Patient Misconceptions In Physiotherapy (Part 2…)

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Following on from Part 1 (Misconceptions 1-5), we conclude with misconceptions 6-10…

  • “Pain Equals Harm”

While this is an entire (future!) blog in itself, pain can be somewhat simplified. Pain is quite often not the result of harm, instead it being a “warning sign” produced by the brain to make you aware that you ae doing something to which the body is unaccustomed, hence potentially harmful. Pain is produced to either force you to consider the wisdom of your actions, or to force you to stop. The key when receiving physiotherapy is to gauge for oneself whether the activity being undertaken is actually likely to prove harmful, or is it simply a case that stiff joints are being moved, weak muscles are being worked hard etc. If so, continuing with the exercise within the pain parameters outlined by your physiotherapist, will eventually regain normal tissue state and biomechanical function, with which typically comes a reduction in symptoms and pain levels.

  • “Bending Forward Is Bad For My Back”

Generally, nonsense! Bending forward is an absolutely natural movement. Was it not, we simply wouldn’t be physically able to bend forward. It should be explained however, that repetitive or excessively prolonged periods in a bent/flexed position will see our body incur sub-optimal loads, and over time this can lead to pain in the implicated areas. Sitting for hours at a desk or driving can therefore prove problematic over time.

It is important to stress however that forward bending should not be avoided, rather practiced to improve technique and quality/control of movement. If your back struggles to bend forward to any great depth due to weakness or instability, then it makes perfect sense to go and essentially become better at bending forward, so as to reduce the likelihood of future problems. Such “re-education” of bending technique is typically overseen by a physiotherapist.

  • “I’m Getting Older, I Should Curtail My Activity Levels To Protect Against Injury”

No, no, no! Quite the opposite! As we age, it is by remaining (relatively) active that we actually maintain the physical capabilities to undertake not only leisurely activities, but also the general day-to-day tasks of climbing stairs, carrying shopping, playing with grandkids etc. While we do reinforce the need for any exercise undertaken to be graded and of challenging but manageable intensity and duration, there can rarely (if ever!) be justification for actually ceasing any form of exercise. The list of both physical and psychological benefits, endless and varying, are well documented.

  • “I’m Injured, So I Should Stop All Forms Of Exercise Until I’m Better”

Perhaps somewhat of a traditional viewpoint, this approach to injury management and rehabilitation has been shown to be massively outdated. As much activity and exercise as is reasonably tolerated should always be encouraged. Total rest is counterproductive, as the lack of loading will lead to weakening, tightening, and loss of endurance of the injured tissues, thereby prolonging the overall recovery time as reconditioning of these further weakened tissues must then also take place once pain levels have resolved.

Continuation of modified exercise is vital in seeking prompt recovery and return to sport, but this modification is key. Cross training is an option, where running is replaced by swimming or cycling for example. Simply reducing the duration of loading is another option we often use – if Achilles tendon pain presents after approximately 4 miles, then it is absolutely acceptable to run perhaps 2.5 to 3 miles while recovery takes place. Matching the level of exercise undertaken to the stage of healing is key, serving to ensure the injury gets a chance to recuperate, while also maintaining tissue conditioning.

  • “My Mattress/Number Of Pillows Is Causing My Pain”

Unless you tend to seep in some bizarre positions with a remarkably unforgiving mattress or pillows, there is little evidence to suggests any link between injury and bedding. This is despite what all of these orthopaedic mattress salespersons may say! Generally, whatever is most comfortable and enables a good nights sleep is probably a safe choice!

Liam