Thanks Jon for the review. Means a lot when people give such nice feedback. The different approach he talks about is actually assessing him as a whole and not just the painful body part!
It also includes education about the potential cause of pain (acute injury with tissue damage v chronic pain with central sensitization- Read more about this here, v overload of tissues from poor posture/ altered biomechanics An example of different causes of knee pain). Advice about ways of managing the pain (posture, pacing, exercise) and specific exercises can be given to help both in the short term and long term.
One of the most important things I want my patients to understands is their pain (from whatever cause- Different types of pain) as once they do this it can de-mystify their pain, gives them power to start making positive changes to their pain management and most importantly reassures them. Research shows that there are several 'yellow flags' which can effect peoples recovery. Here are some examples-
Catastrophising (thinking the worst)
Finding painful experiences unbearable (reporting extreme pain disproportionate to the condition
Unhelpful beliefs ("if I bend forward my disc will be pushed out", "my knee is crumbling", "i cant go back to work or my pain will get worse", "if i just push through the pain it will be fine- no pain no gain right?")
Becoming preoccupied with health, overanxious, distressed or low in mood (constantly thinking about the pain and how it means you cant do things)
Fear of movement and of re-injury (eg fear of bending forward as thinks is bad for my back Check out my post about this)
Uncertainty about the future holds, fear of poor prognosis and will never get better
Reliance of medication, doctor reviews, scans, XRAYS
Expecting others to solve the problem
This is why I find the education and advice part of my sessions as important as the manual therapy and rehabilitation as a physiotherapist. All of the above can happen in any injury or with pain, here are some (real life!) examples:
- the professional footballer may become overanxious about their knee injury and how it may effect their next contract
- the tennis player might not want to go back to the powerful serve he had before his shoulder injury in case he injures it again
- the postman might not want to go back to work as he feels carrying and lifting is back for his back, - -the housewife may ignore her pain to clean the whole house but they be in agony for days which she gradually gets better before beginning the cycle again.
Its so rewarding when a patient comes in and tells you that you have dramatically improved their quality of life.