I Feel Good, Should I Stop Treatment?

Mark: Hi, it’s Mark from TLR. I’m here with Dana Ranahan of Body Works Physiotherapy, Sports Physiotherapy in North Vancouver. And we’re talking bodies. How are you doing Dana?

Dana: Hi Mark. I’m good thanks.

Mark: So I feel good, should I stop treatment?

Dana: Oh, that’s a common question. We hear that often in the clinic and I think it is a really tricky one because it’s hard to decide, you know, people come in with an injury and they’re having pain and maybe they come for one or two treatments and they’re feeling a little bit better. And the question is, you know, should they continue with the treatment plan towards full recovery or are they good enough? And should they just leave? So we often get that question and it can be a difficult one to determine.

Often I think sometimes people do leave treatment a little bit too early because they feel pretty good, but they may not quite be a hundred percent recovered or, you know, 90% recovered even. And then they’re at risk of reinjuring themselves again if they’re not careful.

Mark: So what is, like a typical injury say if I’ve hurt my back, like what would be the danger if I stopped treatment too soon?

Dana: Well, if we look at, you know, when you have an injury, there’s usually an inflammatory process. Let’s say you have a big muscle strain in your back from overdoing it. Well, the muscle has been sort of strained and damaged and it does take some time to actually heal and build the collagen structure back in the muscle that it actually has enough tensile strength in the muscle to resist force for whatever it is you want to do.

So if you come in with pain, I might be able to loosen things up or free your muscles up a little bit and help you restore some movement and the pain might start to settle. However, you maybe haven’t regained full strength. And if you don’t have the full structural healing that’s happened yet, then you go to do something again, maybe you go back to the gym, lift weights or you’re out mountain biking or something, and you overdo it peddling too hard or whatnot. You could restrain that muscle again. And it might be worse than it was before. So it may take longer to recover.

So usually when people come in, you know, if you’ve hurt your back, I might say it’s probably going to be about a four to six week timeframe for recovery. And so I try to give people a framework so they know what to expect, but if you stop at let’s say three weeks because your pain is better. You may be vulnerable to reaggravating.

Mark: What about if the cause of the pain, the cause of the injury was some other issue in your body that you didn’t get to, you didn’t address. What about that?

Dana: That’s a good point. And I will say that often we treat, you know, if someone comes in and has an acute back issue, sometimes you treat that area just to settle it down again. But ultimately, we want to get at the mechanics of why you injured it. So in a lot of times it is whole body. So, you know, if I have like a shoulder issue and I’m dropped on one side, maybe my back’s getting jammed on that side because it’s tying to my upper back or shoulder.

So if we can then get you out of the acute pain and start getting you healing, then we can look at your overall movement strategies and try to help you learn to move a bit better and be stronger. So you’re not as vulnerable to reinjure it again. Even if you know the muscles have healed in the low back, we can improve your mechanics.

Mark: So the danger really of quitting early, even though it might seem like, oh, I’m saving money. I think that’s maybe a secret reason.

Dana: That’s a big factor for a lot of people. Yeah.

Mark: The danger is you’re probably going to hurt yourself again. And you can spend up, end up spending more money. Pay me now, pay me later. Is that’s kind of what.

Dana: Exactly, and it is tough for some people right now. There are some people that aren’t working and whatnot or, you know, reduced hours. And so we have to sort of weigh all that out and determine what people really need.

And you know, if someone doesn’t have as much funds, we can talk about that upfront and like maybe space out treatments a bit and try to give them a little more in the interim. However, it is nice to carry it out over the whole timeframe that we need to really get them to full healing. So those are factors that we would consider when we see someone, but usually it’s money well spent.

And a lot of people have extended health benefits that can help them afford it. So that’s a positive too. And we do a lot of direct billing here for most insurance companies, so that saves people having to deal with it themselves. But it is usually worth putting that little bit extra money into it.

And then hopefully you don’t recur the injuries. You can get back to all your activities and whatnot without pain. Otherwise we’ll see you again, you know, six months or something with another injury. And at the end of the day it will cost you more.

Mark: So if I’m feeling like, geez you know, I feel pretty good. Should I call and just try and see if I can talk to somebody prior to going, you know what, I’m not coming in.

Dana: After they’ve already come for treatment a couple of times? Yeah. And I think it would be good to talk to the therapist that worked with you if possible, because they will know your situation the best. And you know, we leave notes in our charts about patients. And so we can share clients sometimes, but if I’ve treated you specifically, I’ll have a better handle on exactly what’s happening. So usually it’d be a discussion I’d have hopefully before the patient leaves, but if that gets missed, then yes, definitely. You can either call us or email us and we’ll try to have a brief communication about it. And, you know, if it’s hard to determine what’s happening we could set a followup assessment and just kind of do a reassessment, with a view to whether you need to continue or not. If we can’t provide enough information on the phone or on email. Sometimes it’s hard to tell.

Mark: What about a zoom call. We’re still in the pandemic, all that sort of stuff. Do you do any of that?

Dana: Exactly. Yes, we do. We offer online telehealth visits so we can either do a phone consult. If someone doesn’t have the technology to do zoom calls, or we can do video calls where you kind of actually see quite a bit and people can show us what’s hurting and show us where the pain is. And talk a little bit about things. We really can actually disern quite a lot from video calls. So I think some people think, you know, you can’t put hands on them or you can’t use your acupuncture needles or whatever it is that they’ve been used to when they come for in-person treatment. But if someone’s not able to come, related to COVID or work, or their concerns about what’s happening currently with the Omicron variant and so on. We definitely can deal with a lot of stuff on video. So it is a good, good tool to have, and it’s built into our software. So it’s very easy and user-friendly for everyone.

Mark: If you want to get better, you got to finish what you started, basically. So body-works.ca to book your appointment, or you can call at (604) 983-6616. Get in, get feeling better. Get moving better. Get back active out on the ski trails. And of course finish your treatment. Thanks Dana.

Dana: Thanks Mark.