Why Strength Training is Overrated for Pain Management

Why Strength Training Is Overrated for Pain Relief

You’ve probably heard it before:

“You’re in pain because you’re weak. Get stronger, and the pain will go away.”

It sounds logical—but for many people, it simply doesn’t work.
They get stronger… yet the pain stays. Sometimes, it gets worse.

Here’s the better explanation:

Pain isn’t just about weakness. It’s a warning.

It’s your body’s way of saying:

“This cup is getting full.”

In Bud Craig’s model of homeostasis, pain is a danger signal—not damage.
It tells you that your system is overloaded, like water spilling from a cup that’s too full.

And strength training?
It’s adding more load to that cup. If your system can’t drain or adapt fast enough, it overflows—and pain is the result.

Being Strong Doesn’t Make the Cup Bigger

• Top athletes can squat 200kg—and still deal with back pain.

• Lifters, weekend warriors, even older adults on strength programs often feel tight, sore, or fragile.

• So clearly, strength alone isn’t the answer.

If your body can’t manage the load, more strength just adds more pressure.

What matters more is how efficiently your cup can drain, recover, and adapt—not just how much you can pour in.

What Actually Helps: Build a Bigger Cup

If your goal is lasting relief and long-term resilience, focus on building capacity—not just strength.
That means training your body to handle life with more ease and less overflow.

Here are 5 ways to do that:

1. Build your aerobic engine.
   Long, low-intensity movement (walking, slow jogging, cycling) helps improve blood flow, clears waste, and gives your system space to recover.

2. Add variety to your movement.
   If you only move in one way (like lifting in straight lines), your body gets stiff and narrow in how it adapts. Rolling, crawling, twisting, and flowing open up more options.

3. Move more often, not just harder.
   Gentle movement throughout the day clears the cup. It keeps your system flowing, instead of building up pressure all at once.

4. Prioritize recovery.
   Sleep, hydration, rest, and breathing are the drainage system. Without them, the cup fills up faster, no matter how strong you are.

5. Train with awareness, not just effort.
   Instead of pushing through pain, listen to it. Pain isn’t weakness—it’s your body asking for a better strategy.

Final Thought: Strength Isn’t the Goal—Capacity Is

Strength isn’t bad.
It’s just one tool—and if you use it too soon, or too often, it fills your cup without building the drainage system.

Pain doesn’t mean you’re broken.
It means your body is protecting you from overflow.

So instead of asking:

“How do I get stronger?”

Start asking:

“How do I build a system that can handle more, with less pain?”

That’s the shift—from overload to capacity, from control to flow, from pain to power.

When “Healthy Habits” Backfire

Training with Low Energy Availability: When “Healthy Habits” Backfire

Imagine this: you’re someone who genuinely cares about your health.

You’ve been reading, learning, and experimenting.

You want to optimize your body, so you start intermittent fasting—skipping breakfast, eating a light lunch, and having a big dinner.

You’re also vegetarian, which feels great ethically and digestively.

You’ve ramped up your strength training and walking, thinking you’re ticking all the right boxes.

And yet… something feels off.

The Case of the “Healthy” Person Who Feels Like Crap

Meet Alex.

Alex isn’t new to exercise. They love staying active, and they’re committed to making smart choices for their health.

But lately, they’ve noticed:

🔻 Sore muscles that linger for days instead of bouncing back.
🔻 Workouts feel harder—even though they’re training consistently.
🔻 Less energy and motivation—despite getting enough sleep.
🔻 Tight, stiff muscles that don’t seem to recover properly.
🔻 Nagging joint discomfort—especially around the knees and hips.

What’s going on? Isn’t intermittent fasting supposed to help with recovery and longevity?

The Molecular Breakdown: What’s Happening Inside

1. Energy Availability & Protein Deficiency

Your body runs on fuel, and when you increase training without increasing nutrition, things start breaking down.

In Alex’s case, skipping breakfast & eating a light lunch means they’re in a low-energy state for most of the day. This creates:
⚠ Reduced muscle protein synthesis (MPS) – The body struggles to repair and grow muscle.
⚠ Increased muscle breakdown – The body starts using existing muscle for fuel.
⚠ Poor tendon & joint repair – Because connective tissues also need amino acids for recovery.

