Pain on Purpose: The Beneficial Aspects of Pain in Manual Therapy and Martial Arts

by Kevin Prunty

In the lead-up to this month’s understanding pain event, with its focus on pain, I was asked if I would like to contribute a presentation. Almost immediately I knew what I wanted to speak about.

My talk is titled “Pain on Purpose: The Beneficial Aspects of Pain in Manual Therapy and Martial Arts.”

Increasingly, I see a reluctance within parts of our profession to acknowledge that painful experiences can sometimes occur within effective remedial therapy and rehabilitation. We are rightly reminded that there are many ways to help people find relief, and that pain is not always a necessary part of the process. Yet I believe something important is lost when we refuse to discuss the constructive role pain can sometimes play.

My interest in this topic goes back much further than my work as a therapist.

As a child, I loved movement. Inspired by martial arts films and television, I spent hours practising kicks, punches and throws. When I was ten, my father brought me to a Wado Karate class. I was tall, awkward and forever falling over, growing faster than my coordination could keep up. Karate offered structure, discipline and a new way of understanding my body.

The culture of the dojo was striking. We bowed before entering, listened attentively, trained respectfully and finished classes with breathwork and meditation. Unlike gymnastics, where stretching often came with a “no pain, no gain” attitude, flexibility training in karate was approached differently. We were encouraged to work with mild discomfort, not pain.

Over the years I trained in kickboxing, boxing, Shotokan karate and grappling arts. More recently I’ve explored Irish Collar and Elbow wrestling and Irish stick fighting. Across all of these disciplines, discomfort is sometimes unavoidable. Joint locks provide an interesting example. The goal is not pain itself, but pain often serves as feedback that a technique is effective. Within a relationship built on trust and mutual respect, that discomfort becomes information. It communicates something useful.

I believe a similar principle exists in manual therapy.

When someone experiences pain down a leg, for example, the source may not be where the symptoms are felt. The pain may be referred from tissues elsewhere, creating a mismatch between source and sensation. A therapist can spend considerable time treating the area of pain, but when a familiar symptom is reproduced by contacting a different structure, something significant often happens.

There is pain, but there is also recognition, OF THEIR PAIN.

The patient feels understood. Their experience is validated. The therapist has identified something meaningful. Reproducing symptoms is not always comfortable, but it can build trust and provide valuable clinical information.

This is not an argument for causing unnecessary discomfort, nor a return to outdated “no pain, no gain” thinking. Rather, it is an invitation to consider pain more honestly and more completely.

Pain is not always the enemy. It can warn us, guide us, teach us and sometimes help us identify exactly where our attention is needed.

At this month’s understanding pain event, I look forward to exploring how martial arts, manual therapy and modern pain science can help us develop a more nuanced understanding of pain—not simply as something to eliminate, but as something that, at times, can serve a purpose.