Pain and physiotherapy: The not-so painful truth

Pain and physiotherapyOne of the most common fears about attending physiotherapy is that it’s painful. While we’re not going to say you won’t experience some pain, our intention is to not cause pain and do not want you to be in pain. Most often pain is caused when we ask you to stress a painful and/or swollen joint or tissue. Immobilizing or taking pressure off the injury will lead to more severe long term problems if we don’t move it or put pressure on it. Here are some common reasons you may experience some pain during physiotherapy:

  • Scar tissue has formed – when an injury is healing, scar tissue forms around the injured area. Like filling a hole in a wall with plaster. Your body needs to do this quickly so it slaps that plaster down any which way it can. Physiotherapy can assure that this scar tissue lays down correctly limiting the restrictions it can cause in muscles and joints. If left alone it can clog up joints and leave you with permanent limitations.
  • The bones may become weak or soft – Your bones become as strong as they are because you stress them with the weight of your body. If you remove this stress for a long enough period, the bones will weaken. If you break your leg and sit in a wheelchair for a couple months, those bones will heal but loose their strength. So when enough healing has occurred you need to begin stressing it to make sure it heals as strong as the original.
  • Soft tissues tighten up around the joint – When you do not move soft tissues through their normal range of motion they will begin to tighten up limiting the available motion of the joint. Have ever heard of the saying “If you don’t use it, you lose it”? Well that works perfectly here. For example, if you keep your elbow bent long enough your biceps muscle on the front of your arm will tighten up because your body will think that you don’t need it to be long enough to straighten your arm any more. And this applies to most soft tissues of the body.
  • Muscles are inflamed or tight – When you tear a muscle inflammation will instantly flood to the area. While inflammation does bring chemicals and nutrients to the injured site that help with healing, too much, or prolonged inflammation can have a negative effect. Whether good or bad, inflammation can be painful especially when a joint or a muscle that is inflamed is being moved or pressure is being applied to it. You can also have painful muscles when they remain tight for a prolonged time from trying to protect a joint. This is often seen with lower back and neck pain. The muscles of the back or neck will tighten up in response to the pain to limit joint movement. Trying to get them to relax can be painful… but this pain is often described by patients as the “feel good pain” or that it “hurts so good.”

Although these are reasons you may experience pain during physiotherapy, it will often be mild pain or just a discomfort. Our suggestion is to speak with your physiotherapist about what to expect first. This way there will be no surprises. Often the relief of pain is one of our top goals, however with some injuries we may need to cause a little discomfort to make sure your body recovers the fastest and most efficient way possible.

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