How to tell if physical therapy is working

This may seem like a funny question to ask, but plenty of people ask it. There's the obvious answer: You get better! 

Unfortunately the answer to this question isn't always straight forward. Recovery can depend on how recent the injury occurred and if you've been pushing through pain for a long time prior to seeking (or during) treatment. It will also depend on if you're getting the right kind of treatment. It's easy to get discouraged, especially if you've been dealing with the pain for a long time. 

For acute pain which has been present for days or a few weeks you can often see rapid progress, sometimes even after just one treatment! Pat yourself on the back for grabbing the bull by the horns and taking control of your pain early on! 

With appropriate treatment and as long as you follow the plan you should see steady progress. More severe injuries can still take a while but in general it won't be hard to see progress. Keep in mind that most tissues should heal (under ideal conditions) in 4-6 weeks. Bone healing takes a bit longer, 6-8 weeks. 

There can be underlying factors that caused you to become injured such and muscular weakness. Even though your pain may go away, it takes time to build strength, so be patient AND consistent with your exercises.

Your progress will be delayed if something is repeatedly aggravating your pain. 

For Chronic pain that has been going on for several months or more you need to take into consideration that your condition gradually worsened over a long period of time. Had you come in when your pain first began you probably would have seen more rapid progress and resolution (tisk tisk!) 

For many people, improvement will be a roller coaster ride with ups and downs. One day you'll be feeling great and singing praises to your physical therapist as some kind of miracle worker.  

The next day you may have a flare up and curse your physical therapist as some kind sadistic witch doctor (we get called a lot of things). 

Don't get discouraged! On your good day you were probably feeling so good you decided to conquer the world and tackle that giant to do list that you've been in too much pain to do, or maybe you decided to try running again. Maybe you even felt great while doing these things but the next day you're hurting so much you feel like you're back to square one. 

This is a common cycle when rehabbing an injury. If you're on the right track you'll notice that you seem to be having more good days than bad days. Your pain will still be there but not as intense, or you may forget about the pain for a while. You'll still have bad days (frustrating, I know) but try to see the big picture. Think about where you started and where you are now. Make sure you're following the plan. 

If you take an honest look at your situation and see that you've made no progress or even gotten worse after several visits then something needs to change. You may be doing too much, or too little, or you may need to see a different therapist, or sometimes a different type of provider. 

Here are some tips to ensure you make good progress:

• Consistency is the key! Consistently doing your prescribed exercises will help immensely! Only doing them during your office visit is not nearly enough. 
• Don't push through the pain! This will only perpetuate the pain cycle. Be as active as you can without increasing your pain. Your body NEEDS movement, but too much will just make the pain worse. If you hurt worse the next day you probably did too much. There are times when you should push through some pain, but this is not usually the case.
• Communicate with your therapist. Communication will help identify problem areas, trends that may be killing your progress, or the need to pivot and try something new. 
• Find a physical therapist that listens and can spend enough time with you. If your PT seems too rushed or you spend most of your time with techs or aides you may not be getting the quality of care that you need for optimal improvement. 
• Keep a positive attitude, think about what you can do and not what you can't. Our thoughts and emotions heavily influence how our body responds to treatment. Negative thoughts and stress are killers, literally!