Treating Pain
To treat pain, it is a very good idea to try to figure out as best you can what exactly is wrong, where the pain is coming from, why the issue has occurred and what is exact best evidence-based recovery. The unnerving thing for many practitioners is to understand that it unusually in fact it is not the be all and end all. Let me explain. After years of study, practice, experience and research I have come to understand it is just as important, if not more important to communicate, listen, project positivity and confidence, educate and then encourage gradual exposure to exercise or movement, socialization, nutrition, sleep, hydration and stress management to name a few.
Knowledge of Rehabilitation
This is not to say your therapist doesn’t need to know what they are doing, to have a sound knowledge of pathology, pathophysiology, syndromes, disease, anatomy and biomechanics. In fact, these are essential so that we are in a position to be confident, educate and plan your recovery. It is with this this sound knowledge and experience we can analyze where you are in your recovery stage be it 30 seconds post injury or 10 years chronic pain and how to progress through your rehabilitation to get you back to your best. This is why I often find myself giving similar plans for different conditions. For example, a therapist cannot tell you with 100% certainty exactly what structure in your medial knee has been ‘irritated’, and neither can an MRI for that matter. However, a good therapist can tell with a good degree of certainty what is going on, ensure it is nothing serious and more importantly for the large majority of cases from your reactions and descriptions form a very good recovery plan. If it has been decided that rehabilitation is the route to go rather than surgery (which in my opinion it should be at least initially) then it is your description of what happened and how you have reacted since and will react to the initial plan that informs good rehabilitation.
Evidence Based
In fact, as stated above you might find your therapist and myself may often be giving similar advice for different injuries. To use the knee above, rehabilitation for a medial meniscus and medial collateral ligament injury might not be shockingly different. They should be thorough, gradual, methodical, suit your goals and include all the above but not necessarily chalk and cheese!
Thompson et al, 2002, assessed studies of soft tissue injuries of the knee, namely ACL, MCL and menisci and found ‘the available evidence for physiotherapy led rehabilitation of ACL, MCL and meniscal injuries is wide-ranging in terms of scope but insufficient to establish the relative effectiveness of the various approaches and methods in current use’. So, we as physiotherapists use wide ranging methods to successfully rehabilitate and the evidence supports this. However, these various approaches could not be analyzed to prove true effectiveness. It is for this reason I believe medial knee issues as an example may not be so different.
What does this mean to me or you?
Get a physiotherapist you trust to try figure out the seriousness of the issue. And then hope they communicate, listen, project positivity and confidence, educate and encourage socialization, nutrition, sleep, hydration and stress management to name a few. Then they should encourage exposure to exercise or movement thorough gradual, methodical and enjoyable rehabilitation.