As Physical Therapists we have all heard it…….. P.T. = Pain & Torture, Physical Terrorists, it goes on…….
Occasionally, but fortunately not too often where I used to work, when I would first talk to a patient at the initial evaluation they were completely frightened of their initial Physical Therapy appointment, some even to the point of tears before I even say “hello.”- which breaks my heart......which is why I founded Perseverance Physical Therapy so you can have ALL your questions answers and fears calmed BEFORE you even begin therapy.
Some even remark that they took a bunch of pain pills “just to be ready” for the appointment. Others report how friends, family members, neighbors, etc. have forewarned them about how painful Physical Therapy is, and how they loathed coming to their appointments or their entire recovery process.
This definitely makes me pause and wonder. What type of Physical Therapy have these people unfortunately experienced or how far astray have their friends, Dr. Google or YouTube led them.
And, no Physical Therapy should not be painful. Painful in the sense where people report they were brought to tears while their therapist cranked on their knee, leg, or shoulder…….or had to bit down on a towel or pillow…………. what is going on?
Physical Therapy may be uncomfortable for brief moments, but this type of pain, nope. I’d head for the door.
Pain is there for a reason. It is like a stop sign. This goes for patients and the therapist. No one should be “cranked” on, IF the body part is not making the gains needed the answer should not be to force it. There are many layers and facets to healing, each unique to the individual, the injury or procedure. When people experience pain or injury it sends a signal their body and brain to be “on guard” and “protect," when you try to force the body to do what it is protecting against it only makes things worse, increases inflammation, and then the body remembers and anticipates these painful scenarios(you can even tense up and develop aversion to the therapist or exercises- which should be helping you).
You should never experience sharp, searing, or stabbing pain with Physical Therapy. And you always have the right to stop. Pain should not last for days or weeks after, or leave you far worse than before treatment and without any sign of improvement.
Discomfort with physical therapy. Yes. Depending on your unique case, individual tolerance to pain (acute or chronic) and presentation it will vary. But this discomfort should be momentary, your should be able to recover from manual Physical Therapy within 24-72 hours if not- you need to let you Physical Therapist know your tolerance level. This is why I like to check in on my patient’s response to manual treatment and their exercises, “better, no change, increased discomfort” within 24 hours. But, you should observe and feel positive changes as you body heals, adapts and recovers, and these improvements should outweigh the brief level of discomfort.
Communication is Critical.
I try to remind and encourage patients that one of the hardest things with the process of Physical Therapy is honoring and committing to your healing and rehabilitation journey. Everyone is different, I have yet to see the same presentation of an ACL, rotator cuff, shoulder pain etc.(and I’ve treated a lot)…..there may be patterns but the same- no. I encourage patients to disregard the PT peanut gallery comments, expectations and pressures you experience (be especially on your guard if you are in a sling or braced), people mean well but it only confuses and discourages your own hopes, goals and expectations.
This was only a brief introduction to Physical Therapy as it should or should not be experienced. If you are thinking about beginning Physical Therapy and have any questions please feel free to call here, (805) 941-0125. You can also schedule a FREE phone consultation or FREE Discovery Visit with one of our Specialist Physical Therapists in order for us to better understand your pain or limitations and how we can help get you back to doing the things you love.
At Perseverance Movement Specialists & Pilates we help people aged 40+ stay fit, active and overcome mobility loss to be able to live the life they love without fear, limitation and depending on painkillers or procedures.
Yvonne A. Castillo, MSPT, DPT, CPT