Injuries & Chronic Pain: When Physical Therapy and Other Treatments Stop Working for You

It’s so hard and very frustrating when we follow the rules of rehabilitation and continue to run into the same challenges with pain and injury.  When we follow every doctor’s advice and see the referred specialists and commit ourselves to the weeks and months of physical therapy along with all assigned exercises and stretching.  When we have to keep making those appointments with the chiropractor again, or the massage therapist or acupuncturist.  But yet, we still face resurfacing problems, pain, inflammation, repeat injury and returning pain in the same places and often new places.  Why?  For the love of G-d, whyyyyy?

We will never discount the quality and benefit of working with any or all of the aforementioned professionals, in fact more often than not we work alongside them and partner with them to provide supplemental follow up to their programs.  This is not a dig towards any form of therapy, more of a way to opening doors of further discussion.  Why do some of these therapies seem to fail so often?  And how can we do better?

runners-kneeIf you tear an ACL and get surgery, you will need a lot of follow up care, including physical therapy.  This is critical.  But we often see clients who did everything from A to Z and are still unable to straighten their leg out fully or go down a flight of stairs without pain.  They succumb to the idea that this is just their lot in life now and accept the longterm challenges they’ll just face until they’re dead.  That is the idea they accept.  This is due to several reasons:

1.  Insurance companies only cover a certain amount of pre-determined appointments, they do not take into account the individual and their unique requirements of treatment

2.  Insurance companies only cover certain kinds of pre-determined treatments, and this poses a financial burden on the patient who now has to choose between supplemental care for optimal and sustained recovery and performance… or simply dealing with what’s left and putting up with it/working around it.

3.  We’re led to believe that certain levels of discomfort, pain, injury or re-injury is “normal”, so we don’t always see the red flags or even consider performance without pain a feasible goal.

4.  We do not consider the longterm affects to our health or how the current, yet seemingly low-level imbalances can lead to even bigger issues down the line.

So let’s address these four main roadblocks.  

Number 1 & 2 are the most common things we run into with our clients and it’s really unfortunate that patients are cornered by the financial burden of looking outside of the box to supplement their treatment and recovery.  We suggest using your
HSA (or health savings accounts, which most companies offer), but if you don’t have that and you are serious about regaining peak performance and being pain-free, then go back to your budget and see where you can fit in even one appointment a month.  Can you cut back on your Starbucks outings?  Sell a few of those designer purses you never use anymore?  Pause your gym membership (since you’re not using it right now)?  Get creative and see how you can fit in some work with an integrative therapist, NST practitioner and/or corrective exercise coach who can help you design the program and lifestyle you need, specifically you.

Numbers three and four are tricky ones because we get to a point of pain tolerance, we all do, that we don’t even know what’s normal and what’s not.  And on top of that, we all seem to know a handful or more people who are dealing with the same thing and therefore reaffirming how “normal” it is.  Listen, if you’re only 32 years old and you can’t sit in a chair for more than 5 minutes without pain – that’s not normal.  If you’re a 40 year old who gave up cycling because you’re “too old” to be competitive anymore anyway – you’re wrong.  If you think it’s normal, at any age, to limit your activities, deal with the pain and just expect injuries to happen simply because you play this sport or compete in these races (and everyone who does that gets hurt) or because you’re getting older, think AGAIN my friend.  How you perform today will determine how you perform tomorrow, and next year, and next decade.  If you allow an old injury to simmer at a low level, you are allowing the entire kinetic chain to perpetually react and compensate for that imbalance and over time that creates a huge imbalance that can/will lead to even worse injury, higher levels of chronic pain, digestive issues, headaches, insomnia, chronic fatigue and more drugs and surgery.  And the problem here is that we’re all conditioned to believe this is normal if (a) we play a competitive sport or (b) we’re getting older.  And what keeps this problem rolling is the fact that we address all of these things separately, so if we start getting headaches, we go see a doctor who treats the headache.  And we compartmentalize all of our symptoms separately and treat them separately which allows the problem to snowball even further.  What we need to do is address the root cause.  That old knee injury that kept showing up in life is what caused a potentiweb slide 10al hip misalignment, which led to the lower back pain, which caused you to adopt improper breathing mechanics, which led to chronic constipation (which is made worse by the pain meds you take for your back), which caused you to hold your breath even more, which led to a stiff neck, which led to the headaches… and so on.  Do you understand now?  You can live a full, happy, pain-free life no matter what age you are.  Yes, that is a feasible goal!

Just because you play high school varsity football doesn’t mean you should expect to be sidelined by injury all the time because that’s what most good players go through.  And just because you’re entering your 40’s or 50’s now doesn’t mean you can use age as an excuse to slow down.  You just have to decide what you want and put in the work, budget for it and make time for it.

When we work with our clients, it’s not to eliminate doctors or physical therapy.  In fact, it’s quite the opposite.  We want to address the factors of your program that most physicians and therapists do not have the time or the specific training for.  You will want to find someone who can work with your caretakers to supplement your recovery for the best results.  This professional will address lifestyle factors such as nutrition, hydration, rest and corrective exercises at the very least.  And they should be tailored to fit you as an individual because not one person is even close to the same as the next and your needs will be very unique.


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