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How Pain Works Part 1. All pain comes from your Brain

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Over the last 5-10 years we have learned A LOT about pain and how it works, but a lot of this is completely foreign to most people, so we’ve decided to produce a series of articles to help people actually understand their pain and what is going on… Firstly because KNOWLEDGE IS POWER! And secondly because understanding why you feel how you feel is empowering and dethreatening (as they say – just knowing is half the battle)

This is part one of a 5-part series on learning how pain works!

ALL PAIN COMES FROM YOUR BRAIN

Now intuitively we all understand that pain comes from receptors in our body. We have nerve endings all over our body that pick-up pain signals and signal to our brain that we are in pain, right?

Sorry but that’s actually wrong!

All pain (and all sensory experience for that matter) comes from our brain. Our body is providing millions of sensory input signal to our brain at all times, but our brain computes everything and then works out what to experience.

Then the OUTPUT from our brain is what we experience.

This makes sense when we compare what we may know about our other senses.

Our ears don’t hear sound. There are receptors in our ears that are sensitive to vibration of air particles, and when it picks up vibration of air particles those receptors then turn that into electrical information that is transmitted to our brain. Our brain then interprets that electrical signal and works out what we are hearing. What we hear is an output of our brain computing the signals.

Now we don’t hear everything the same. If you’re doing something else you might not hear at all, even though the vibrations coming into the ear are the same. So just having the receptors stimulated doesn’t mean we actually hear. It’s what the brain chooses to do with the input it receives that determines what we actually experience.

The same as our eyes don’t see – our brain sees from the information provided by our eyes. Our eyes bring in light and focus it on the parts of the back of our eyes. Light hitting those parts of the eye then stimulates electrical signals to the brain. (If you’ve read into this before you know that the brain actually receives the information upside down). Your brain has to interpret this information to then give you an experience of what you are actually seeing. If you’ve ever seen an optical illusion, noticed a blind spot or realise you can’t actually see your nose (even though it’s always in your field of view) you can understand that your brain interpreting the information it has available to it is what allows us to see.

(I bet you all just looked at your nose right now)

The same happens with pain as an input. Your brain is provided input from all over your body and it decides what you feel based on its own priorities (which we’ll cover in the coming articles).

So because of this, we know that pain isn’t just fixed or static, and more pain doesn’t necessarily mean more damage. It also means you can have a lot of pain with very little damage at all (have you ever seen someone scared of needles scream in pain before the needle even touched them??)

Knowing that pain is an output of your brain means that we can understand how we experience pain, and then help us to control our experience of pain.

Coming up in part 2, we’ll learn about pain as a warning system, rather than pain being an indicator of damage.

 

Julian Bowen

Julian is the Director and Principal Physiotherapist at EMC Physiotherapy.  He has spent  over a decade working exclusively in private physiotherapy practice, and estimates he would have performed over 40,000 individual treatments in that time. He has worked with everyone from Paralympians, elite athletes, WAFL Footballers, the Defence Forces and weekend warriors; to thousands of everyday people with all manner of issues.  He is passionate about injury prevention and has a special interest in the treatment of headaches, shoulder issues, hypermobility management and exercise rehabilitation for the prevention and treatment of injuries.

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The other top 3 mistake people make with their Physio Treatment

The other top 3 mistake people make with their Physio Treatment

I recently wrote and article about the top 3 biggest mistakes I see people make when it comes to approaching their pain and injuries. (you can check it out here)

so I thought I’d add the biggest 3 mistakes that I think people make with their physio treatment.

1. Not having a goal or a plan

Let me give you an example. A few months back I saw a lovely 78 year old lady who her GP had referred to us to help with her low back pain. Now she has had quite advanced arthritis and persistent back pain for 30 years. (not that arthritis always means pain, but in this case it was pretty severe). She said to me at the start of the session:

“I don’t know why I’m even here. You aren’t going to be able to fix my back – nothing is”

No she wasn’t exactly wrong. I can’t change her arthritis. But in many cases I believe that’s not the most important thing. I asked her

“In a perfect world – ideally what would you want to achieve out of your treatment with us? How is this impacting your life that you wish you could change?”

Her answer was “I just wish I could wish the dishes or vacuum the floors without having to stop, or sit down for an hour after because my back was hurting. If I could get to a point where I could do that I would be so happy”

This is a completely different goal, and outcome for her than “curing her back”. Realistically in this case it’s unlikely we will be able to get her completely pain free, but now we had a goal and a plan, and this was ABSOLUTELY achievable for her. We worked out a plan for some hand on treatment and a lot of exercise work to be able to build her up to a point where she could do those things. And you know what? she can vacuum the floors without stopping now. Once we had a goal and a plan we were able to work together towards impvoing her quality of life and getting her where she wanted to be.