Since Alex is vegetarian, protein intake is already a challenge. Plant-based protein sources tend to be:

• Lower in essential amino acids (especially leucine, key for muscle repair)

• Less bioavailable (meaning the body absorbs them less efficiently)

This isn’t to say vegetarianism is bad—but without careful protein planning, strength training adaptations suffer.

2. Intermittent Fasting & Cortisol

Skipping meals increases cortisol levels—which isn’t necessarily bad. In the short term, cortisol helps with alertness and fat mobilization.

But in Alex’s case, consistent fasting + heavy training = chronic cortisol elevation. This leads to:
❌ Increased muscle breakdown (catabolism).
❌ Reduced recovery (cortisol opposes muscle repair).
❌ Tighter, more rigid muscles (because they aren’t getting the nutrients to stay pliable).

Ever feel like your body just won’t loosen up despite stretching, foam rolling, and massage? That’s what happens when your muscles aren’t recovering properly.

3. Why Alex Feels Stiff, Sore, and Drained

On a molecular level, this combination of low protein intake + intermittent fasting + increased training leads to:

🚨 Less mitochondrial energy production – Muscles feel weak, heavy, and slow to recover.
🚨 Reduced collagen synthesis – Tendons and joints start feeling achy and more prone to irritation.
🚨 Increased metabolic waste buildup – Muscles feel stiff, sore, and less responsive.
🚨 Lower glycogen storage – Energy crashes happen more often.

Alex thinks they’re doing everything right. But in reality, their body is in a mild survival mode, prioritizing essential functions over peak performance.

How to Fix It: Smart Adjustments Without Losing the Benefits

1️⃣ Prioritize Protein Timing & Quality

• Aim for 1.5g protein per kg body weight per day.

• Ensure each meal has at least 20-30g protein (especially post-workout).

• Consider a plant-based protein shake if whole food sources aren’t hitting the target.

2️⃣ Reassess Fasting Strategy

• A lighter fasting window (e.g., 12-14 hours instead of 16+) might be better for muscle recovery.

• If sticking with a long fast, prioritize a high-protein meal right after training.

3️⃣ Support Recovery & Flexibility

• Hydration & electrolytes – essential for muscle pliability.

• Active recovery (walking, foam rolling, self-massage) – clears metabolic waste.

• Smart strength training – not just more, but better quality and timed with nutrition.

Final Thoughts: Strength Isn’t Just About Training—It’s About Recovery

Many people fall into the trap of thinking “more training = more results.”

But when energy and protein intake don’t support that increased demand, strength doesn’t translate into function—it just turns into stiffness, soreness, and fatigue.

Want more adaptable, stronger muscles?
👉 Feed them.
👉 Recover well.
👉 Train smarter, not just harder.

Your body isn’t a machine—it’s a living system that thrives on balance.

Find yours, and you’ll not only feel stronger, but you’ll actually move and function better.

Tennis Elbow - A new innovative approach to healing

The Resilient Elbow Protocol

Does This Sound Familiar?

You’ve been diagnosed with Tennis Elbow and tried everything—resting your arm, stretches, braces, even injections—but the pain keeps coming back.

Every time it flares up, it’s more than just physical discomfort.

It’s the frustration of not knowing what to do next, the fear of making it worse, and the nagging thought:

"Am I going to deal with this forever?"

You’re not just struggling with elbow pain—you’re wrestling with the uncertainty and loss of confidence in your body.

What You’re Afraid Of:

You’re scared this might be permanent.

You’ve heard horror stories about surgeries or endless treatments that never work.

You might even be wondering:

• "What if I can’t play tennis, lift weights, or even work without pain?"

• "What if this keeps happening no matter what I do?"

• "What if this means giving up the things I love?"

It’s not just about your elbow anymore—it’s about feeling in control of your body and your life again.

What You Want:

What you’re looking for is simple:

• To live your life without constant reminders of pain.

