Guide
The pain scale for exercise, and what to change at each score
Most pain scales stop at the number. This one ties each band to a training change, lists what the number cannot tell you, and marks where the coach's job ends.
By RaiNGE product teamUpdated 6 min read
Written for coaches and trainers deciding how a client's pain report changes today's session.
See how flagged limitations keep conflicting exercises out of an AI draft before a coach reviews it. See the AI safety filters
On this pageWhat to change at each pain score
What to change at each pain score
Ask for a 0-10 rating before the session and again during the hardest set, then act on the band. The bands are conservative on purpose. They build on the pain-monitoring approach used in tendon rehab research, which allows pain up to 5/10 during exercise if it settles by the next morning (Silbernagel et al., 2007 (opens in a new tab)). When a report sits between two bands, use the more cautious row.
What the number does not tell you
A score means little on its own. A stable, familiar 2/10 in a client who has had the same ache for months is a different decision from a new, sharp 2/10 that changes how they move. Ask five quick questions before you act on any score.
Ask before you act on the score
- Where is it? Same place as last time, or somewhere new?
- Is it familiar? New or unusual pain moves the report to the top band, whatever the number.
- Which way is it trending? Across the set, across the session, and since the last session.
- Does it change movement? Limping, guarding, or a shortened range means the exposure is already too high.
- Any red flags? Numbness, tingling, weakness, pain spreading down a limb, or pain after a fall or impact go straight to referral.
Make the smallest change that keeps the session's goal
In the 3-5 band, work down this list and stop at the first change that brings pain back to 0-2/10 and keeps it there. Each step gives up a little more of the original training effect.
- 1
Reduce the dose
Cut load by 10-20%, drop a set, or cap effort at RPE 6. Keep the exercise if the pattern itself is tolerated.
- 2
Change the setup
Shorten the range with a box target, switch to a neutral grip, adjust the stance, or move to a dumbbell or machine version.
- 3
Substitute the pattern
Keep the goal and change the exercise: a hamstring curl or sled push for a loaded hinge, an incline push-up for a floor push-up. The deadlift alternatives for lower back pain and the push-up regression ladder list options by goal.
- 4
Change the session goal
Train a different region, or make the day about technique at low effort. One easier session costs far less than a flare-up.
- 5
Stop and escalate
If none of the above settles the pain, or a red flag appears, end the provocative work and follow the facility's referral process.
Worked example: knee pain at 4/10 on split squats
The plan calls for Bulgarian split squats, 3×8 at RPE 8. On the first warm-up set the client reports right knee pain at 4/10 on the way down. It is the same spot as two weeks ago, and it settles when they stand.
- 1
Classify the report
Pain 4/10, familiar, settles between reps, no red flags. That is the 3-5 band: modify and keep training.
- 2
Make the smallest change
Switch to a split squat with the back foot on the floor, lowering to a box at knee height. Keep 3×8 and cap effort at RPE 6.
- 3
Watch the response
Pain drops to 2/10 by the second working set and does not rise on the third. Continue the session.
- 4
Write the note
Right knee 4/10 on split squat descent. Changed to box split squat 3×8 at RPE 6. Settled to 2/10 by set 2. Stop lower-body loading if pain sharpens, spreads, or climbs above 5/10.
- 5
Plan the next exposure
Repeat the box split squat next session. Restore range before adding load, and only after two sessions stay at 0-2/10.
Had pain reached 6/10 on the modified set, the split squat would end for the day and the session would move to upper-body or hip-dominant work the knee tolerates. At 8/10, or with swelling or the knee giving way, loading stops and the client is referred.
How RaiNGE handles a pain score
RaiNGE treats a check-in pain score as a prompt for the coach. Nothing in the plan changes automatically, and RaiNGE does not route clients to clinicians. The referral is the coach's call, made through the facility's own process.
Limitations flagged on the client profile work differently. They trigger the safety rules that keep conflicting exercises out of AI drafts, before the coach ever opens the program.
Common questions
Is it okay to exercise with pain at 3/10?
Often, if the pain is familiar, settles during the session, and is no worse the next morning. Reduce load or range first and watch the response across sets. If 3/10 becomes 5/10 mid-session, stop that movement. A new or unfamiliar 3/10 is a different case and needs review before loading.
What is the next-morning check for exercise pain?
Compare pain the morning after a session with pain before it. Back to baseline means the dose was tolerated. Higher than baseline means the next exposure should be smaller. Pain that keeps climbing across several sessions means stop progressing and get the client reviewed.
Which pain scale should coaches use?
A 0-10 numeric rating, where 0 is no pain and 10 is the worst imaginable. Clients understand it, it fits a quick check-in, and the same number means roughly the same thing session to session. Ask at the same moments each time, such as before training and during the hardest set.
What happens when a coach approves a pain adjustment in RaiNGE?
The approved changes to sets, reps, duration, rest, and intensity notes apply to the assigned workout as one change that can be reverted, and the athlete is notified after it succeeds. If the coach rejects it, the workout stays as written. The next AI draft also reads the client's latest progress check-in pain.
Is the Borg scale a pain scale?
Not as gyms use it. The printable Borg charts rate effort, how hard the work feels, not pain. Someone can rate a set RPE 9 with no pain at all, or RPE 5 with pain at 4/10. Ask for both, separately, and act on each with its own rule. The RPE scale for coaches covers effort ratings.