I have always loved working as a physio in rural areas, particularly farming communities. Many of the people I see there are farmers, and farmers typically have little time for frivolity, or time away from work. That being the case, I find I am more likely to be trying to convince those patients to slow down, take it a bit easier in their rehabilitation efforts, work with the things that seem to make the situation better, than exhorting them to do more, work harder, work through the pain.
A large part of getting the injured individuals to slow down, is trying to get them to listen to their bodies. This same advice is good for athletes, weekend warriors, and the “man on the street” who is trying to fix a musculoskeletal problem recently acquired. The basic point of the advice is that your body most likely already knows what it needs to repair itself, and what it needs to avoid to prevent aggravating and injury or obtaining a new one.
The examples abound around this issue, but some common ones are:
1. most commonly, having continued pain or disability for some time (week, month, longer) but ignoring it, or convincing oneself that it will still go away
2. applying strong physical effort to a project past the point of fatigue so you muscles no longer provide the necessary support for joints
3. recognizing that certain movements make the injured area feel better, and certain ones make it feel worse
4. pushing through pain during competition, working to completion, or just through plain stubbornness.
The above do not complete the list but offer enough examples to bring the grin of recognition to many faces. People with musculoskeletal injuries or conditions can make their situations much better, or much worse depending on whether they listen to what their bodies are telling them. Particularly, people who have had surgical repair need to listen to what their body is telling them about the state of the repair and whether they are likely making the situation worse by “pushing through” to speed up recovery (impatient patient syndrome). Later articles will cover things like how much time it takes for various different tissues to heal and what exceptions there might be to these generalizations, but for now, listen to your body, it’s trying to help.
These comments are general in nature. Be sure to check with your physio or doctor if you are not sure whether they apply to your situation.
David A Rohe, MPH, PT, MNZSPT
Dave Rohe is a recently retired physio having practiced in New Zealand since 2004. He originally qualified in the USA, subsequently practicing in Malawi, Egypt and Cambodia prior to emigrating to New Zealand in 2003. He has enjoyed management positions in pediatric and adult outpatient facilities as well as taught physiotherapy for 15 years at the University of Georgia. He is currently living in Parakai with his wife, Sharon Robinson, a local midwife, near his adult children who are working, and one of whom is studying to qualify as a physio through the programme at the University of Otago. His articles previously appeared in local newspapers in Taranaki and on the blog site sponsored by NZSPT.