The most common reason why a patient may seek physiotherapy assessment and treatment is PAIN!
(see this blog post for more on this)
Pain that is in some way impairing function or sports participation, disturbing quality of life or just becoming intolerable.
And it is sometimes surprising just how long patients’ allow symptoms to persist for before consulting a health professional for treatment. In no small part this is influenced by delayed access to consultation and treatment, self-diagnosis and attempts at google searching a diagnosis and management (see this blog post) or in some just a stubborn stoicism to ‘put up with symptoms’ whilst in others they have an impression that ‘they are beyond help’
In fact, the overwhelming majority of conditions are amenable to treatment and achieve fantastic outcomes. Take a moment to check out our website, google and facebook reviews!
So, now we understand pain to be the most common reason why a client may wish to seek advice and treatment we begin to understand why patients often judge the cessation of physio treatment often upon pain alone. In the clients’ perspective this was clearly the most important barometer of outcome success. Clients often perceive their treatment to be complete when their pain has resolved but there is often quite a way to go to attain optimal outcomes from treatment and importantly mitigating the risk of persistent or recurrent symptoms.
It might be helpful to view treatment and rehabilitation as a journey. And on this journey (let’s say the destination is full, pain free function) you need to pass through several stations to successfully reach the destination. Each of these stations builds upon the one before and is very important in successfully reaching the end point.
The first (or certainly an early station for most) should be, and often is, resolution of pain. Reducing pain allows improved movement, better sleep and enhanced functional capacity and is often the beginning of the rehabilitation journey. This vital step allows the brain to move away from ‘threat mode’ and start to normalise movement patterns, build strength and endurance capacity. All vital foundations for later stages of successful rehabilitation and successful return to sport or activities of daily living.
And this early success in pain reduction is where patients may also decide that their rehabilitation journey should end, as pain was their most important reason for seeking treatment. But evidence demonstrates that the absence of pain has poor correlation to reducing the risk of recurrent symptoms. And this is because painful symptoms often leave behind a legacy of altered movement and inhibited strength and endurance capacity. So effectively the body exits this painful episode with reduced load/force capacity, reduced function and impaired endurance. This then makes it somewhat easier for the body to become over-loaded (as it now has reduced capacity) and the same or other tissues to become pain sensitive. And in some cases the injury or pain recurs and becomes persistent over time.
To outline typical phases of rehabilitation in most cases it will follow the phases outlined below
- Pain reduction
- Normalised movement and range
- Strength endurance
- Maximum strength and force capacity
- Rate of force development/speed/power
And this is important to understand irrespective of age, gender, sports participation or functional capacity. The ability to jump down from a step, play football with their child or participate in high performance sport are specific to the individual but the rehabilitation principles remain similar. It is merely the magnitude and requirements of these factors that alters.
Also, this does not necessarily mean that you will require lots more physiotherapy sessions – it is the timing of these sessions that is the important factor. Each time we aim to see you at a point of progression in the treatment plan thus maintaining momentum and motivation.
You can be assured that we aim to be as efficient as we can in the smallest number of sessions required and we are fully transparent at initial assessment and in your welcome email. You have decided to consult an expert in their field so it makes complete sense to follow their guidance as they are working to achieve the best possible results in the most efficient way.
Therefore, it is very important that you follow and complete the treatment plan initially outlined by your therapist and this includes continuation of care beyond the ‘painful phase’. Taking time to rebuild high quality movement, regain strength and endurance will not only lead to improved outcomes but also reduced risk of recurrence.
So, before you may think that you have fully recovered and possibly ask to cancel your session based upon reduction of pain please consider the above information and most importantly open a discussion with your therapist about what areas need to be covered in the remainder of your treatment plan if this hasn’t already been discussed. They should be able to clearly outline your progress along your treatment plan and where you need to head next.
Spending a little time in the short term by successfully completing these phases of the treatment plan can save ongoing, recurrent or persistent symptoms and more lost time from work, sport or just spending time doing the things you love in life!
I hope you have found this information useful
I’d be happy to help further and you can contact me on 07970110526 or admin@active-therapy.com
Or if you wish to book an appointment you can now do this quickly and securely online via our website www.active-therapy.com
Look forward to meeting you soon and helping on your journey toward a pain free, active lifestyle
Andrew Caldwell BSC (Hons) MSc MCSP
Physiotherapist & Sports Performance Consultant
Clinical Director – Active Therapy Ltd