2. Expecting Miracles

oh-youve-had-this-problem-for-2-years-tell-me-again-how-it-should-magically-disappear-in-1-session

The unfortunate truth is usually the longer you’ve had a problem, the longer it will likely take to resolve. This is because you get neurophysiological changes, more stiffness, more weakness, protective patterns, altered movement patterns, etc, etc.

(Happily the opposite is true too. A study in hamstring injury came out last year which found that if you start treatment within 48 hours of injury then, on average, you would get back to sport 2 weeks quicker than if you started treatment later).

Some problems can get better very quickly, but by and large it takes time and work.

for some reason people often have two conflicting view points. They are very concerned that their problem will never get better, but then they also expect it to be cured immediately. In most cases neither of these are true.

3. Not following through

Another unfortunate truth is that there is often a big difference between feeling “ok” and being actually 100% better. Pain is a warning system (and a very complex one at that) so it is unreliable to base our management entirely on if you have pain or not.

As a good example – we know that following an ankle sprain you are at 50% risk of re-injuring that ankle within the next 12 months. That’s 1 in 2 ankle injuries that are destined for multiple sprains! That’s a terrible outcome. (How would you feel if you got a new battery for your car but 1 in 2 of them would fail?)

BUT – if we ensure you do at least 6 weeks of neuromuscular retraining (that’s strengthening, balance and stability retraining) after the pain resolves then your chance of re-injury is more like 10%. It is actually irresponsible of us to not ensure that your are not only pain free, but back to 100% strength, movement and function AND ensuring the problem is not going to recur or become ongoing. Anything less is, I believe, poor management.

Now you (the public) don’t know these facts and statistics, so once you start to feel “ok” the motivation to continue doing the work can wear off. This unfortunately leave a large percentage of people who are out there only 70-80% better and likely to have further problems down the track. And it’s true that many health professionals don’t necessarily communicate these facts very well to help you understand WHY you need to keep doing the work (or having further treatment) once you are starting to feel ok.

If you were an athlete, and you suffered a hamstring injury – you wouldn’t stop all management once you could move around without pain and run. you need to be able to sprint from a cold start 100 times in a game, and jump, and stretch, and back that up with training every day or two, and keep that up for 6-9 months without a break. This is the difference between many elite athletes and regular people. Everyday people can end up with dodgy hamstrings (or knees, or ankles, etc) because they never get to fully rehabilitating their problem. Elite athletes do the full amount of work to give them the best chance of 100% long term recovery.

Bonus: Not doing your share of the work

The reality of life is people are busy (and a bit lazy) so we find a lot of people don’t get around to doing their homework. We may see you for something like 1/168th of the week, so that’s a very small impact we can have on your life time wise. That’s why you will often get ‘homework’ from your physio. Things you can do for the other 167/168ths of the week that are going to significantly accelerate your progress and mean optimal recovery and avoiding recurrence.

There was some research done over 15 years ago that showed that about 1 in 10 people completed there home rehab exercises! That means 90% of our clients aren’t getting the fastest or best outcomes because they aren’t holding up their end of the bargain.

Everyone who comes into the clinic just wants to lay down on the treatment couch and have someone else “fix”them. Sometimes there are issues that only require this, but usually there is some work to be done to improve capacity, endurance, mobility, strength, etc.

We help those who help themselves :)

(Actually we’ll try and help you even if you don’t help yourself at all… But it would make our job a bit easier if you do a bit too)

 

Julian Bowen

Julian is the Director and Principal Physiotherapist at EMC Physiotherapy.  He has spent  over a decade working exclusively in private physiotherapy practice, and estimates he would have performed over 40,000 individual treatments in that time. He has worked with everyone from Paralympians, elite athletes, WAFL Footballers, the Defence Forces and weekend warriors; to thousands of everyday people with all manner of issues.  He is passionate about injury prevention and has a special interest in the treatment of headaches, shoulder issues, hypermobility management and exercise rehabilitation for the prevention and treatment of injuries. 

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The Top 3 Mistakes People Make with their Pain and Injury

The Top 3 Mistakes People Make with their Pain and Injury

If there were a few pieces of advice that I would love to give to everybody to help them the most with their pain and injuries – the following would be it. These are big picture things that I end up talking to people about nearly every day.

