Here are 10 things I learned in 2022 about physical therapy, pain, and relationships.
1) Pain is more complex than anyone fully understands. There are always multiple systems involved: biomechanics, musculoskeletal, bio-psycho-social factors, and beyond. Placebo is very real, however, education and understanding within a framework are how placebo treatments are effective. Use placebos as a part of the solution.. not THE solution.
2) Quick fixes DO NOT exist. Any solution to solve pain, especially chronic pain; will take a plan of care over weeks, months. Quick fixes DO NOT solve root issues, they solve symptoms. If it sounds too good to be true… it is 99.9% of the time.
3) Managing expectations creates buy in. Paint a very clear picture of what the next week, month(s) will look like when trying to go from pain to performance. When the story unfolds exactly as you said it would; the patient wins. Nobody likes surprises when it comes to health.
4) Most of REHAB SUCCESS comes in doing the things you always avoid. Want to solve back pain with picking things up, deadlift. Want to solve pinching in the shoulder with reaching overhead, press overhead. Want to solve knee pain with going up stairs, do loaded step ups.
5) Always ask: how does this treatment play into the big picture of my health and wellness? And always refer back to #2. If the treatment plays ZERO to NO role in making you healthier or more FIT…. You DO NOT need it.
6) If you do the opposite of what traditional medicine tells you to do, you’ll likely be in a good place. So google your issue, and DO THE OPPOSITE of what Google Says.
Example 1: For an acute ankle sprain most would say: RICE
Rest, Ice, Compression, Elevation and take an anti-inflammatory.
What actually to do: LOVE
Load (use the ankle), Optimism (understand you are resilient and have a healthy relationship with your injury), Vascularisation (bring blood flow to the area), Exercise (restore mobility, strength, and proprioception to the injured tissue)
Example 2: If you have back pain you should get a medical image to know the source of your symptoms
What actually to do: get physical therapy first to develop a game plan and be educated on back health, movement, strength, load management, and how adaptable you are.
If you started PT within the first 14 days you saved an average of $2,700. Getting an MRI first cost $4,793 more than getting PT first. You are not your medical image and pain can not be diagnosed with a picture. Many findings on medical images need context. Like 70% of adults have disc related changes. Your skin wrinkles. Your hair turns grey. You WILL see changes on your medical image. The fear and anxiety following a medical image without proper education and guidance will play a HUGE role in solving your back pain.
6) Systems matter more than symptoms. The body works in systems. Fix the system and you fix the symptom SHORT and LONG term. Fix the symptom, and the system can still be broken or flawed.
Example: Jon Doe has knee pain. Jon has not exercised in years. Does not sleep well. Does not have quality nutrition. He is 75 pounds overweight. Has loads of stress in and around his life.
Me rubbing his knee with a magic wand to get pain relief is QUACK SERVICE. Me expecting to solve Jon’s knee pain in one visit WILL NOT happen. But if I have the time to find’s Jon’s baseline and build a plan that is realistic for him to follow, hold him accountable, empower and educate him.. Jon can overcome knee pain. Because his ecosystem is better.
7)Flexibility is the most overrated athletic quality in the world. Most people do not ever need to static stretch. Everyone needs more strength. Your hamstrings are NOT tight. Your hamstrings are either 1) weak 2) overworked trying to pull you back into a posterior pelvic tilt. Stretching hamstrings never fixed back pain… for anyone. If you think it worked for you.. refer back to #1
8)Movement is the gold standard for musculoskeletal pain. There is not ONE SINGLE injury movement does not benefit. Movement… as tolerated… as much as possible.
9)You don’t need to do more. You need to do less, better. Changing too many variables and plans is why you aren’t getting the results you want. I once had a patient that had access to only one #5 DB at home for her shoulder pain. Each week she did ONE exercises. But she did it perfect. Each week she did a little more than the last week. After 8 weeks she solved a years worth of shoulder pain because she followed a simple plan.
10) People are begging to be listened to. It’s not the magic exercises or the magic game-plan that gets people results. It’s the fact they feel understood. They feel cared for. They can trust me. In the first evaluation, we usually spend about 40 minutes… just talking. Never think you can understand someone’s pain point in a 10 minute conversation. Most healthcare visits, patients are interrupted within 7 seconds of speaking. And they have less than 10 minutes with a provider. Relationships… It’s always about relationships.
What did you learn in 2022 about yourself or your service?Author: Brian Keith of myomuv.com
