On Track Physiotherapy


(Part 4) The Setback, The Comeback, and Staying On Track!

February 29, 2016

Learning The Value Of Physical Therapy – A Patient’s Perspective

Let’s Recap: Last week you heard about my successful experience with physical therapy, and how I was ready to ride off into the sunset. You can read Part 3 HERE (or maybe you missed Part 2 and Part 1).

This week I talk about how I thought I was good to go, acted like I was invincible, needed a reality check, and finally put an end to all the madness!

Prior to what I refer to as “The Setback”, I had taken big steps to improve my overall health. The PT I worked with was also a fitness trainer, and I didn’t’ hesitate to hire him for this venture. He understood my ability and history of injury, and took this into consideration when developing a fitness regimen. Everything was going great for about six months. I had lost 50 pounds, gained a lot of strength, and was feeling awesome! This was the best shape I had ever been in, and I was starting to feel “invincible”. I started doing too much, too often, and taking things too far………

The Setback

After a few weeks of being “invincible”, I woke up one morning feeling a very familiar pain. My right arm was aching and I felt some pain in my back and neck area. I didn’t panic right away….. but then three days passed and the pain was still there. Now I started to panic. The thought of re-living that pain was terrifying to me. My anxiety went from 0-100 in a matter of days, and the pain started to increase. I saw the physical therapist, and he did a brief evaluation. He didn’t seem overly concerned, and thought I had just overdone it with exercise. He encouraged me to do the PT exercises and stretches again for a few weeks. This calmed me down, but that would be short-lived. I did what he told me to do, but I was full-on freaking out and things started to get worse. The pain was similar to before…….but different…… not as consistent in level or location, and I didn’t have any weakness……. but range of motion in my neck was decreased (the pain I had before was constant and unrelenting). My fear and anxiety about the pain returning took over, and I threw myself back in the ditch!

I went back to the physical therapist and insisted I had another herniated disc. I had been in pain for over two weeks, and was starting to feel like I was in a vicious circle. He agreed that my range of motion was decreased and something was going on, but not for the reason I thought. I argued with him about my previous MRI, cervical disc problem, and my pain. He had me sit down to try to explain something to me……. but I didn’t get what he was saying. All I heard was “Your body has an alarm …. blah blah blah…. brain thinks there is a problem……blah blah blah……not a herniated disc.” It sort of sounded like he was saying the pain was all in my head. I was certain it was caused from the disc issue, and I didn’t have a clue why he would be thinking anything else. Did he not believe me?

I got home and started thinking about what he said, and of course went on the internet. I found myself on websites that talked about something called “pain science”. I didn’t grasp this concept, but I was intrigued. I saw him again for another appointment, and we talked more about pain science. He explained that he DID believe that I was having pain, but my clinical symptoms weren’t consistent with a herniated disc. He used some different analogies that made more sense to me, and went into more detail about this “alarm” going off. I still was having a hard time with the concept that this pain wasn’t necessarily coming from the area I was feeling it, but I was determined to find a way to understand this.

The Comeback

It was time to move on to getting me out of trouble yet again. This PT was standing there by the ditch, but he wasn’t going to pull me out this time. He was going to throw me a rope, and make ME pull MYSELF out! He gave me a “reality check” and said I needed to get my fear and anxiety under control if I wanted to change what was happening. He gave me more information on pain science, as well as reputable websites and professionals who had written about it. I read some very good books on the subject, and realized that I was the person in the books……..and the light bulb turned on!

My pain was definitely real, but was being magnified by my brain “thinking” I was in danger, and not from an acute injury. My prior injury had “sensitized” my neurological system, and pushing myself too far with exercise alerted my brain that I may be in danger, thus setting off this alarm. This was why my pain was so inconsistent and would wax and wane depending on what I was doing, or my emotions (and also why no weakness was present). Sometimes the brain can be a little too protective and respond with pain even if there is not an actual injury, this is because it remembers the previous injury. (Pain science is a whole other blog post!)

Grasping the pain science concept and knowing that I didn’t have an acute injury reduced my symptoms significantly, but there was still work to do. My neurological system had gone haywire, and it would take some trial and error to reset it. I did the exercises and stretches, got my anxiety under control, and the PT did some manual therapy. Before I knew it, I had pulled myself out of the ditch and turned the alarm off. It would still take a little time until I got the hang of this “alarm” in my brain. My neurological system was really sensitive now, and I had to be careful not to flip the switch. I tried going back to my fitness routine, but every time I did, it would trip the alarm and the symptoms would return. I finally realized I needed start over and do what the PT said and what I had read in the pain science books…….“graded exposure”. I needed to start out very slow, take small steps, and work my way back up. This drove me crazy, because I had no patience and wanted to be back to the level of fitness I was at prior to the setback. It took an entire year, and there were bumps along the way, but I finally got there!

Staying On Track

It took me almost two years to fully appreciate the value of physical therapy and how it improved the quality of my life. There are so many lessons learned, that I have lost count! This experience forced me to develop patience, which I definitely needed. I learned to understand my body, how it works, and that I need to listen to it when it is trying to tell me something. I learned that doing things the right way might take longer, but I will get a better end result. I learned that anxiety and emotions can have a big impact on me physically. I learned that I need to participate in my own healthcare, and what I want in a healthcare provider. I learned that physical therapy is an excellent choice as a first-line treatment for pain and movement problems, and it will ALWAYS be the first place I go before considering other interventions.

I could waste time thinking about what I should have, could have, or would have done differently, but I’m not going to do that. The fact of the matter is, there are a lot of times that “You don’t know…..what you don’t know”. You find out things along the way that help you make better choices. You can’t go back, only forward, and use what you have learned in the future. I wouldn’t go back and change any of the events that happened, because then I wouldn’t know what know now.

I ended up meeting that physical therapist by happenstance, and I feel like I dodged a bullet because of it. There are several different unpleasant scenarios that could have played out here. I could have had an unnecessary surgery gone wrong. I could have ended up dependent on prescription pain medications or injections. If I hadn’t learned about pain science, I may have ended up as a chronic pain patient, living in a terrible vicious cycle. Instead, I went to physical therapy and met a smart PT who helped me learn how to help myself. I am very grateful for that, and now I have a healthcare professional I trust who I can use as a resource.

If I have to be totally honest here, I’m pretty sure I initially went to physical therapy out of pure spite towards that neurosurgeon, because he said it wouldn’t work. This will probably be the only time in my life where being spiteful actually worked in my favor! Regardless of how I got there, I made it to that first appointment, continued going, and learned the value of what physical therapy can do for a person. I may have shown up on that PT’s doorstep looking like a “train wreck”, but I left that experience with the information, education, and tools that are going to help me stay “on track”……..and the rest is history!

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