For the most part these “top 3” mistakes aren’t going to cause anyone any serious harm (unless they miss a bad diagnosis) but these would save a lot of people a lot of time, money and heartache.

So below are the top 3 mistakes I think people make with their pain and injuries:

They don’t do anything at all!

Before I had kids, I would go to parties or gatherings, and nearly every night when people found out I was a physio, someone would ask “hey I’ve been having this pain in my (whatever body part) would you mind having a look at it?” (nowadays it’s more likely to be parents at school)

Normally one of my first questions would be something like “how long have you had it for?” and they would usually say something like “aw like 4 months” (or 2 years!?!)
Then I would say “wow you’ve been putting up with this for quite a while. Have you seen anyone about it?” and they would ALWAYS say “Nope”

And here’s the biggest issue I always see with people and pain. So many people are just walking around in pain and not doing anything about it. Some studies have estimated that 25-30% of people are experiencing musculoskeletal pain at any one point in time! How long do you have to put up with a sore arm before you decide you can’t put up with it anymore? Ow badly does it have to be affecting your quality of life before you get of the couch to do something about it? Or seeing as you’ve had this problem for 2 years it’s now a big, chronic complicated problem when it could have been a quick and easy fix 1 year and 50 weeks ago.

Sure, you don’t have to go running to a health professional with every boo-boo you get, but if it’s negatively affecting your life and not going away (or getting worse) for the love of Odin’s beard go and see someone about it. We usually find that the quicker we get to assess and start correctly managing a problem, the quicker it will get better.

You are making (mostly incorrect) assumptions about it

Now as an example – I’m no mechanic and I only know the basic of maintenance of cars. I can replace a tyre and a battery and that’s about it. If the problem isn’t one of those things I’ve got no idea what to do. What I wouldn’t do is just go along my merry way thinking “it’s just a crank handle sensor (is that a thing in a car?) – it just needs some whatever-I-might-have-read-on-the-internet and it will be fine”. There’s a very good chance my car has a completely different problem and my assumptions are doing nothing to fix it.

But there are so many people we see who have decided they know what their problem is already (and don’t get me wrong a good health IQ and knowledge of your condition is paramount so I think it’s great people nowadays are informed) but if you don’t know what the problem is, how can you do the right thing to fix it.

Regularly people will come in – “I’m pretty sure it’s a pulled muscle, so I’ve been putting heat on it and stretching, but it’s been weeks and it’s not getting better” when once we get down to the actual problem we might find that the heat and stretching weren’t helping because they were actually prolonging the problem. To solve a problem, you first need to

  • Accurately identify what the problem is, then
  • Provide the correct solution for that particular problem.

Pain is a complicated thing (as is the human body). Every week I see someone who has been trying to fix their shoulder pain, when the actual issue was their neck, or their back pain when it was actually a hip issue that was causing all the problems.

I don’t try and fix my car myself, and if your body isn’t progressing how you want it to, maybe you should get more expert help too.

(I’ll record a video soon to tell you the story of my friend Kim who thought for 2 years that she was allergic to chocolate because every tie she ate it she got headaches, only to find after abstaining for two years she had an entirely different problem).

Trusting the internet for everything

Let me tell you a story of a patient I saw many years ago (around the time that Bikram Yoga was just hitting popularity – that’s important for the story).

So this patient (let’s call her Jill) hurt her back. Common story – she bent over and twisted and felt a sudden quite severe pain in her low back on one side. This was really quite sore – she couldn’t straighten up, she was stuck leaning over to one side, the whole deal.

So she limped over to the computer and started googling “what’s good for back pain?”

And she came across a few articles and videos about yoga being good for low back pain.

So she decided (after this expert advice from the internet) to go and book in to a 90 minute Bikram Yoga class (34 degrees and all). Now Jill could hardly move, but she pushed herself through 90 minutes of sweaty smelly pain to try and help her back. After a bit of movement, she did feel a little looser

BUT

The next day she was sooo much worse. She couldn’t get out of bed, and it took quite a few days to just get back to how she was before the yoga session.

Now Yoga certainly can be very helpful for long term and mild low back pain (to improve flexibility, postural endurance and functional capacity) but trying to fold yourself in half is not a good idea when you are in severe pain and can hardly move.

