The most effective physical therapy treatments fall into two buckets.
Drawing from one bucket but not the other is like Bruce Wayne without his expensive toys – not so super. So implement the two-bucket strategy: Use both buckets for efficient injury rehab.
Bucket 1: Pain Relief
Pain relief treatments promise a quick fix. Bucket 1 treatments are like owning crypto – your friends think it’s cool, plenty of ups and downs, and it’s a questionable stand-alone strategy.
Lots of treatments fall into bucket 1.
Topical gels and TENS units alter pain sensation and sometimes provide short-term pain relief.
Massage guns (aka percussion therapy) have taken the health & fitness world by storm. Read my take on this popular modality here: Do Massage Guns Even Work?
Massage and manual therapy don’t break up tight spots as much as you’d expect; they reduce muscle tone by affecting the nervous system. And research shows they’re beneficial in conjunction with exercise.
Spinal manipulation isn’t realigning anything – that’s a common back pain myth – but manipulation can offer substantial pain relief for some cases of spine pain.
Last but not least, trigger point dry needling is the most powerful (and uncomfortable) option to relieve muscle pain.
Bucket 1 treatments work. There’s solid research supporting their short-term benefits.
But just like dumping your life savings into Dogecoin, they are risky all by themselves.
You need Bucket 2.
Bucket 2: Build Resilience
Bucket 2 treatments are like brushing your teeth. Not very exciting. No big deal if you skip it once or twice. But long-term, they make all the difference.
As you can probably guess, Bucket 2 involves exercise.
Aerobic exercise, whether running or low-impact alternatives, offers a host of benefits like stress relief, better sleep, heart health and exercise-induced analgesia.
Looking to build a cardio habit? Check out this article for low-impact options and a strategy to get started.
Resistance training is my favorite way to build resilience – and the science says it’s the best strategy to prevent injuries.
For example, many people think this exercise is dangerous for the spine. But it’s arguably the best treatment for low back pain.
Mobility work falls into this bucket too, when it’s specifically applied to regain lost motion.
Finally, dispelling negative beliefs and instilling positive expectations with cognitive behavioral therapy principles is another evidence-based strategy to build resilience.
For a successful rehab, strike a balance between Bucket 1 and Bucket 2 – pain relief and building resilience.
What About Stretching?
Long-time readers know my thoughts on stretching: static stretching is overrated.
Stretching alone is not an effective physical therapy treatment for most musculoskeletal problems, with the notable exception of plantar fasciitis.
And it doesn’t reduce injury risk – that’s a common stretching myth.
Here’s what most people don’t realize: Too much flexibility causes problems.
The human body requires a balance of mobility and stability. Super stretchy people are injury-prone because their joints are less stable.
I permit my clients to stretch if it feels good – and encourage them to stretch if they have specific range of motion deficits.
However, I prefer dynamic mobility drills over static stretching because dynamic work trains stability and mobility simultaneously.
Forgotten Factors
Your body is not a machine. It’s a living, adaptable organism. And therefore, many factors influence pain and recovery.
Optimism and expectations have huge ramifications on a treatment’s success. That’s why taking four placebo pills is more effective than taking two.
In addition, we heal slower when we’re stressed out. It’s hard to recover fast without adequate sleep, regular exercise, a healthy diet and psychological well-being.
Ignore these factors at your own peril.
Effective Physical Therapy: The Verdict
It’s easy to focus on Bucket 1, pain-relief treatments. It’s also easy to become reliant upon them.
For your healthcare provider, treating you 3x/week forever is almost as profitable as joining LIV Golf.
But it’s not ideal for you.
Pain relief treatments play a key role in effective physical therapy. Don’t stop there. Use Bucket 2 strategies to build confidence, grow stronger, and create resilience for the long term.
Readers: Have you been through rehab for an injury? Did you use Bucket 1 or Bucket 2 treatments more? What helped you the most? Share your thoughts in the comments.
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