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Updated: Sep 27, 2022

When most people have an injury and start Physical Therapy, the expectation is that you will get some massage, a little exercise and BAM- the pain will be gone as easy as that. While that might be the case for some of you, the real truth is the pain probably won’t go right away. This is 100% normal and in no way means you are not getting better. Sometimes you have to shift your mindset and expectations on what progress actually looks like.

Pain is a funny thing. It can feel like it comes out of nowhere in an instant, and then takes 5x as long to go away. In reality, most of the time it probably didn’t happen overnight, but instead your body was developing motor patterns and neurological changes over a long period of time that ultimately resulted in problems. As for fixing it? Well, it takes our bodies a long time to adapt to change, and therefore pain doesn’t magically go away with a few fancy exercises. You have to re-work those muscle and nerve connections for a while before you start to see any real progress.

Unfortunately, all too often I see patients stop going to PT too early because when the pain doesn’t go away immediately, they become frustrated and assume it isn’t working. Even though pain may have been your #1 reason for initially starting PT, I want you to consider the idea that less pain doesn’t always equal progress. So, if pain is no longer the biggest benchmark, how do you know you’re actually getting better??

For starters, FUNCTION is way more important than pain level. Yes, you feel pain and you want it to go away… but why?? Probably because it is stopping you from doing something you love- sleeping, playing soccer, dancing, picking up your kids, etc. People don’t come and see me for Physical Therapy because something hurts, they come and see me because they have lost the ability to do x,y, and z. Trust me, when you start looking at your function instead of pain level, it will seriously shift your mindset on the whole situation!

The other thing is, progress doesn’t happen all at once. It happens in little bits and pieces over time. You don’t go from jogging 1 mile to running a marathon overnight, you build it up, little by little, over a couple of months. Rehab is the same thing. Going from a 10/10 pain to 0/10 pain in 1 week or 1 month, may not be your reality and that’s OK. Shift your mindset of what progress is and you won’t feel like you are failing!

So here’s real life. This is what progress actually looks like:

  • Pain is still present but it went from an 8/10 to a 4/10 at its worst

  • Pain is still an 8/10, but you only feel it for an hour instead of all day

  • You can sleep through a full night, even if it isn’t every single night yet

  • You can reach the top shelf, there is pain but you can reach it now!

  • You can do squats 10x before pain, instead of only 5x

  • You can clean out your garage and realize it didn’t hurt while you were doing it, even if you are sore afterwards

  • You can run for 3 miles before your foot starts to hurt instead of 1 mile like last week

  • You can press 2.5 more lbs… and it didn’t hurt!

  • You were able to do the elliptical for 10 minutes. Sure, it isn’t running- but you could only do the bike 2 weeks ago!!

The real take-away here is that progress looks different for everyone, and having zero pain is only one tiny piece of the puzzle. It is completely normal for full healing to take a long time so celebrate those little victories!! Once you start adding up all the little wins, you will be amazed at how your mindset around your pain and injury changes. Go in with this expectation and I can promise that you won’t be disappointed!!


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