Physical therapy isn’t about fixing what’s broken, it’s about rediscovering what you’re capable of.

Help! Why do I have more pain after my session?

Having an increase in your pain after a treatment session is not always a bad thing. It is important to track correctly and sometimes a modification to your home program is necessary.

Centralization & Peripheralization

Centralization & peripheralization refers to the change in symptom location when it comes to pain coming from the spine. Movement towards the center of the spine (centralization) is actually a sign of a good prognosis, but it needs to be interpreted correctly.

Extremity Pain of Spinal Source

This is a fascinating phenomena that has been shown to occur in almost half of patients with extremity pain without any spine pain.

Derangements

This is the most common form of musculoskeletal pain that mimics many other diagnoses. It is theorized to be caused by a displacement of articular tissue causing a disruption in normal joint resting position, obstruction in motion, and pain.

Articular & Contractile Dysfunction

This is another cause of musculoskeletal pain that is a lot less common compared to Derangements. A shortened description of this condition is “weak and shortened” tissue that causes pain with tension.

Mechanically Unresponsive & Atypical

This is a complicated diagnosis that does have hope, but the treatment approach and road to recovery is a lot more rocky and nuanced. This may even require some other types of treatment like steroidal anti inflammatories along with mechanical treatment.

Imaging (MRIs, X-Rays, etc.)

Imaging is commonly referred to as the “gold-standard” to diagnosis. There is a mountain of evidence that says otherwise and unfortunately, most healthcare providers still use imaging to make important decisions and do not share the evidence that discredits the findings of imaging.

Injections

Injections are not good or bad, but due to improper education on the effect of specific types of injections, injections are commonly overdone and actually very harmful for most cases in musculoskeletal care.

What exercises should I be doing?

Movement and exercise is medicine. It’s important to know what and how much to take while you are in session and while you are at home.