As another example – I looked on WebMD once (out of curiosity) to see what it would say my abdominal strain was. It’s top 2 likely diagnoses were

  1. Pregnant (I’m a guy), or
  2. Ovarian cancer!

The internet is a wonderful place where you can learn just about anything you want. But sometimes it just can’t replace a real person who can think critically, and problem solve according to your specific context.

I estimate that when I see a new client and they say I’ve googled it and I think it’s this – over 80% of the time those people end up being wrong.

One final thing about the internet (and I absolutely understand the irony seeing as you are likely reading this on the internet – unless someone has kindly transcribed the entire blog onto a toilet stall somewhere) is there is no quality control on the internet, and we all tend to assume that all information on the internet is equally valid or accurate. For some reason we as people don’t seem to be very good a critically appraising what we read on the internet.

So what should we do?

If you have a problem and it’s negatively (or severely) impacting your life – please consult a healthcare professional who will be able to tell you

  1. What the problem is, and
  2. What you need to do about it

If you are trying things you think should be helping and they aren’t – go and see someone who can help.

And by all means be informed and aware about your problems, but don’t place the opinion of the internet (or faceless strangers on Facebook who’ve never met you or seen you and your exact problem) above the opinion of highly skilled and trained health professional who literally do this for a living.

And one final (and a little more sobering thought) – very rarely we would see someone who has been putting up with a problem for a long time, or even having other treatments for a long time without benefit, and eventually when we see them we realise something’s not right and it ends up being something more serious (like a kidney infection, or your gall bladder, or sometimes even cancer). This is the worst outcome of trusting the internet and putting up with problems – something that may have been treatable early on becomes something that it’s too late to do anything about.

Now I don’t intend to scare anyone, as this is very very rare, but it never hurts to be mindful of these things (we obviously always have to be).

But just to make sure I finish on a happier note… here a picture of a cat :)
kitten stretching

Happy not-mistake-making

Julian Bowen

Julian is the Director and Principal Physiotherapist at EMC Physiotherapy.  He has spent  over a decade working exclusively in private physiotherapy practice, and estimates he would have performed over 40,000 individual treatments in that time. He has worked with everyone from Paralympians, elite athletes, WAFL Footballers, the Defence Forces and weekend warriors; to thousands of everyday people with all manner of issues.  He is passionate about injury prevention and has a special interest in the treatment of headaches, shoulder issues, hypermobility management and exercise rehabilitation for the prevention and treatment of injuries. 

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The ONE thing I recommend for everyone!

The ONE thing I recommend for everyone!

Someone asked me the other day “what is the one thing you would recommend that would benefit everyone the most?” What could everyone do that would help them avoid injury and pain, or help them stop having pain?

Now most people think the answer is going to be stretching, but they’re wrong!

If there was just one thing that I could recommend EVERYONE should be doing (I guess besides eating healthily/managing an appropriate weight) …

Strength Training!

That right! Resistance training…. Lifting weight…. Developing greater muscular strength and endurance.

I’ll tell you why:

Being stronger makes life easier by comparison. It builds resilience in your body to be able to better withstand whatever life throws at you. There’s also a massive amount of health benefits of improving your lean muscle mass, from reducing your risk of many diseases, fractures and injuries, to even reducing your risk of premature death!

Not to mention that there is so much research now that has proven strengthening helps you to reduce pain (such as with arthritis, chronic back and neck pain etc) and reduce your risk of injury. Studies have found strength training reduces the rate of non-contact injuries in sport by 50%! Strength training was more effective than stretching, ergonomics changes or fancy chairs at reducing neck pain in office workers.

Exercise and resistance training has been shown time and again to be as effective (or more effective) than surgery for the management of mild to moderate knee and hip arthritis, degenerative (read: wear and tear) rotator cuff issues, bursitis, tendinopathy… the list goes on!

(Yes sometimes surgery is the best option, but even if you do need surgery, strength training beforehand means quicker recoveries and a much higher chance of full recovery)

In fact, did you know the World Health Organisation guidelines for MINIMUM levels of physical exercise includes 2 or more resistance training sessions per week? (You can read it here)

Now this doesn’t necessarily mean you have to join a gym and buy matching lululemon tights (but that’s perfectly fine if you want to). The gym is an excellent place because it has all the equipment you need to be able to achieve what you want.

But there’s heaps of exercise you can do at your own home with either just your bodyweight or light weights or household items that will get you started.

