focus Can Miss the Bigger Picture
Over the last few years, exercise-based rehabilitation has become more structured and more strength-focused — and in many ways, that’s a good thing. Strength training is valuable and here to stay.
But when recovery becomes too narrowly focused on one outcome, we can lose sight of the bigger picture.
Pain relief doesn’t require extreme strength — it requires the right support, at the right time, for the individual.
Small steps, taken consistently, still move you forward…
So What Else Might Help Pain Improve?
Pain is influenced by much more than tissue strength alone.
Exercise can help by:
Helping you feel safer to move
Reducing fear around pain or injury
Improving confidence in your body
Calming a sensitive nervous system
Improving overall health, sleep, and energy
In some cases, pain can also improve without structured exercise, particularly when stress reduces, confidence returns, routines normalise, or life circumstances change. That doesn’t mean exercise isn’t helpful — it means pain is responsive to more than one pathway.
Sometimes pain improves not because your body is stronger — but because it feels less threatened by movement or your general health improves.
That’s a very different way of thinking about recovery.
Why This Matters for You
When people are told:
“You need to get stronger to feel better”
and they don’t feel better — despite trying — it can lead to:
Frustration
Self-blame
Fear that something is “wrong”
Stopping activity altogether
But pain isn’t a measure of effort or motivation.
Progress can show up as:
Moving more freely
Feeling less anxious about everyday tasks
Doing more of what matters to you
Pain feeling less dominant or threatening
Those changes matter — even if pain hasn’t disappeared yet.
From Getting Stronger to Getting Healthier
Instead of focusing only on whether strength is increasing, it can be more helpful to notice how movement is starting to feel.
Do you feel more confident using your body?
Are you doing a little more than you were before?
Does movement feel less threatening or restrictive?
These shifts often matter just as much — sometimes more — than changes in strength alone. Strength is still part of the picture, but it doesn’t have to be the only thing we measure progress by.
The N=1 Perspective
There isn’t one reason pain improves.
For some people, strength is a key driver.
For others, pain reduces when:
Movement feels achievable
Exercise fits their life
Fear reduces
Confidence grows
Health improves more broadly
What matters most is how you respond — not what usually happens on paper.
That’s N=1.
One Gentle Reframe
If you’re exercising but still in pain, try this question:
“Do I feel healthier and more capable than I did a few weeks ago?”
Pain relief doesn’t always come first — but it often follows.
Strength still matters.
Exercise still matters.
But your health is bigger than one metric.
Your health isn’t one-size-fits-all.
Your Health. Your Journey.
N=1.