Up to about 5 out of 10, settled within an hour, the tendon checked the next morning, and no pinch at the frontEmerging evidence
This guide uses the foot and ankle hubs' rule, as our ankle pain on the treadmill guide carries it. Some discomfort during exercise is fine. Aim for pain you would call mild to moderate, no more than about 5 out of 10, that settles within an hour, with no more swelling or stiffness the next morning. If it's worse the next day, do a little less (a smaller range, fewer reps, a lighter band), not nothing.
The exceptions: pain in one spot on a bone should be pain-free, because it could be a stress fracture, and experts managing these fractures aim for no symptoms during, after or the day after loading. Burning, tingling or numbness means stop that movement. After a sprain, an NHS hospital leaflet moves on when the exercises are easy without discomfort, and starts hopping once jumping causes little or no discomfort.
If pain climbs day after day, or you notice a warning sign, stop and get it checked. The 5 out of 10 figure is an editorial starting point that matches this site's other pain guides, not a tested rule.
For pain at the back of the ankle, our Achilles tendinopathy guide's rule applies. In Silbernagel's 2007 trial, carrying on running and jumping while monitoring pain did no harm. The 5 out of 10 limit comes from later studies: in a 2023 study by the same research group (Hanlon), patients were told that tolerable pain, under 5 out of 10, was not harmful to recovery, and in a 2025 trial in insertional pain (Pringels), exercise moved on only while pain stayed under 5 out of 10 during exercise, 1 hour after and the next morning. The 2024 guideline recommends using pain monitoring to guide activity, and the Dutch guideline advises using a pain scale.
This site's suggested rule: pain during exercise up to 5 out of 10, back to its usual level by the next morning, and not creeping up week on week. If it is worse the next morning, lighten the load for a few sessions rather than stopping.
For a pinch at the front, our anterior ankle impingement guide's rule applies. Bending the ankle up under load (squats, lunges, stairs, the knee-to-wall rock, landings, plié): stay short of the sharp pinch at the front of the ankle. A stretch in the back of the calf is fine; a pinch at the front is not. Let the depth come back over weeks (our suggestion).
After a sprain, NHS hospital leaflets say the exercises should not increase your pain, and gentle exercise from the first week was safe in a trial: re-injury was 4% with or without it.
Chest discomfort that comes on with effort, such as brisk walking or stairs, and eases within a few minutes of rest, or feels tight, squeezing or heavy, or comes with breathlessness, sweating or feeling sick, is not a pain-rule question: that is how angina and heart attacks behave. Stop, and follow the warning signs.
On the elliptical (our suggestion, built on the same rules): judge each session by its last 5 minutes, by that evening and by the next morning, as Achilles guidance asks. Use the time, resistance, ramp and stride at which your ankle stays at 5 out of 10 or less, settles within an hour and is no more swollen or stiff the next morning, aiming for 0 to 3. NHS inform's ankle exercises use the same limit, and an NHS trust allows a mild increase if it settles within 24 hours. A pinch at the front of the ankle at the back of each stride is a sign to lower the ramp, shorten the stride and let the heel rise, not to push through. Change one thing at a time: time first, then resistance, then the ramp. A pop at the back of the ankle, an ankle you can't stand on, a hot, swollen ankle and a swollen calf aren't pain-rule questions: see the warning signs.
Sources 51, 58, 59, 53, 60
