Focus Physical Therapy

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I Thought It Was Better... But Then It Came Back

I had a patient come in with knee pain, knee cap pain, tendinitis, pain with working out and pain with stairs. They came in and did well with physical therapy, but they had the question of “where are we going? What is the expectation as far as physical therapy and the knees? How should I feel once I get to a certain point?”

The hard part about that question is, in healthcare we assume that when we get treatment we’re going to get a total fix. We’re going to get all the way better after doing A, B and C. That’s really not how things go across the board – especially with musculoskeletal conditions, knee pain, back pain and shoulder pain. We don’t cure anything. There is no cure. Even surgeries aren’t a cure. What we have to talk about is what our actual expectations are.

In this case, for the knee, we want to get pain-free walking, pain-free stairs and being pain-free. At rest, those are things that we should get better no matter what. Despite that, we also have to make the next step which is maintaining good soft tissue mobility, maintaining good flexibility and getting the strength where it needs to be to handle what you want to do. Then you have to work toward maintenance of that.

What I mean by that is you’re going to have to learn all of the exercises. You’re going to get to the point where you feel better and you still have some issues off and on. That’s okay because you learn how to take care of it.

The main expectation long term is that, yes, it’s okay to still feel it a little bit sometimes. Maybe some achiness, maybe some tightness – that’s going to happen. You’re not going to get to the point where you’re 25 or 15 again. You’re going to get to the point where you feel really, really good! You can still do most everything you want to do! You might still feel it here and there, but that’s okay. You learn how to take care of it. You use the resources you’re given, whether that be physical therapy on a maintenance schedule or doing soft tissue work on your own, exercise on your own, all these tools you’ve been given.

The main expectation needs to be that you’re going to get better, you’re going to be able to do all of the things you love, but it’s not cured. It’s something you have to take care of forever and it’s okay to still have some pain or some discomfort along the way. You’re just never going to be 15 again so I hope this helps out. I know it’s confusing, but if you have more questions about what your expectations should be, talk to us! If you have the wrong expectation, thinking you’re going to be magically cured, you’re setting yourself up for failure. Again, no matter what you get done, whether it be therapy, injections, surgery or whatever, you’ve really got to have realistic expectations and be prepared.