• A clear plan that actually works—not just for today, but long term.

• To know exactly what’s happening in your body so you can fix it and stop worrying.

Most importantly, you want to feel confident again—whether you’re gripping a tennis racket, typing at your desk, or lifting your child.

The Path to Recovery:

Here’s the truth: quick fixes won’t solve this.

But there’s good news: you don’t need endless rest, invasive procedures, or complicated solutions to heal your elbow.

The Resilient Elbow Protocol is designed to:

1. Calm the pain so you can focus on recovery without fear of flare-ups.

2. Strengthen and rebuild your tendon to handle the demands of your life.

3. Empower you with the knowledge and tools to take control of your recovery for the long term.

Imagine This

What if, in just a few weeks, you could:

• Grip, lift, or type without wincing in pain.

• Feel confident your elbow can handle the activities you love.

• Stop second-guessing your every move and enjoy life without fear of setbacks.

Your body isn’t broken—it’s adaptable.

With the right plan, you can rebuild strength and resilience and finally put pain in the past.

Why The Resilient Elbow Protocol Works

We’ve combined the best evidence-based strategies from physiotherapy, biomechanics, pain science, and recovery coaching into one integrated, easy-to-follow program.

• No Gimmicks, No Quick Fixes: Just real, actionable steps that fit into your daily life.

• Clear Guidance: We teach you not just what to do, but why it works.

• Long-Term Resilience: Stop chasing relief and start building confidence in your body.

Why Trust Us?

We know how overwhelming pain can feel—and how confusing the advice from "experts" can be.

That’s why we’ve created a program that’s both comprehensive and practical, designed to give you the tools you need to manage pain and prevent it from coming back.

We’re not here to fix you—we’re here to empower you to take control of your recovery.

Ready to Take Control?

The Resilient Elbow Protocol is your step-by-step guide to overcoming tennis elbow, strengthening your body, and reclaiming your confidence.

Stop fearing pain. Start building resilience.

Join Now and Start Your Recovery Today!

To get started, please fill out the questionnaire below and then we will be in touch to see if you are eligible for access to our online Tennis Elbow Learning Platform.

2024 Adelaide Half Marathon - Review

Adelaide, South Australia - 25th August 2024

This morning, I was looking for a bit of inspiration before lacing up for the Adelaide Half Marathon and happened to come across a short documentary on Robert de Castella’s iconic 1982 Rotterdam Marathon win.

Some of his words really stuck with me:

"You have to be prepared to push yourself through barriers of pain. The biggest pain you have to work yourself through is the incredible weariness, the incredible fatigue that envelops you like a cloud. You need to concentrate on achieving little goals. You can’t become totally introverted and withdrawn during the race, because you dwell on little things like how your feet are, losing a toenail or getting a blister, or sore muscles. You’ve got to monitor those things, but you can’t afford to let them become too dominant a feeling."

As the run started I could feel some great energy and buzz as we lined up outside of the Adelaide Oval.

For the past few years my goal has been to go under 1:45 for the half marathon and I have just missed out for less than a minute. My strategy has been to go out with the 1:45 pacing group from the start and try and hold on, but just seemed to be fatigue in the second half.

This year I thought I would change things up.

I decided to start with the 1:50 pacing group, with the idea being to relax for the first half running a little slower, save my energy and then come home really strong picking up the pace.

My run was going okay, but by the 17km mark, my legs were toast, with fatigue accumulating heavily after making some strong surges trying to pick up the pace.

I threw in a few walking breaks to try and get a bit of recovery.

Then, out of nowhere, I heard a voice from the sideline:

"C'mon, you've got this!"

I looked up, and there he was—the great man himself, Robert de Castella!

As if that wasn’t enough, I spotted a couple of very fit-looking Indigenous Marathon Project athletes just in front of me too.

That was the spark I needed to switch gears.

I found a new energy and finished the last 4km with a spring in my step, crossing the Morphett Street Bridge and finishing strong at Adelaide Oval.

My time - 1:46.

A huge thanks to SARRC and all the volunteers for making it a fantastic morning.

