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Why does my old injury still hurt?

Injury (n): harm or damage sustained

Pain (n): the experience of an unpleasant feeling

When you are injured, let’s say a broken leg, it hurts and you experience pain. This is usually true with trauma- there is an event, there is an injury and then there is pain.

Here is a different scenario: You have a flare up, or period of increased pain, in your back that you have been dealing with on and off for years. You may think, “What have I done to injure myself now?”

But is there an injury? Is there true tissue damage in your back? That would assume that pain=injury.

However, there is plenty of research to show us now that pain DOES NOT equal injury. Meaning, there is NOT tissue damage (strain, sprain, disc bulge, nerve irritation, etc) for every pain we feel.

So why does your shoulder still hurt after 8 months of resting it, getting massages, trying to slowly return to activity, working on exercises, etc?

“Chronic pain” is simply pain that has lasts longer than 3 months. For some, they have experienced pain for YEARS and others it may be 6-8 months- but they are all considered chronic. Another characteristic of chronic pain is the fact that it is lasting past “usual healing time” of 6-8 weeks. That is the expected healing window of tissues. So when a pain lasts longer, we (the prudent medical professional) are thinking “ok, the ‘injury’ would be healed by this time so what is their pain ‘experience’ now?”

Notice in the definition of pain it says “experiencing” rather than “having” an unpleasant feeling. That’s because pain is not this concrete object that you have or don’t have. It is very much an experience that varies person to person, and sometimes day to day.

Factors that influence your pain experience:

  • Beliefs about pain

  • Perceptions about control of pain

  • Previous pain experiences

  • How medical professionals explain your pain to you

  • Support system

  • Culture

  • Gender

  • Age

  • The list goes on!

The pain mechanism in our bodies is not simple. There are some great resources to explain these details further and put them in different contexts.

Check out this video, it breaks it down well: What is Chronic Pain

Also, this 15 min TED Talk is great too: Why Things Hurt

The moral of the story here: pain does NOT equal damage. When you feel pain, keep in mind that the pain you are experiencing is created by a complicated mixture of factors and many of them are not physical.



  • Pain does not equal damage.

  • Chronic pain is anything lasting over 3 months and which has lasted outside of the usual healing timeline for tissues like muscles.

  • Many non-physical factors influence your pain experience including your previous pain experiences, how medical professionals explain your pain and your own beliefs about pain.

  • Watch the two links-- they are cool.

  • Having trouble making a plan to address pain and performance issues? Send an email to and let’s schedule some time to chat about your goals!


Thanks for reading!

Dr. Jackie, DPT, OCS, CSCS

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