What Should I Avoid?
No movement is universally ‘bad’. Whether an exercise suits you depends on the condition, the phase of healing, the load, the range of motion and how your symptoms respond. This page lists what commonly aggravates each condition, why, what to do instead, and how to bring it back.
Reduce load, range, volume or speed first; swap to a variation with the same movement pattern; or move the exercise to the next phase (PDF pp. 212–217).
Up to 3/10 familiar pain is acceptable; 4/10+ or worse resting pain next morning means modify (PDF pp. 210–212).
Treat the aggravating activity as a dose to rebuild—reduce it for 2–4 weeks, then add a little each week (PDF pp. 188–189).
Head & Neck
Commonly aggravated by: Looking down · Turning the head · Holding one position for long. Detailed why/modify guidance is pending; see Neck Pain (PDF p. 266).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Turning the head · Looking down · Stretching the area. Detailed why/modify guidance is pending; see Neck Pain (PDF p. 269).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Turning the head · looking-up · Holding one position for long. Detailed why/modify guidance is pending; see Neck Pain (PDF p. 273).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: looking-up · Turning the head · Coughing / sneezing · Holding one position for long. Detailed why/modify guidance is pending; see Nerve Pain — Neck (Radiculopathy) (PDF p. 298).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Reaching or lifting overhead · carrying-loads · Holding one position for long. Detailed why/modify guidance is pending; see Nerve Pain — Neck (Radiculopathy) (PDF p. 303).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Looking down · Holding one position for long · Turning the head. Detailed why/modify guidance is pending; see Headache Pain (PDF p. 323).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Chewing / opening the mouth · yawning · clenching. Detailed why/modify guidance is pending; see Jaw Pain (PDF p. 342).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10) → Add phase 3 exercises from the Neck Pain protocol (here– here) to prevent future jaw pain flare-ups
Shoulder
| Commonly aggravating | Why | Instead / how to modify |
|---|---|---|
| Reaching overhead or away from the body | Loads the cuff tendons—especially supraspinatus—as the arm elevates. | Keep work below shoulder height temporarily; use PROM with a dowel in phase 1. |
| Sleeping on the painful side | Compresses the irritated tendon for hours. | Sleep on the other side or on your back with a pillow supporting the arm. |
| Lifting objects with an extended arm | Long lever arm multiplies load on the cuff. | Hold objects close to the body. |
| Rounded shoulder postures | May increase load on irritated structures. | Change position often; angel and prone T exercises in phase 2. |
Protocol cautions: Phase 1: Reaching overhead under load · Phase 1: Sleeping on the painful side · Phase 1: Active lifting that flares pain
When to progress: No pain at rest and no more than mild pain (3/10) with the exercises → Exercises performed with no more than mild pain (3/10)
| Commonly aggravating | Why | Instead / how to modify |
|---|---|---|
| Reaching overhead | Narrows the subacromial space under load. | Stay below the painful part of the range; progress range gradually. |
| Sleeping on the painful side | Sustained compression of the bursa and tendon. | Change sleeping side. |
| Lifting with an extended arm | Long lever increases cuff load. | Keep loads close to the body. |
Protocol cautions: Phase 1: Reaching overhead under load · Phase 1: Sleeping on the painful side · Phase 1: Active lifting that flares pain
When to progress: No pain at rest and no more than mild pain (3/10) with the exercises → Exercises performed with no more than mild pain (3/10)
Commonly aggravated by: Reaching or lifting overhead · Lying / sleeping on the painful side · Lifting the arm out to the side. Detailed why/modify guidance is pending; see Shoulder Pain (PDF p. 360).
