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Physical Therapy No Pain, No Gain?
If you have ever received traditional physical therapy care you likely answer the question, “No pain, no gain?” with “Are you kidding? Of course therapy hurts!” Many people equate therapy with pain and in my 13 years of practice I have heard many patients compare “PT” to things like “pain and torture” and “physical torment.” But what if you considered the possibility that you could receive physical therapy care without necessarily having to endure pain to get gain? Would that make you more likely to seek out care?
Don't get me wrong, sometimes we therapists have to use a little more effort to get the desired outcome, but for the most part we can get big changes with only a small amount of applied force. In fact, your body typically responds better when less aggressive treatment techniques are used. Consider this, when someone starts to stretch your arm or leg, do you feel yourself tense up in anticipation? How about when that stretch starts to cause discomfort? Do you notice your muscles tightening more as the stretch becomes more painful? You can't help this reaction, it's a natural protective instinct, but it can be a big hurdle to positive therapy gains.
Now consider your therapist engaging your muscles in a slow and gentle fashion. By giving your body the time to trust and relax into the stretch, your muscles have a better chance of achieving a greater stretch that will carry over for a longer period of time. For stretches to be effective they need to be held for at least 90-120 seconds, or just about two minutes. I like to compare it to stretching a rubber band. If you want to lengthen a rubber band you have to hold it in a stretched position for a long time. If you don't hold it long enough that rubber band will just return to the same short length it started at. The same theory applies to our muscles when we stretch them.
Whether your therapist uses techniques such as myofascial release or just regular passive range of motion for stretching and restoring movement, all your stretches should be gradual and sustained. By approaching your treatment sessions in this manner, your therapist can work with your body instead of fighting that natural muscle guarding response. This results in greater carry over from session to session with subsequent treatments having more gain and less pain for you.