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A very common question. Well intentioned perhaps, but not fully thought through. If we could provide a simple "if this hurts, do this exact exercise" there would be very few people in pain. We could basically write a cook-book of exercises for various injuries and ailments. Unfortunately we can't do this. As a human, you are an incredibly complex system.
Let's define that. A complex system is one that consists of multiple sub-systems that all interact and coordinate, and in our case, result in our biological self. For example, humans have a cardiovascular system, pulmonary system, nervous system, musculoskeletal system, endocrine system, integumentary system, gastrointestinal system...shall I continue? Each of these sub-systems are inextricably linked and depend on each other for the organism to function optimally. We cannot impact one sub-system without also impacting the others.
It's common in the physical therapy world and in healthcare to make comparisons between the human body and an automobile. For example, comparing a limp after a sprained ankle to a flat tire or comparing joint pain/arthritis with mechanical breakdown of a car. This is an AWFUL comparison. It's apples to oranges. Worse, maybe. A car is not a biological organism like a human. It may be a complicated system, but it's not a complex system. A car can't heal itself, you can.
Let me take this full circle now. If tire flat - change tire. If fuel low - add fuel. If belt breaks - replace belt. The cook-book approach can work decently well for a complicated system. But for you, the complex organism, who has thoughts, emotions, beliefs, adaptability...not so much. There's much more to be considered with a human dealing with pain or injury. To optimize the chance of success when rehabilitating an injury it's important to have a personalized assessment; one that considers your structure, your movement capabilities, respiratory dynamics, injury history, comorbidities, lifestyle factors, beliefs and more. Contrary to what you may have been led to believe, your medical providers, including me, are guessing when it comes to delivering an intervention.
Hopefully it's an informed guess. If you've been given diagnosis "x" followed by, do these 3 stretches for diagnosis "x", by your provider; that's a pretty uninformed guess. This would be a symptom based approach, a metaphorical band-aid. Further, if this is what you've been provided, then the one who has prescribed this simplistic approach has a fundamental lack of understanding of how pain even works on a neurophysiological level (more to come on this in another post).
You, as an active and athletic individual, should not be given the same exact PT plan as the sedentary individual with poor lifestyle choices, simply because you have similar symptoms. Don't settle for that.
The assessment process informs the selection of interventions. But due to the complex nature of the system, we can't possibly know definitively what the outcome of a specific intervention might be. However, with more data points, expectations and observation of patterns, the predictions can certainly become more accurate. There are ways in which we can simplify the process, but there will always be a degree of uncertainty in rehab. This is critical to understand because it can help you to identify potential "low-hanging fruit" with regard to contributing factors to your pain or injury that you may not have considered previously. Remember, all sub-systems impact one another, so there can be multiple ways to achieve a desired result!
Thanks for being here! If you have questions about this or want to discuss how Explore PT can help with your rehab, please reach out!
Chris
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