Help! Why Am I Not Getting Better?
Seven questions to help you recover
Photography: Wallace Chuck
Few things are more frustrating than a body that doesn’t comply with our plans to have it function perfectly, despite ongoing neglect. If you think I’m being facetious, you’re right, kinda. The truth is that we do tend to neglect our bodies a bit, and tend to prefer to focus our energy on more urgent matters. Until our bodies signal an urgent need for help, that is.
If you’ve suffered from an injury or ailment, have sought help and started on the path to recovery, good for you! If you’re well on your way to recovery, even better. If, however, your pain has been your unbidden guest for a while, and shows no sign of an impending departure, it may be time to consider whether you’ve done all you could have to support your recovery and return to full, pain-free function.
Seven questions to help you get better
1.Do you understand exactly what it is that is going on? Here, “exactly” does not refer to a diagnostic label, but the pathological process and its roots. Do you have “knee pain”? A term that simply tells you where the pain is located is not specific enough to guide you to the correct interventions. What part of your knee? What is this part (bone, cartilage, meniscus, bursa, ligament, kneecap, tendon? Why is it ailing? How does the rest of your body contribute to the ailment? Inform yourself with the help of a knowledgeable healthcare professional willing and able to teach you. Ask for additional literature to read. Ask questions to make sure you’ve understood correctly.
2.Have you started on the initial steps to recovery, unloading the painful tissue by decreasing the aggravating activity until the worst irritability subsides?
3. Do you know how to adequately support your body while it’s recovering? Do you know how to support your sleep and cover your nutritional bases? Do you understand how your specific situation and circumstances affect your body’s ability to bounce back, and how to address your particular issues? Are you in menopause/andropause, underweight, stressed, hypermobile? Do you follow a restricted diet, suffer from a lack of deep sleep, work the graveyard shift? Are you overweight or limited by previous incompletely healed injuries? All of these unique circumstances can affect your rate of healing, and can be addressed through specific interventions.
4.Have you had a thorough physical therapy examination, initiated your therapeutic exercise program based on this evaluation, and been consistent throughout, performing your exercises at the frequency, for the duration, and with the load that was prescribed? Seeing an orthopedic surgeon is a way to explore the potential appropriateness of a surgical intervention, and perhaps to get a biomedical diagnosis. A physical therapy evaluation will also give you a diagnosis, but also uncover the underlying dysfunction that has led to your ailment, or is prolonging your path to full function, and help you address it. Again, the importance of consistency cannot be overstated.
5.Have you progressed your exercises appropriately? The simple exercises you may be prescribed in the beginning can rarely take you all the way to your goal. As your strength, mobility, tissue resilience and skills grow and develop, you need to progress to more demanding and more complex exercises that will help you move through the recovery process.
6.Have you appropriately taken into account what type and level of activity you are preparing your body for? Our bodies are marvels of adaptation. Why do astronauts lose bone mass so rapidly in a zero-G environment? Because their bodies are skilfully adapting to a world without gravity, a world without the need for strong bones. Why won’t your hips straighten fully anymore? Because your body has adapted to a sitting posture. If you would like to be able to tolerate physical activity, you need to first help your body prepare for it, and physical therapy is the discipline that specializes in this process.
7.Do you think you’ve recovered, only to find out that you haven’t — with the same old problem cropping up again and again? You may be making one of the most common mistakes — using pain, and the absence of pain, as your gauge. Pain is actually a lousy measure of how well or how poorly you’re doing. For example, your teeth may be pain free, but your dentist still finds a cavity. When symptoms appear, problems have usually been brewing for a while, and when symptoms disappear, you are not necessarily fully prepared for every activity you’d like to participate in. As a matter of fact, there are many tests that look for certain deficiencies — in range of motion, strength, balance etc — that are known to predispose us to injuries. If you drop out of your rehabilitative process without addressing these problems and fully correcting them, you are putting yourself at risk and will more likely than not, unfortunately, have to pay the price in the future, either through a return of the original problem, another acute injury, or gradual degenerative changes in the body. These changes are likely to leave you limited in your tolerance of physical activity well before time, and it is therefore well worth the effort to address them.
Not everyone can heal from everything. Sometimes the damage to the tissue may be too great, the injury too far gone. But you will never know the true potential of your body to recover if you haven’t given your recovery 100%. Aren’t you curious to find out how well you could feel at your best? And since the body you’re in is the only one you have, why not give it your best effort?
About the author: Lilian Holm, PT, DPT is a doctor of physical therapy in private practice in Evanston, IL. She specializes in orthopedic and chronic pain conditions and hypermobility disorders. She is passionate about maximizing your health and function. She can be found at https://www.lilianholm.com/ as well as on social media.