Physical therapy is widely recognized as an effective and safe treatment, helping individuals regain function, manage pain, and improve physical well-being. It plays a significant role in recovery from injuries, managing chronic pain, and rehabilitation after surgeries. Despite its proven benefits and safety record, a common concern is whether physical therapy could inadvertently worsen an existing injury. While uncommon, understanding how an injury might worsen during therapy is a valid concern. Physical therapy aims to reduce pain and improve mobility, but certain factors can sometimes lead to setbacks.
How an Injury Might Worsen During Physical Therapy
An injury might worsen during physical therapy due to factors related to the treatment or the patient’s condition. An inaccurate diagnosis or an inappropriate treatment plan is one reason. If the underlying cause of pain is not correctly identified, prescribed exercises may not be suitable, potentially worsening the issue. This can lead to increased discomfort or further damage to the affected area.
Another scenario involves inappropriate exercises, excessive intensity, or progressing too quickly through rehabilitation stages. Physical therapists tailor plans to individual needs, but pushing a patient beyond their current physical capability can result in muscle strain, joint pain, or re-injury. Overexertion or exercises that are too strenuous for the specific injury can stimulate an inflammatory response, causing increased swelling and pain. Lack of communication between the patient and therapist about pain levels can also contribute.
Patient actions, such as not following instructions or overexertion outside supervised sessions, can also lead to setbacks. Performing home exercises incorrectly or pushing oneself too hard without guidance can counteract the benefits of therapy. Unforeseen medical issues or pre-existing conditions, like undiagnosed arthritis or nerve damage, can also cause the body to respond unexpectedly to therapy, potentially worsening symptoms if not accounted for.
Recognizing Signs of Worsening Injury
Distinguishing between typical post-exercise soreness and signs of a worsening injury during physical therapy is important for effective recovery. Normal muscle soreness, often called Delayed Onset Muscle Soreness (DOMS), presents as a dull ache or stiffness that usually appears 12 to 48 hours after activity and resolves within three to five days. This soreness indicates that muscles are adapting and strengthening.
Signs of a worsening injury, conversely, are more severe or persistent. Increased or new pain that is significantly worse than before therapy, pain in a new area, or pain that lingers long after a session can signal a problem. Sharp, stabbing, or intense pain, especially during movement or at rest, is a concern, differing from the burning or fatigued sensation of sore muscles.
Other indicators include:
- Increased swelling or inflammation, alongside redness or warmth around the injured area.
- A noticeable reduction in the ability to move the affected body part or increased stiffness.
- New or worsening neurological symptoms, such as numbness, tingling, weakness, or radiating pain.
- Unusual sounds or sensations like popping, grinding, or tearing during exercises.
Patient Actions for Safe Recovery
Patients have an active role in minimizing the risk of their injury worsening and ensuring a safe, effective recovery. Open communication with the physical therapist is important. Clearly articulating pain levels, discomfort, and any changes in symptoms, even subtle ones, allows the therapist to adjust the treatment plan. This feedback helps prevent overexertion or inappropriate exercises.
Patients should actively ask questions about their treatment plan, the purpose of specific exercises, and proper form. Understanding what to expect during and after sessions, including anticipated discomfort versus concerning pain, empowers individuals to engage safely in their therapy. Asking about movements or activities to avoid is also beneficial.
Listening to one’s body and distinguishing between therapeutic discomfort and sharp, worsening pain is a learned skill that protects against re-injury. It is important not to push through sharp pain, as this can exacerbate an injury. Adhering to the therapist’s instructions for exercises, repetitions, and rest periods, both in the clinic and at home, is essential for consistent progress.
If concerns about progress or worsening symptoms persist, or if there is a lack of improvement over time, seeking a second professional opinion can provide additional perspectives and potentially lead to a more suitable treatment approach. Report any concerns promptly to your physical therapist, as early intervention can prevent minor issues from becoming significant setbacks.