We do want you using the treated structures, as opposed to keeping them immobile and staying ‘off’ them during a course of treatment. Anything that increases blood flow and activity will, in general, promote healing. This includes moderate activity, massage, heating the area with any form of heat, including infrared treatments and ‘cold laser’ treatments, and may include some Chiropractic treatments (being careful to avoid ‘high velocity’ manipulation!). Physical Therapy may be a useful addition, keeping in mind that the premise of Physical Therapy does NOT recognize the reality of vulnerable connective tissue and connective tissue damage. They focus, instead, on the muscles and muscle function. They try to ‘exercise you out of’ the problem by improving muscle strength, balance, and flexibility. If Physical Therapy makes you feel better, all good. If you ‘walk in, crawl out’, if the ‘treatment’ causes increased pain, then it would reasonably be avoided. These ‘increased pains’ seem not to lead to ‘increased healing’ in our patient population.
Oddly, though, I do not mind if you are a little ‘over active’ and you make your symptoms get worse. This almost never means that you have ‘set yourself back’ in the treatment course. This just tells us that we are ‘not there yet’. The goal of treatment is that you are pain free AT YOUR DESIRED LEVEL OF ACTIVITY, not that you are pain-free sitting on the couch watching Dr. Oz. The only way we know whether your structures are strong enough to handle your life is by using them. We can continue to ‘upsize’ these structures to handle any load, from ultimate frisbee to MLB pitching, from jogging to Olympic level running, from puttering around in the garage to playing linebacker in the NFL. So, we DO want you to gradually increase your activity level as you feel ‘better’ during treatment, just use some common sense in light of what is going on in our structures. This is another place where understanding the actual mechanism of the pain-causing process, and how the treatment ‘works’, helps us craft the best strategy, while maintaining peace of mind. The endpoint of treatment is that, with the desired level of activity, structures are free of tenderness and symptoms. This means that the collagen content of the individual structures is now adequate to ‘hold’ any load applied to the structure without any abnormal ‘stretching’ which would damage the indwelling nerve supply. In plain English, healing is now complete.