Chiswick Physio founder Nathan Carter on how the traffic light system helps you judge pain during exercise

Why pain doesn’t always mean stop, and when it does

In his monthly column for The Chiswick Calendar, physiotherapist Nathan Carter explains how a simple traffic light system can help you judge whether pain during exercise means stop, ease off, or keep going.

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Guest blog by Nathan Carter, Chiswick Physio

Most people treat pain as a simple on or off switch. Either it hurts, so you stop, or it doesn’t, so you carry on. That leaves out everything in between.

Pain isn’t a direct readout of damage. The body senses touch, temperature and movement, and the brain decides what that means by weighing it against past experience, beliefs and behaviour. Stub your toe and the pain can hit 6 or higher out of 10, then fade to nothing, usually with no injury done.

That’s why we score pain with clients using a traffic light. Green is 0 to 3 out of 10, and it means carry on and push a little harder: more weight, or more sets, or more repetitions. Amber is 4 to 5, and it means keep going but hold at the same level rather than adding to it. Red is 6 to 10, and it means stop or make the exercise easier.

The same scores apply afterwards. If an exercise leaves you at 6 out of 10 later that day or the next morning, that’s a red light, whatever it felt like at the time.

Having a scale rather than a switch gives people something they can act on. It means you can keep progressing without waiting for pain to disappear first, and without pushing into the range that sets you back.

Nathan Carter is a qualified physiotherapist who has worked in New Zealand, Australia and London. He is the founder and Business Director of Chiswick Physio, which has been treating clients in west London for over 17 years. He also completed the Marathon des Sables, a 250km race across the Sahara, in 2010. Chiswick Physio is a Chiswick Calendar Club Card member.