The key is just to start! Anything you do is better than nothing, and if you do it consistently you will see the benefits. Exercise is a very simple science. Do the work consistently at the correct amount and you will definitely improve. The benefits from any exercise require consistent effort over time. You won’t feel the benefits straight away but give it a few weeks of consistent work and you’ll definitely start to notice the difference. Suddenly you’ll realise it didn’t hurt walking up the stairs for a change. Or you managed to work at the computer for 2 hours without starting to feel a headache coming on.

If you don’t know where to start, or what to do – then find someone who does. Start with exercises that address multiple muscles and large muscle groups (like squats and push ups). If you have problems or issues that may limit your ability to exercise (or you’re worried it might do some harm) then see a professional and have them guide you on what you can do. Even people without legs can do strength training so we could definitely work out ways to train without upsetting your dodgy knee (even though – as mentioned above, strength training at the right level and intensity will actually do it the world of good).

Work at getting stronger and life gets easier.

And start today! 2-3 times per week is all you need.

Happy lifting!

Julian Bowen

Julian is the Director and Principal Physiotherapist at EMC Physiotherapy.  He has spent  over a decade working exclusively in private physiotherapy practice, and estimates he would have performed over 40,000 individual treatments in that time. He has worked with everyone from Paralympians, elite athletes, WAFL Footballers, the Defence Forces and weekend warriors; to thousands of everyday people with all manner of issues.  He is passionate about injury prevention and has a special interest in the treatment of headaches, shoulder issues, hypermobility management and exercise rehabilitation for the prevention and treatment of injuries. 

 

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Negative Attitudes, Thoughts and Feelings: Some thoughts on the recovery process

glass half full

Over this week I’ve had a couple of in depth discussions with patients who are both struggling with long term injury – and I wanted to share some thoughts about some common themes with both of them.  Perhaps if you are also struggling through an injury or recovery this will help you with some of the barriers you are experiencing too.

One client is a high level hockey player who has recently undergone an ACL reconstruction (and looking at up to a year to return to sport) and the other is a labourer who suffered quite a bad low back injury. My discussions with both of them this week focussed on how they were coping and dealing with the injury mentally and emotionally.  When dealing with clients we know that your mental and emotional state can have a drastic impact on your physical symptoms and recovery – so discussing this side of a client’s recovery is also a very important part of their rehabilitation progress.

Both clients were struggling emotionally with their injury, and I wanted to share some common issues between them (and others we see) and my thoughts on them

Catastrophization

With any injury our minds seem to jump to worst case scenarios straight away.  This week it was “what if I can never play hockey again?” or “what if I can’t go back to work? How will I be able to support my family?”  While these are normal concerns, statistics and research tells us that by and large people almost always recover. Your body is a powerful healing machine and is incredibly good at recovery in its own right.  Also the fact that I am talking to you means that you have also taken proactive, positive steps towards a faster, better recovery.  You are in good hands and are well looked after.  Considering that people can recover from injury eventually without any guidance or treatment, the fact that you are under expert guidance already puts you ahead of the game.

These negative thought patterns lead to negative emotions, stress and anxiety. These mental states have been proven to adversely affect your symptoms (pain) and your recovery. Understand that you (like everyone else) will get past this and you will get back to normal.

And even if you do have a rare injury that won’t recover (like losing a leg for example) it may affect your ability to do certain things, but your life still isn’t over.  Spend 30 seconds on the internet and you will find all manner of people living with significant conditions or injuries who are living life to the fullest and enjoying life every day.

Fear Avoidance

Fear avoidance and chronic pain cycle

Fear avoidance and chronic pain cycle

Fear of pain or fear of damaging your injury further may be normal behaviour, but often to recover you may need to push yourself a little bit.  If you never do anything for fear it might hurt (or damage) your injury – eventually you might not do anything at all.  To paraphrase Finding Nemo:

Marlin (Nemo’s father): I promised that I’d never let anything happen to him

"Not much fun for little Harpo" (Source: Disney Pixar)

“Not much fun for little Harpo” (Source: Disney Pixar)

Dory: Hmmm that’s a funny  thing to promise.  Well you can’t never let anything happen to him. Then nothing would EVER happen to him.  Not much fun for little Harpo.

One client was avoiding bending his back at all because he was afraid of hurting it again.  The other was struggling to wean out of her knee brace because she was afraid it might get hurt again without the support.  In both cases, to be able to improve they need to be able to do those things. It is perfectly normal to bend your back, and it is normal to walk without support.  Normal activity is unlikely to damage you, but fear avoidance can certainly hamper your recovery. Understand that pain does not equal damage – pain is a warning system.  When you have had an injury or surgery, your brain is on high alert for warnings around that area (because of this sudden insult/injury).  So whenever you start to do new things, or increase your activity, you could be setting off more warning signs.  Understand that not all pain is bad pain – and do not fear some pain, it is unfortunately necessary sometimes.

