Posted by SportsMed NQ, 27 July 2015

Life is so busy!  We learn to selectively ignore many things – rude drivers, telemarketers and I am sure my wife would say I ignore her at times, as well as signs or symptoms of pain.

After 20 years (I can hear you all saying “has he really been around that long!”) in the business, there is 1 thing I know for sure and that’s that nothing remains the same. Pain changes, treatment changes, research changes, technology changes, techniques change, I could go on and on.

In the clinic we see people who will often put up with pain until it gets unbearable and starts to compromise their lifestyle.  We also see a number of patients who have been trying their own home remedies or treatment advice from when they last had this injury 10 years ago, or trying something that their mothers’ neighbours’ brother has recommended from when he had the same thing! A recent survey by the Australian Physio Association looked at why people don’t seek treatment and the most common response from females was “they will only tell me to lose weight” and males “they won’t be able to help me”. These things couldn’t be further from the truth.

With injuries, tissues are still recovering long after pain disappears and therefore we need to be aware of movements not to aggravate, but also movements that will help facilitate recovery.  A good example of this is a statistic with low back pain.  Many pathologies will respond and settle within 6 – 12 weeks (80%) but 70% will re-aggravate within 12 months.  Our main role as a Physiotherapist is in the reduction of re-aggravation.  This will be covered in the forthcoming issues.

healthwellnessjourney-498x333Often the patient will instinctively discontinue treatment and assume natural recovery as soon as the pain stops. Sometimes the underlying cause of the problem remains largely unidentified or unresolved if treated only once or twice.  This incomplete recovery will be at a higher risk of re-aggravation when the patient resumes normal activities.

I have seen this clinically time and time again where clients will come for treatment saying they were told their condition would just get better, but symptoms have continued.  Often these patients have been on the incomplete recovery merry-go-round and they seek a second opinion or they seek advice from another health professional.

It is important to look at the client’s symptoms, preventative symptoms and self management techniques (yes, you do have to do your exercises at home!) at each appointment.  What I mean is, if you have a sore back – look at the causing factor i.e. stiff vertebrae or tight muscle.  Return your movement pattern to normal, look at prevention exercises and strengthening exercises, but also look at external factors such as your lifting techniques or desk ergonomics.

For example:  A parent lifting a toddler hurts lower back.  The traditional model would be to rehabilitate pain via physiotherapy manual techniques, avoiding movements that would aggravate symptoms but medication to help settle pain and inflammation.  The current management is rehabilitative strength and control via core stability exercises and clinical pilates, stretching to restore lumbar and hip movement, education on standing, sitting and lifting posture.

In summary:

  1. If you are time poor, you tend to take short cuts to health
  2. Quick fixes don’t last and they waste time and money
  3. Your treatment pathway should address the complete holistic and deep rooted causes of movement disorders
  4. Don’t pull out of your recovery too early or when the pain has stopped, as good health is a lifestyle commitment. You need to be motivated and have a good understanding of treatment and health goals.


Written by Paul Parker for DUO Magazine, May Issue 2015


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