The Passage from Pain

The passage from pain with physiotherapy – In recent months, I have become aware of what it means to live with pain, day and night. Not acute pain like some poor people might have and that must truly be awful. No, my pain comes from a stupid fall I had when rushing around back in April last year. I tripped when my toe caught the top on a small raised step in my house. I went flying and landed badly. The heavy bruising across my abdomen eventually cleared, but I damaged muscles in my shoulder.

I assumed it would eventually disappear too, but it didn’t. It got worse and affected everything. It got to the point where if I made a false movement without thinking, I would have 30 seconds of extreme and debilitating pain. I wake up several times a night. If I am lucky, I fall asleep again. Often I am not lucky. In September I started to see a physio for some physiotherapy. I went to see Pieter Faasse at Art of Physio and this is about that with a Q+A with Pieter about pain. He told me to snack more! Read why….

First Steps.

The first session with Pieter was all about talking. He asked a lot of questions in order to learn about the nature of the injury and learn more about me. Like a detective building a case. Then he set about testing which movements were causing the pain. I was given ‘homework’ to do between the sessions. Exercises I could do at home to have pain free movements. At the start these were quite hard to do, but over time became easier. Week in, week out, I could feel progress. Some weeks were better than others. I feel I am approaching normal movement again in many ways. As I near the end of the passage from pain, I thought it would be interesting to do a Q+A with Pieter.

Thank you Pieter for your time answering these questions.

How doing physio saved my year

Please tell us what kind of issues you most encounter with the people you help.

As we are located on the Zuidas business district, we see a lot of posture-, work- and stress related issues. Sometimes these issues manifest themselves in the arms, neck and/or shoulders, but also in the spine or legs. Our team of specialists is highly trained to help you get rid of the issues.

Please tell us more about how you work.

For me the most important thing is to find the underlying cause of your issue and determine what you need to get better.

The place where your issue occurs, is only the tip of the iceberg; the end result of compensation over time. So just looking at and treating the site of the pain isn’t going to solve your problem. You probably find several therapists doing this.

None of the systems and joints and muscles in your body work alone so you have to look further than just the site of the pain in order to solve it.

The Technique and the passage from pain

The techniques and methods we use have been cherry picked over the years to target the biggest issues people have in the best way.

I also strongly believe in the combination between hands on work (what we do) and hands off work like training / movement and relaxation therapy (what you do). The hands-on work facilitates the body’s innate self-healing capabilities, and the hands-off work solidifies it. That synergy just works. We not only offer these physiotherapy services to individuals, but also to companies because that is where we spend most of our time.

What can we do to limit our exposure to the risk of injury in daily life while working from home?

Snack more! I know that sounds like a weird advice from a physiotherapist, but I’m talking about a different kind of snacks, movement snacks. Movement snacks are fast, easy and make you feel good.

The idea is simple. 2 (or more) movement snacks an hour. 30-60 seconds each. Combine them to the things you are already doing. So, bounce up and down while waiting for your coffee machine, bend forward and touch your toes 10 times after a call or meeting, rotate your shoulders and wrists during a STUM. You’ll be surprised how good it feels!

By moving more throughout the day, it breaks through the negative cycle of not-moving. You stimulate blood flow, circulation, it moves your organs (yes that is important!). Also, movement improves brain function and makes you better at solving problems.

And stretch, and stretch….

What are the dangers of resorting to medical solutions such as strong pain killers?

Pain is a request for change. If you experience pain and you continuously take a pill or injection to take away that pain, it kind of beats the purpose, don’t you think? The question arises, what is your body trying to tell you?

So your body needs more movement and it is telling you by being stiff and tight? Maybe your body is asking for different nutrition by giving you a bloated feeling. Perhaps your body needs more sleep and it’s letting you know by being tired and low on energy.

In the end, it is your responsibility to act listen and act accordingly. We, as physiotherapists are here to help you figure out what your body is telling you

Especially when we’re talking about pain and injuries to muscles and joints, research shows that movement is actually more beneficial. Pain killers or corticosteroid injections can however, give huge relief when you have acute and serious pain. Just remember, they may take away the pain but they don’t actually solve your issue.

When should people seek physiotherapy?

Most people only thing about physiotherapy when they experience an issue. As a rule of thumb, when an acute issue persists after 5 days, or a less acute issue lingers after 4 weeks, you should go and look for help. Too often people walk around with physical issues longer than they should. Most of the times, the issue is solvable and apart from the treatment you’ll also get more knowledge about how the human body works and tips on what to do when you experience symptoms.

Ideally, people should visit a physiotherapy centre every quarter for a preemptive session. That way, a build up of strain and tension can be assessed and eliminated before they become problematic.

Give us some examples of your greatest success stories.

I remember a 30 year old-ish guy coming in with a lot of pain in his mid back. He could barely move his spine without a crippling stabbing pain in his back. After a few session where we focused on hips and shoulders, it improved slightly but not significantly. So we needed to look a bit deeper. After doing another assessment we found that one of his toes wasn’t extending properly due to a small fracture he had a year prior. After we treated his toe, his backissue significantly improved and we were able to make great progress and solve his issue. It is amazing to see how previous injuries, like a broken toe, can have a huge impact on other injuries.

Another great story was with a dentist in her 30s who had such pain in her thumb (quervain’s syndrome) that she was scheduled for surgery and would have not being able to work for about 6 weeks. With our treatment we were able to solve her issue in a few weeks without her having to take time off work. There was no longer need for the operation.

In the end what is success for me is to find the root cause of an issue and give the client the tools they need to become better.

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Thank you Pieter for these great insights into your physiotherapy work and how you help people with the passage from pain.