Owner- Jenna Siracuse Loewer, DPT  
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       Haymarket, VA 20169

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Managing Pain through Physical Therapy

June 12, 2016


As a physical therapist, I hear a lot of interesting things from patients. One of my all time favorites is when the rotator cuff is referred to as the rotor cup..... but this is besides the point! What I really want to talk about is the other thing I hear all the time--  "I have a high tolerance for pain". You would be surprised at just how many of my patients tell me this. It's almost as if they wear it as a badge of honor, like it is a good quality to have. I have to be honest with you, its a terrible quality to have! When did it become OK to accept pain as a normal thing? Let me be the first to let you in on a little secret-- one of the first things you learn in PT school is that pain is not normal. It is your body's way of telling you that something is wrong or about to go wrong. So of course it is not a good thing for you to tell your therapist you have a high tolerance for pain, because that means you have probably accepted it as something you "just have to deal with" and I am here to tell you, it most certainly is not!


I have found that especially in the dance world, pain is a widely accepted fact of life. And what is even more upsetting is that dancers are expected to fight though it, because it is "normal" for dancers to have pain. I know that dancers are not alone in this, and the same mentality is found among a wide range of other athletic populations as well. Somewhere along the way our perceptions of pain have become distorted. I am sure you have all heard the quote "No pain, no gain". I am not sure why or how this thinking started, but it is time to educate people on the proper way to train. Working hard and feeling fatigued after a good work out is very different from what pain is in its true sense. Learning the distinction between "good pain" and "bad pain" is an important concept that can have a huge influence on your overall health and wellness. 


Injuries obviously do happen, especially if you are an active individual, but rather than accepting it as the norm we need to focus on better management and prevention. It makes no sense to wait until the pain is limiting you so much that you cannot move or have to miss a day of work. Instead, we need to focus on preventing it before it ever gets to that point. It is so much easier to prevent the problem than it is to try and fix it after the fact. 


In one form or another, you have probably experienced pain in your lifetime. What's the first thing most of us do? Reach for the bottle of aspirin and keep on going. Really, this should be the last thing we do. Most of the same patients that are telling me they have a high pain tolerance are usually also taking some form of pain killer.  Physical Therapy has been proven time and time again to be one of the best ways to conservatively manage pain. It has been proven superior to pain medication because it addresses the cause of the problem and produces a lasting effect, versus the "band-aid effect" you get with medications. I won't bore you with a million research studies, but go ahead and do a quick google search and see what you get!


Especially with the national opioid crisis at center stage, there is no better time than now to be spreading the word on how Physical Therapy can help conservatively manage pain. Exercise is truly the best medication. Instead of reaching for the bottle of pain killers to hide your pain, call your PT and have them prescribe you exercise instead. This is what Physical Therapists specialize in, and I can promise you they will be able to find at least 1 exercise that gives you immediate relief. Yes, it will take longer for your pain to completely go away but there really is no quick fix for this. We live in a world of "I want it right now", so this is a hard concept for people to accept. But if you stay compliant and do what your PT prescribes for pain relief, I can promise you it will be worth it in the long run.


My suggestion to anyone reading this would be this-- if you start to feel that something is uncomfortable and bordering on pain, that is your cue to seek out help from a Physical Therapist or other qualified health care provider. Sometimes I think that people don't want to admit something hurts because they are afraid it means they will have to stop their activity. That is NOT always the case. Sometimes it is as simple as adjusting your movement patterns or needing to stretch/strengthen a certain muscle to allow you to produce a movement without pain. The list of possibilities is endless but unless you seek out help from someone who is qualified to identify these things, you may never know. Accepting the pain is the worst thing you can do for yourself. 


Another important tip: if you are not sure if it is something you should seek help for... That probably means you should seek help for it! All the time I hear "I waited 3 months because I just kept thinking it would go away". This makes all the PT's in the world shed a tear, because we know we could have helped you at the first sign of a problem and you would have not had to suffer for the past 3 months. 


Even if your pain has magically disappeared overnight, you should still make a PT appointment. There is plenty that a PT can do for you even if you do not currently have pain. There is something that caused you to be injured the first place, and most likely pain will come back if you don't learn how to prevent it. Spending time up front to address potential problems makes far more sense then suffering from your 10th sprained ankle. 


There is still so much we don't know or understand about pain and the research is ongoing. I certainly do not have all the answers but starting the conversation is so important. I hope that if you are reading this you will think twice the next time you feel pain, and instead of popping medications and accepting it you will seek out the right way to get relief. 


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