Request a consult

Pain Cycle vs. Healing

The Pain Cycle – when is it time to seek help?

Hi. Becky Austerer – Blanton here. I am here to talk pain to you today. Like when it is you need to seek help? The answer seems simple. I’ll get help when I hurt – or when I am injured and in pain, or when I can’t do the things I like. But is that true? Is that what we do? No. Here is what I normally hear.

Me – “so tell me how you got hurt”

The client “well, I was working out/playing with kids/painting etc and I hurt my shoulder and I kept doing what it was I did when I hurt it until I couldn’t do that any longer. Then I rested. And the pain went away until I did more painting/playing/throwing and then the pain came back. So I rested some more. I took some Advil. I stayed home from work a day or 2 because I am a contractor and that work hurt my shoulder. And then I found if I hammer differently the pain was ok and I could do my work as long as I didn’t throw a ball or paint. So I hired a painter. Anyway, now it hurts all of the time and I am not sleeping well. I mean it’s ok at work, maybe it’s getting better. I’m not sure. How long will it take to get better?”

Me – “How long has this been going on?”

Client –“About 3 months”


And I bet they want it better in 1 physical therapy visit. So I will go over not only the healing time table but also the injury one as well.

Here goes.

Your activities are in layers. Imagine it like this.

So on the outer layer of triangle, that’s where the things that you love to do are. Biking, playing ball with your kids, pitching, coaching soccer, running, lifting, you name it. The middle layer are things like watching games on uncomfortable bleachers, light housekeeping, cooking, grocery shopping – you know – stuff you HAVE to do but don’t necessarily like. Mow the lawn, laundry – you know that stuff.

The middle layer is the easy stuff- sleeping, sitting on the couch, relaxing, going to the movies if the seats are comfortable, watching TV. Stuff you can do no matter what, even if you are sick. Things that require little to no effort or movement.

SO you get this stiff back. It hurts a little, but only in the morning. It bothers you enough that you don’t want to go walk with your neighbor before work, but after an hour or so, it loosens up. You feel better at work. This goes on for a month.

Your husband wants to start going to a gym, but that morning pain bugs you. You don’t want to make your back act up so you decline his invitation – so no gym for you. So now you are not walking with your neighbor and you won’t go to the gym with your husband. Then you hire someone to put the flowers in your flower beds because Saturday morning the pain was really a little worse. You see where this is going? You are starting to lose the outer layer of your triangle.

So now you are only really doing things that you HAVE to do. But one day when you are watching your 3 year old son and doing the laundry, you reach into the washer and you throw out your back. Now you can’t move. You are stuck bent over. You walk to the couch and you lay down for a while (this is something you should NEVER do, by the way.) Now you have lost even the middle triangle. How long will you lose this for? A day? A week? And how many times this year will this happen? Will you always have chronic back pain? Maybe. Maybe not. But you are going to constantly worry when you pick up your child or do your laundry. You are always going to have this pain in the back of your head and live in fear. Is this how you want to live? Going to the park with your kids wondering if bending down to get the diaper bag out of the stroller is going to mess you up? Or worrying that pushing the lawnmore out of the garage will trigger your pain? Make you miss work? Make you miss wrestling matches and cancel vacations? You laugh. You say ‘oh that won’t happen to me” but we’ve seen it and heard it. It happens.

But therapy is expensive. I don’t have time for it. 3 times a week for 3 weeks? 2 times a week for 2 weeks? That’s a lot. 50 dollars a visit? 35 dollars a visit? But my deductible.

Those are all true things. What is the cost of a missed flight? 300.00? 600.00? What’s the cost of missed work? 200.00 a day? How about a missed kindergarten graduation? Ahhhh. Priceless. A missed date? A missed golf game with your son who is in for 3 days? What is the worth of worry? Stress?

So money and time. I understand – but physical therapy is averages about 10 hours of your time – sometimes a little more – sometimes a little less. But let me tell you why.

You come to us in excruciating pain. It takes us 3 visits the first week to get you from a 9/10 pain to a 4 so we can actually work with you. The next week we focus on managing pain reduction. The third week – visits 7, 8, 9 we introduce some strength training and postural retraining and see how you handle that.

Your pain rises a little, but not much. 10-14 visits we solidify the strength, fix your posture and give you a home exercise program. And you are done. You are pain free, have the tool kit to manage the pain if it does come back a little, you have the confidence to resume your activities and get your outer triangles back. Things are good. And you like us and trust us so if you get hurt again, you know where to go and what to expect.

The moral of the story here is that 14 visits can be 6-10 if you come in before you lose your outer triangles. And guess what? You did it without 9/10 pain. You did it without missing that trip. You did it without missing that band concert, playing golf with your son, and without missing your nieces wedding. No one is disappointed in you. No one is angry. Your bank account takes one small hit instead of several large ones – your boss is happy. And your body is happy because it is a little bit heathier than it was last month. So come in before the stiff back is stuck on the couch. Oh.

And click the link down below to see my video that will tell you why you should never lay on the couch when you hurt your back…