By Sara Bresnick, PT
Since I have the opportunity to work with such an active population of physical therapy clients, an issue that continuously surfaces for me is that of recovery. Over and over again, patients come in with an injury and their first response is, “I didn’t want to come in because I knew you would tell me not to run/bike/row, etc.”
When an athlete ends up at physical therapy it is most likely due to pain and associated symptoms such as swelling and lack of motion. This pain often leads to the inability to perform a function. This function is often a sport. For most athletes, the inability to participate in this sport is what has most likely led them to the office.
Pain is your body’s way of telling you that something is wrong. Pain receptors let us know that we are doing harm and we should stop the activity that is causing it. As an example, imagine if you put your hand on the stove burner and you didn’t feel pain? You would have no way of knowing to quickly retract your hand because you were doing your body harm? Pain is a defense mechanism, and it is a great one. It is a mechanism that should not be ignored. Without it we would be in big trouble.
A client should think of their physical therapist as an ally in the process of return to activity. Being an athlete myself, I understand how difficult it is to stop the exercise you enjoy doing. Many people are training for competitions, some exercise for stress relief and to stay in shape. This exercise becomes very important both physically and mentally to the client, and he/she doesn’t want to be told to stop.
When in this situation with a patient, I find it is very important to let the patient know that I understand the situation, have been there before, and my primary goal is to get them back doing what they want to do. Often this process involves rest. Not rest forever; not never returning to the beloved activity; but temporary rest to let the body heal and recover, a process that it wants to do naturally.
Again, the physical therapist is your friend in this quest, not your foe. With rest, the proper stretching, strengthening, modalities, and manual work you will be back doing the activity you enjoy. Being patient from the start will get you back to where you want to be much faster than fighting with a body that needs rest and recovery.
I often tell my patients that pain free alternative exercise is ok. For example, the elliptical machine vs. running. One also must keep in mind that when returning to activity your body must be eased back in a pain free manner. For instance, a cyclist that takes 3-4 weeks off to rehab a knee injury, should not go back to cycling at the same volume and intensity as she was riding before the injury. A good physical therapist will work with the athlete to provide a protocol for safe return to activity with the proper amount of rest and recovery.
In summary, pain is your body’s way of letting you know something is wrong. It is a defense mechanism that is very important. Quite often when in pain from a given activity, rest and recovery is needed. A physical therapist will be a partner and ally in your safe return to the activity that you love. Don’t avoid us, and don’t be scared of us. We are here to help.
Sara Bresnick is a Physical Therapist at Boston Sports Medicine