Protocol cautions: Phase 1: Reaching overhead under load · Phase 1: Sleeping on the painful side · Phase 1: Active lifting that flares pain
When to progress: No pain at rest and no more than mild pain (3/10) with the exercises → Exercises performed with no more than mild pain (3/10)
| Commonly aggravating | Why | Instead / how to modify |
|---|---|---|
| Overhead lifting and throwing | Places the joint near end range where passive restraints are compromised. | Avoid end-range overhead loading until phase 3 control is established. |
| Reaching up | Combines lever length and rotation—typical subluxation positions. | Work in mid-range with the elbow closer to the body. |
| Stretching the shoulder | Stretching a hypermobile joint can increase instability (no stretching in phase 2). | Prioritise strength and motor control instead of stretching. |
Protocol cautions: Phase 1: Stretching the shoulder · Phase 1: End-range overhead or behind-the-body loading · Phase 2: Any stretching — it can increase instability in a hypermobile joint
When to progress: No pain at rest and no more than mild pain (3/10) with the exercises → Exercises performed with control and no more than mild pain (3/10)
| Commonly aggravating | Why | Instead / how to modify |
|---|---|---|
| Moving into external rotation | These are the restricted capsular directions. | Use dowel PROM to the point of a moderate stretch, not severe pain. |
| Prolonged immobilisation | Lack of movement promotes further stiffness (Ch 10, PDF p. 185). | Daily mobility, 2–3 sessions per day in phase 2. |
Protocol cautions: Phase 1: Prolonged immobilisation
When to progress: No pain at rest and no more than mild pain (3/10) with the exercises → Exercises performed with no more than mild pain (3/10)
| Commonly aggravating | Why | Instead / how to modify |
|---|---|---|
| Reaching | Tensions and compresses the LHB tendon. | Work below painful height; phase 1 ball-assisted flexion keeps range without load. |
| Sleeping on the painful side | Sustained compression. | Sleep on the other side. |
| Moving the arm behind the body (deep dips | Shoulder extension stretches and compresses the tendon against bone. | Use the floor press (limits extension) before full-range pressing. |
Protocol cautions: Phase 1: Arm behind body under load (deep dips · Phase 1: bottom of bench press) · Phase 1: Sleeping on the painful side
When to progress: No pain at rest and no more than mild pain (3/10) with the exercises → Exercises performed with no more than mild pain (3/10)
Elbow
Commonly aggravated by: Gripping · Lifting with the palm down · Typing / mouse use. Detailed why/modify guidance is pending; see Tennis Elbow (Lateral Epicondylalgia) (PDF p. 465).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Gripping · Lifting with the palm up · Throwing / bowling. Detailed why/modify guidance is pending; see Golfer’s Elbow (PDF p. 485).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: pushing · dips · push-ups. Detailed why/modify guidance is pending; see Triceps Tendinopathy (PDF p. 504).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Wrist & Hand
Commonly aggravated by: Weight through the wrist (push-ups) · push-ups · Gripping. Detailed why/modify guidance is pending; see Wrist Pain (PDF p. 530).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Pinching / using the thumb · lifting-child · wrist-deviation. Detailed why/modify guidance is pending; see Wrist Pain (PDF p. 533).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Typing / mouse use · Gripping · At rest / at night · Holding one position for long. Detailed why/modify guidance is pending; see Carpal Tunnel Syndrome (PDF p. 553).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Back & Spine
Commonly aggravated by: Bending forward · Arching / leaning back · Prolonged sitting · Lifting heavy objects. Detailed why/modify guidance is pending; see Low Back Pain (PDF p. 575).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain with the exercises → Add phase 3 when you can do the exercises with no more than mild pain
Commonly aggravated by: Bending forward · Lifting heavy objects · Twisting. Detailed why/modify guidance is pending; see Low Back Pain (PDF p. 579).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain with the exercises → Add phase 3 when you can do the exercises with no more than mild pain
Commonly aggravated by: Arching / leaning back · Twisting · Prolonged standing. Detailed why/modify guidance is pending; see Low Back Pain (PDF p. 583).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain with the exercises → Add phase 3 when you can do the exercises with no more than mild pain
Commonly aggravated by: Arching / leaning back · Jumping / landing · Prolonged standing. Detailed why/modify guidance is pending; see Low Back Pain (PDF p. 585).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain with the exercises → Add phase 3 when you can do the exercises with no more than mild pain
Commonly aggravated by: standing-on-one-leg · Stairs · rolling-in-bed. Detailed why/modify guidance is pending; see Low Back Pain (PDF p. 587).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain with the exercises → Add phase 3 when you can do the exercises with no more than mild pain
