The E3 Rehab Podcast 232. Reframing Exercise for Pain Relief w/ Justin Martino
Dec 23, 2025
In this discussion, Justin Martino, an orthopedic physical therapist and early-career researcher, explores the complexities of exercise in managing musculoskeletal pain. He challenges conventional beliefs about exercise specificity and highlights the modest effects of exercise on pain relief. Martino emphasizes the psychosocial factors influencing outcomes and the pitfalls of seeking certainty in treatment. By advocating for a flexible, patient-centered approach, he explains how attentive interaction can often drive improvement, making a compelling case for reevaluating how we view exercise as therapy.
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Set Realistic Expectations For Exercise
- Expect modest analgesic effects from exercise for chronic musculoskeletal pain.
- Use exercise for broader benefits but avoid overselling it as a rapid pain cure.
Load Over Perfect Technique
- Biomechanical tweaks matter for symptom tolerance but rarely explain pain relief fully.
- Justin argues load management often explains outcomes more than precise technique changes.
Psychosocial Mediators Drive Pain Change
- Psychosocial factors often mediate exercise-related pain relief more than strength gains.
- Studies show pain catastrophizing and kinesiophobia can explain substantial portions of benefit.