Therapy Hurts!?!?

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Many people ask, “If physical therapy is supposed to help me feel better, why do I hurt so much after therapy?”

Very good question. Let’s just look at a typical muscle strain that a person may have had for 3 months and is now affecting their daily activities. Many times when we have injured muscles, those muscles become tight and weak. When we continue to perform the same activities, the surrounding muscles begin to get overworked and also become strained.  During this time the body protects the injured muscle by preventing it from working.

Now that the person comes to therapy and gets the injured muscle worked on and starts to perform specific exercises for the muscle, that causes increased lactic acid build up which causes more irritation.  The surrounding muscles are also affected and they too develop irritation and pain.  That is why it is important to apply ice after therapy to decrease some of the symptoms that will occur.

That being said, the therapist should also evaluate the amount of irritation that has been caused and adjust the level of activities accordingly.  This will facilitate a more comfortable rehab process.

Once the muscles start to stretch and get stronger, the amount of pain should decrease and activities start to return to normal.

Hope this helps!

It seems this is a popular question and needs a little more insight.

Let’s look at 3 common pain producers in physical therapy:

1. overworked muscles

The most common cause for increased pain in therapy is due to an overworked muscle.  A patient will come into the clinic with no complaints of pain.  The patient will workout under supervision of the therapist and leave the clinic feeling fine.  But once they get home, they will feel that they are worse now than before.  In this case, try to apply ice to the irritated muscles and rest.  Contact the therapist to notify him of the issues that you are having.  This means that you did too much too soon.  But, at least now you and your therapist know where your limits are.

2. irritated nerves

Physical therapy will challenge your positions and postural stability.  Doing this can irritate your nerves.  Hopefully, you and your therapist have identified the position that provides the most relief of your symptoms.  Find that position and try to take a moment to stay in that position to allow pressure to decrease from the nerve. Usually, a good position for lumbar nerve irritation would be to lie on your back with pillows propped under your knees. It is also a good idea to apply ice to that area because of the inflammation that may be present.

3. inflamed  joints

You are having therapy to improve your mobility. So, it is important to take your joints to the limit.  Unfortunately, this will cause more pain.  This is another case where it is important to know the position of comfort for that joint. Rest in that position and apply ice to it.  A position of comfort for the joint is usually a slightly bent position (if possible).

When icing, make sure not to apply ice directly to the skin as it may cause irritation to your skin.  A good way to ice, would be to put ice in a plastic bag or get a bag of frozen peas and put the bag in 1-2 pillow cases.  Ice should not be applied more than 25 minutes at a time.

All this being said, it is NOT the goal of therapy to put you in pain.  The goal of physical therapy is to help you reach YOUR goal.  It is important to report all symptoms to your therapist.  This will give your therapist more information and she will be able to make changes and provide a more comfortable and successful rehab for you.

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