I have a triple which I use when I travel. My bike comes with me to Maine and Vermont and they have some serious hills up there. I still feel it in my knee when I start mashing - even a little bit, the tendonitis lingers and reminds me it's still not completely healed.
That pain is my red flag and I'll go into whatever gear I need, whatever ring, at whatever speed it takes to keep the inflamation under control.
My body deserves at least that much care.