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  • Writer's pictureKely Kuhn PT

The 2 Things I Want Every Patient to Know

Updated: Nov 13, 2019

I probably have a thousand exercise variations floating around my head. I have a " tool box" full of manual therapy techniques to use on patients to help them feel better. But none of that matters if I don't get my patients to understand two very important things. One: Movement is good, safe and can ease pain. And two pain does NOT equal damage.

It seems so simple. We hear it all the time now a days, " Movement is medicine." But in reality our culture doesn't support it and we don't really understand it. We have a skewed

understanding of what pain is and why it happens and that actually leaves us fearing things that really help such as movement and exercise. This is what we call a fear avoidance pattern. I see it often in my patients. Something hurts so we "protect" it, we stop moving it, and we find compensations to live life and avoid that movement. Sometimes its a conscious decision and sometimes we do not even know we are doing it.

But when we understand what pain actually is, just a protective mechanism from our nervous system, we can do more to manage it. Pain is our brains way of alerting us to potential danger and to encourage us to make a change. If you put your hand on a hot stove pain tells you to pull it away. Sometime there is pain because we damaged a tissue such as broken bone, but that pain is still from the nervous system. On the other hand the vast majority of pain is not related to tissue damage, its just a sensitized or wound up nervous system. This can happen for so many, complex reasons, related to but not limited to stress, daily activities, diet, sleep and our overall health. But we as a culture have learned that all pain means damage and we become afraid of doing more damage. We stop exercising, we avoid movements and the pain gets worse and persists and patients just feel broken. That is usually about the time patients seek treatment, after months of pain. But when we understand that pain does not mean we are broken we can have some control over it. So I give every patient guidelines as to when its ok to move through pain. First and foremost any increase in pain when moving has to be " acceptable to you. " Thats a very personal decision, some pain is ok but how much you are comfortable with tolerating must be your choice. Secondly, any increase in pain with a movement should walk off within about 5 to 10 minutes of stopping that exercise/movement. The pain may not disappear all together but it should return to the baseline level you started with. For example if you wake up with a stiff neck and it hurts to turn the neck, but as soon as you stop the pain eases up its safe to turn your neck and you should turn your head just as you would normally any other day.

Next time you are in pain, note to see if you are inadvertently avoiding certain movements, such a bending over and follow the guidelines above. Try a light workout. You might surprise yourself at how much better you feel with just those little tweaks. If pain persists, sometimes you may need some specific movements and that's where a physical therapy comes in. We can help finds specific movements and add them into your day to help you overcome pain A physical therapist can also help identify those rare times where tissues are really the problem and refer you to the right doctor to continue care.


This program, videos and content is not intended to diagnose or treat any illness or injury. It is for educational purposes only. If you chose to try any of the exercises presented here do so at your own risk. Please consult a physician before you start any new program.

Not every exercise is safe for everybody. Correct execution of all exercises is imperative to prevent injury. Please consult a healthcare professional if you have any questions about your exercise execution or if an exercise is right for you.

You are responsible for yourself and will not hold Kelly Kuhn or Kelly Kuhn Physical Therapy liable for any injury or illness.

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