Your identity and self-worth

This was the really big one:

You are not defined by your injury.

Nor are you defined by your ability to do or not do certain things.  You are not just a person with a sore back.  Nor are you just a hockey player.

In both these clients’ cases, they were struggling with feeling of loss of identity and loss of self-worth because of their injury.  One identified themselves strongly as a hockey player, and without playing hockey she felt like she had lost her identity.  The other felt that if he couldn’t work to provide for his family currently, then he was feeling like he was worthless.

In my opinion neither of these is true.  You are not just a hockey player. You are not just a worker, or provider. You are a father, mother, sibling, lover, drinking buddy, partner-in-crime, and confidant. You are someone’s closest friend. You are the love of someone’s life. You are likely the entire world to your children. What you do does not define you or your value.

If you cannot work for a period of time, it does not make you any less of a father, or husband, or friend, or partner.  And like I said, by and large people will recover, so you will still be all of those things, even if you are having some short term difficulty fulfilling all of those roles right now.  None of the people who are important to you will judge you as worthless for not being able to do something. In fact they will (and should) be proud of you for facing pain and adversity and working to overcome it. There is nothing to feel worthless about, nor is an injury anything to be ashamed of.  You are not weak for being injured – you are strong for fighting to recover.

And again, if you find yourself in a situation that the problem you have isn’t going to go away (like losing a leg) you are still every bit a father, husband, friend, etc. that you were before. Sure you might not be as good at hopscotch, but see what is important in your life and appreciate what you have. Even if life takes you in a different direction – you are capable of so many more things than just one career, or one sport.  I’ve read studies that say people change career 7 times in their life – so even if you can’t go back to labouring, there is a whole world of possibilities out there for you to explore. Even without your leg, you are still every bit as capable as a provider and carer.

Have realistic expectations

Recovery takes time.  In the case of my hockey playing ACL injured friend, it is quite normal to take up to a year to return to sport.  This means that for the first few months you will probably feel pretty terrible.  This is perfectly normal.  At our clinic we like to outline from the very start exactly how long recovery is likely to take – and the process we will go through to get you there.  Sometimes this is quite simple and sometimes it can be quite difficult to determine exactly how long recovery will take from the outset.

Remember that recovery is a journey – and not a straight line either.  Often there are lots of ups and downs along the way. Sometimes you will feel worse before you feel better. (I think immediately after surgery my client was definitely feeling worse than before she had surgery). This is all a normal part of the journey.  Pain is also a normal part of recovery.  Just because you are feeling more pain today doesn’t mean you are going backwards, or have damaged it further.  Sometimes it just hurts – and that’s normal too.

Trust in your team

At EMC Physiotherapy, we have over 40 years of combined physiotherapy experience, so chances are whatever you have – we’ve seen it before and know what to do about it.  Having an injury can be scary – you’re suddenly immersed in a previously unknown world of big words and scanning machines and lots of people telling you what to do.  While this is all new to you, it’s quite routine to us.  It’s normal to be worried that what you are experiencing is different from everyone else – but usually it’s not (unfortunately you’re not always as special as you think you are).  If you have concerns please ask – we will certainly reassure you regarding what you’re experiencing.  Allow us to educate you and guide you along your journey towards recovery, and trust us to guide you towards the best outcome possible.

 

As you can imagine, we spend a lot of time talking to/educating our patients and guiding them along their path (as well as providing all the other treatments and services we provide).  This is an important part of the process, and not to be taken lightly.  Hopefully this has provided you with some food for thought – especially if you are struggling through your own injury and recovery.

As always, if we help you with anything at all we are always happy to hear from you.

Happy recovery

 

Julian Bowen

Julian is the owner and Principal Physiotherapist at EMC Physiotherapy.  He has spent  over a decade working exclusively in private physiotherapy practice, and estimates he would have performed over 40,000 individual treatments in that time. He has worked with everyone from Paralympians,  elite athletes, WAFL Footballers, the Defence Forces and weekend warriors, to thousands of everyday people with all manner of issues.  He is passionate about injury prevention and has a special interest in the treatment of headaches, shoulder issues, hypermobility management and exercise rehabilitation for the prevention and treatment of injuries. 

 

*This article first appeared on the South Perth Physiotherapy blog, by the same author

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