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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Causation Versus Correlation In Pain
- Clinicians often assume impairments cause pain but correlation doesn’t equal causation.
- Justin Martino warns weakness may be a result of pain, not its cause.
Specificity Isn’t Always Key For Pain
- Specificity taught in PT may not translate to pain relief in real-world practice.
- Justin highlights manual therapy parallels where specific techniques lack consistent specific effects.
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.