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When Nothing Seems To Be Working

When Nothing Seems To Be Working

What if you are doing every thing right in your rehab but you don’t feel any better?

 I am sure some of you will identify with this feeling.  You are going to your Physio, you are doing the exercises they have given you, you have modified your training regime, perhaps you’ve even had some time off but that injury or pain you feel doesn’t seem to be improving.  What should you do next?

You might say this is a bit of a follow up post from the one I wrote previously where I discussed the “Phases of Rehab” rather than time frames. If you haven’t checked it out read it first to ensure your approach to your injury has been one that will yield success. Assuming you’re all up to speed, what happens if you aren’t getting the results you want from physiotherapy?

 

Getting a scan

 This is quite often our first port of call when we aren’t yielding results in Physio. It’s often a way of ensuring that the pathology matches the presentation. Unfortunately, scans can have their limitations as the results don’t always match your presentation, and sometimes the abnormalities identified are a normal part of ageing.   Furthermore, not all pathologies are seen on scans.  Having said all of this though, scans can be a useful piece in the puzzle to ensure there is nothing more sinister going on, to help ensure we are on the right track and often they can be re-assuring for the client.

 

 

Trying another Health Professional

 

It almost seems counter intuitive that I would write a post suggesting you go to see another Physio or another Allied Health Professional but we all come with our own skill sets and experiences – even within the same clinic, and sometimes a fresh pair of eyes from a colleague or a more senior Physiotherapist is exactly what you need. It’s all about achieving the best outcome for you.

 

Specialist Referral

 Sometimes we get the diagnosis right, the rehab protocol right, but your progress is very slow. This might be the time for a Sports Physician or Musculoskeletal Specialist point of view.

They ensure you have the correct diagnosis, the correct rehab protocol and might even be able to offer a range of interventions such as injections to help the process or assist with your pain. If necessary, they also have the ability to refer you on to some of Brisbane’s best surgeons.

 

Pain Relief and Injections

 

Sometimes when a structure is quite irritable, it can be difficult to rehab without flaring up your pain – even if the dosage of your exercise is low. In order to assist with the pain you may experience during exercise, pain relief can be prescribed in a variety of forms to help facilitate your rehab. One of the more popular prescriptions for musculoskeletal pain is corticosteroid injections. Results with injections vary greatly from person to person. You might get complete relief, or it might make it worse. If you do get success from an injection, great, just be mindful that there is a degenerative component associated with too many injections, and many doctors won’t inject the same structure more than three times for this reason. It’s also worth mentioning that because of this risk, you may have to rest completely from 10-14 days after your injection. This is to reduce the risk of rupture or damage to surrounding structures.

 

Surgery

It’s by no means the easy way out and most people are pretty aware of the lengthy rehab process that occurs after surgery. Often we have a medical diagnosis (for example, a rotator cuff tear) and a movement diagnosis (excessive/limited rotation of the shoulder) and we need to address the medical diagnosis before we can address our movement limitations. It bares mentioning that like injections, results can vary from person to person and understanding your diagnosis and rehab time frames can go a long way to reducing the likelihood that you will need to go under the knife. During this process, maintaining your rehab and treatments as much as possible is going to ensure your prognosis after surgery is the best possible. Quite simply, the better you are before surgery, the better you’ll be after.

 

Complete Rest

It’s every athlete’s least favourite prescription, but sometimes you just need to stop! Your body just needs a break from the constant attempts to “fix it” while you continue to aggravate your injury in your chosen sport. It doesn’t work. Even the greatest athletes in the world have an off-season, why shouldn’t you?

 

So, don’t lose hope if you’re not kicking goals in rehab. Some injuries are more complicated than others and require multiple practitioners with multiple different interventions to work as a team to guide you through your injury plateau.

 

 

 

Written by

Daniel Morrison

 

 

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