Which type of physical therapy recovery is best: The tortoise or the hare?

Learn if it’s better to push through the pain or listen to your body when recovering from an injury.

Andrew ignored the pain when he stretched and was determined to get back to kickboxing sooner than anyone else after a partial hip replacement.

Mia heard something pop in her shoulder when she fell.  In physical therapy, as soon as she felt pain, she would put her arm back down.

Which one of these patients, Andrew or Mia, will recover the quickest in physical therapy? The answer might surprise you.

Andrew was a 40-year-old active male who had 6 years of hip pain. He had surgery, called hip resurfacing, which is similar to hip replacement surgery. Two weeks after surgery he went on a 2-mile walk around the track using his crutches ignoring the pain and the advice of his doctors to take it easy.

“I just want to get back as fast as I can so I push myself through the pain”, he said.

Grimacing and sweating while performing simple leg lifts on the table, it was clear that Andrew was going to have frequent setbacks as he put his body past what it could handle. Andrew didn’t need to be motivated he needed to be slowed down during his physical therapy treatment program for hip resurfacing.

When Mia fell and caught her arm on the doorway, she heard a pop and was certain something terrible had happened. She was unable to get an x-ray or MRI because she was pregnant so she decided to only lift her hand as high as pain would permit.

“If it hurts I just stop because it can’t be good to push through the pain” Mia said.

She was very cautious in physical therapy for her shoulder pain and wanted to make sure she didn’t make her shoulder worse. It was clear that Mia would have very slow progress with her shoulder. Mia needed to be motivated and pushed during her physical therapy shoulder program.

The thought occurred to me, the tortoise or the hare. Which type of physical therapy program is the most effective?

With the hare approach, there can be multiple setbacks after the patient pushes the body past its ability to recover. During setbacks, the patient frequently has to rest completely to get her body back on track.

Similar to climbing a mountain and walking as fast as you can, getting completely out of breath, and having to sit on the log and wait until you can breathe again.

With the hare approach, progress is slowed down because the patient doesn’t push their body to return towards normal movement and use. They’re usually no setbacks however the patient is slower to reach specific milestones during the rehabilitation process.

Using the same climbing a mountain analogy, this person takes small steps to keep plugging along never requiring rest but never leading the pack.

Tortoise or the hare: who recovers quicker? The answer is, neither. The difference isn’t in the outcome; the difference is in the journey.

Patients who push themselves past their ability often endure more physical pain and periods of frustration. When you ignore the body’s pain signal, you invariably will increase inflammation and swelling which will result in a loss of function for short periods of time. Taking a rest and performing gentler treatments feels like two steps forward, one step back.

Patients who take their time, and listen to their body’s pain signal, will have very few setbacks and will slowly progress their way towards recovery. They do not endure periods of increased inflammation or swelling associated with setbacks. This type of recovery feels like one step forward.

So whichever type of person you are, the tortoise or the hare, remember that your destination of returning to your preferred sport or activity will be accomplished. The question is whether you want to go through the ups and downs in physical therapy or steady as she goes.

 

Which type of person are you: Tortoise or Hare?