It was great to see everyone out there challenging themselves and running well!

I’m looking forward to getting back at there in 2025 - same goal - to break 1:45!

Why We Need to Move On From Shockwave Therapy for Tendons

Why We Need to Move On From Shockwave Therapy for Tendons

By Physio Daniel O’Grady

Let’s talk about shockwave therapy for tendon pain.

It’s been around for a while, but is it really worth your time, money, and effort?

A new, high-quality study shows the answer is clear:

No, it’s not.

This research is a game-changer.

It shows us that it’s time to leave shockwave therapy behind and focus on better, more effective ways to recover from tendon pain.

Let me explain why this study matters and why it’s time for us to move forward.

A Study You Can Trust

This wasn’t just another small, poorly done study.

This was a randomized controlled trial—the gold standard of clinical research.

The researchers wanted to find out if shockwave therapy actually helps people with insertional Achilles tendinopathy, a common type of tendon pain.

Here’s what made this study so reliable:

• Participants were randomly split into two groups: one got shockwave therapy, and the other got a fake, sham treatment.

• Both groups received the same high-quality exercise program and education about their condition. The only difference was the shockwave therapy.

• Participants and assessors were blinded—they didn’t know who got the real treatment. This helped eliminate bias and ensured the results were fair.

What Did the Study Find?

After 6 weeks and 12 weeks, the results were in: there was no difference between the group that received shockwave therapy and the group that got the sham treatment.

That’s right—shockwave therapy didn’t improve pain, function, or any other outcome.

Even with a solid exercise program alongside it, shockwave therapy offered no extra benefit.

This finding is consistent with previous research, which has also failed to show that shockwave therapy is effective for tendon pain.

Why Does This Matter?

Shockwave therapy is expensive, time-consuming, and often uncomfortable.

If it doesn’t work any better than a fake treatment, why are we still using it?

This study tells us it’s time to stop chasing ineffective solutions and focus on what actually helps.

The good news? We already have effective tools for tendon recovery: exercise and education.

Why This Study Stands Out

This research wasn’t just any study—it was done right. Here’s why it’s so trustworthy:

1. It included 76 participants, enough to ensure the results were reliable.

2. It measured real-world outcomes, like pain, function, and quality of life. These are the things that actually matter to patients.

3. It followed modern clinical guidelines, allowing participants to keep walking, running, and staying active as long as their pain was manageable. This makes the results much more applicable to everyday life.

Meet the Expert: Professor Peter Malliaras

One of the lead researchers on this study was Professor Peter Malliaras, a world-renowned expert in tendon rehabilitation.

He’s spent decades helping people recover from tendon pain and is a leader in evidence-based approaches to treatment.

Professor Malliaras has published numerous scientific papers on tendon pain and regularly trains physiotherapists around the world.

His work emphasizes what really works—like load management and exercise—and steers us away from outdated or ineffective treatments.

If he’s saying shockwave therapy doesn’t help, you can trust that it’s based on solid evidence.

A Better Way Forward

So, what should you do if you’re dealing with tendon pain?

The answer is simple: Focus on exercise and education.

Exercise, when done right, strengthens your tendon and helps it handle the demands of your life—whether that’s walking, running, or sports.

Education helps you understand your pain and manage it with confidence.

These approaches are backed by strong evidence and don’t rely on expensive, unproven add-ons like shockwave therapy.

The Takeaway

Let’s be bold: It’s time to move on from shockwave therapy.

The evidence is clear—it doesn’t work better than a placebo.

Instead, we should focus on the bigger picture: building resilience, managing load, and using proven strategies to recover from tendon pain.

Your recovery doesn’t need gimmicks or quick fixes.

It needs patience, the right exercises, and a focus on what really matters.

It’s just about to tick over to 2025—let’s leave ineffective treatments behind and embrace what works.

If you’re ready to take control of your tendon pain start with a comprehensive evaluation with expert Physio Daniel O’Grady.

Research link:

Does shockwave therapy lead to better pain and function than sham over 12 weeks in people with insertional Achilles tendinopathy? A randomised controlled trial