Commonly aggravated by: Bending forward · Prolonged sitting · Coughing / sneezing. Detailed why/modify guidance is pending; see Nerve Pain — Low Back (PDF p. 628).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Bending forward · Prolonged sitting · Lifting heavy objects · Coughing / sneezing. Detailed why/modify guidance is pending; see Nerve Pain — Low Back (PDF p. 632).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Prolonged standing · Walking · Arching / leaning back. Detailed why/modify guidance is pending; see Nerve Pain — Low Back (PDF p. 636).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Bending forward · Twisting · Deep breathing. Detailed why/modify guidance is pending; see Mid-Back And Rib Cage Pain (PDF p. 658).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Deep breathing · Coughing / sneezing · Twisting. Detailed why/modify guidance is pending; see Mid-Back And Rib Cage Pain (PDF p. 660).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Hip
Commonly aggravated by: Squatting · Deep hip bending (low chairs, car) · Crossing the legs. Detailed why/modify guidance is pending; see Hip Pain (PDF p. 686).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises
Commonly aggravated by: Pivoting / twisting on the leg · Squatting · Deep hip bending (low chairs, car). Detailed why/modify guidance is pending; see Hip Pain (PDF p. 689).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises
Commonly aggravated by: Walking · Stairs · putting-on-socks. Detailed why/modify guidance is pending; see Hip Pain (PDF p. 691).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises
Commonly aggravated by: Lying on the hip · Stairs · Crossing the legs · standing-on-one-leg. Detailed why/modify guidance is pending; see Hip Pain (PDF p. 693).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises
Commonly aggravated by: Prolonged sitting · Crossing the legs · Running. Detailed why/modify guidance is pending; see Nerve Pain — Hip & Buttock (PDF p. 718).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Kicking · Sprinting · lifting-leg · Stretching the area. Detailed why/modify guidance is pending; see Hip Flexor Pain (PDF p. 741).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises
Commonly aggravated by: Sprinting · Stretching the area · Contracting the muscle. Detailed why/modify guidance is pending; see Hamstring Pain (PDF p. 761).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Prolonged sitting · Stretching the area · running-uphill. Detailed why/modify guidance is pending; see Hamstring Pain (PDF p. 764).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Changing direction · Kicking · Stretching the area. Detailed why/modify guidance is pending; see Groin Strain (PDF p. 786).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Knee
Commonly aggravated by: Squatting · Stairs · Prolonged sitting · Running · Kneeling. Detailed why/modify guidance is pending; see Knee Pain (PDF p. 809).
When to progress: Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Running · Cycling · stairs-down. Detailed why/modify guidance is pending; see Knee Pain (PDF p. 812).
When to progress: Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Pivoting / twisting on the leg · Squatting · Twisting. Detailed why/modify guidance is pending; see Knee Instability (PDF p. 836).
When to progress: Add phase 2 when range of motion is greater than 90 degrees (see finish position in heel slide exercise) → Add phase 3 once you have full knee range of motion and can do the exercises without pain or instability
Commonly aggravated by: Pivoting / twisting on the leg · Changing direction · landing. Detailed why/modify guidance is pending; see Knee Instability (PDF p. 840).
When to progress: Add phase 2 when range of motion is greater than 90 degrees (see finish position in heel slide exercise) → Add phase 3 once you have full knee range of motion and can do the exercises without pain or instability
Commonly aggravated by: Pivoting / twisting on the leg · landing. Detailed why/modify guidance is pending; see Knee Instability (PDF p. 846).
When to progress: Add phase 2 when range of motion is greater than 90 degrees (see finish position in heel slide exercise) → Add phase 3 once you have full knee range of motion and can do the exercises without pain or instability
Commonly aggravated by: Jumping / landing · Squatting · Stairs · Kneeling. Detailed why/modify guidance is pending; see Patellar Tendinopathy (PDF p. 868).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Stairs · Walking · Squatting · rest-after-activity. Detailed why/modify guidance is pending; see Osteoarthritis (PDF p. 891).
When to progress: Add phase 2 after 2 weeks → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Ankle & Foot
Commonly aggravated by: Running · Jumping / landing · First steps in the morning · Pushing off the foot. Detailed why/modify guidance is pending; see Calf And Achilles Pain (PDF p. 919).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Pushing off the foot · Running · Stretching the area. Detailed why/modify guidance is pending; see Calf And Achilles Pain (PDF p. 922).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: First steps in the morning · Prolonged standing · Walking · Running. Detailed why/modify guidance is pending; see Plantar Fasciopathy (Fasciitis) (PDF p. 943).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Uneven ground · Changing direction · landing. Detailed why/modify guidance is pending; see Ankle Sprain (PDF p. 965).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Running · Jumping / landing · hard-surfaces. Detailed why/modify guidance is pending; see Shin Splints (PDF p. 988).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Commonly aggravated by: Tight shoes · Walking · Pushing off the foot. Detailed why/modify guidance is pending; see Bunion (PDF p. 1010).
When to progress: Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises → Add phase 3 when you can do the exercises with no more than mild pain (3/10)