There is nothing more annoying than paying for something and not getting what you wanted. It’s time to address a common question that patients ask “Why are you treating this when I hurt my…”. This is a very important question to ask your physiotherapist so that you understand what is happening and why.
Your body is a closed system and as such it cannot get rid of load, but it can move it around. This means that when you get pain in an area of the body, your body can transfer the load to another area to reduce the load on the painful area and allow it to heal. The complications happen when the system does not return to optimal once the painful area has healed.
We have all heard the song “Your knee bones connected to your leg bone…”. One area of the body or joint does not work in isolation of the rest of the body. There is a complicated network of connections throughout the body involving muscles, tendons, nerves, fascia, etc. that work in unison to allow your body to do all the wonderful movements it does throughout the day.
If you have had multiple injuries to a limb, then there is a good chance that the rest of the chain has had to adapt to take on the load from the injured area. If you injure another area or something else starts to hurt then the body with change the loading again. Eventually, the chain can run out of options for moving the load and the pain becomes worse or hangs around for a while until you seek treatment.
Your physiotherapist has intimate knowledge of the muscle system and how the body loads through different movements. They use this knowledge along with the things that you tell them, such as how you injured the area or what aggravates it, that gives them information on where to look and what could be causing the overload. They then take that information and the information that they gather from your assessment of how you move, load, and what is sore to give them a full understanding of what is happening in your body.
This is where things will differ between physiotherapists, depending on their interests, professional development, and experience to name a few. Your physiotherapist uses their clinical reasoning skills to work out the best approach to your treatment that will resolve your pain and get you back to what you love the quickest. They then give you exercises, stretches, and advice on what to avoid and what can help to speed up your recovery. They should also provide education on your injury, what caused it, how to prevent re-injury, and approximate timeframes for reduced pain and return to strength/endurance and mobility.
It is important to note that resolution of pain does not equal return to full strength/endurance or mobility. Usually, the resolution of pain can happen quite quickly, especially if you are being seen a couple of times per week. Often at this point, the area is about 1/3 of the way through a full rehabilitation program as it takes 2-3 months to build strength to a level that physiotherapists term redundant, meaning that you have more strength in the system than what is required for your task. This will reduce your chance of reinjuring the area or overloading and eventually injuring yourself again.
Next time you are at your physiotherapist’s and you are unsure why they are treating a particular area, please ask them to explain why they are treating it. The answer might surprise you can give a little more information about how your body works.