Physiotherapy didn’t work for my friend, will it work for me?
I think all these exercises are a sham and don’t actually do anything.
Does physiotherapy actually work?
Isn’t physio a waste of time?
These are some of the questions I regularly hear from my patients.
Some people are skeptical about our treatments and don’t take physical therapy seriously because of past experiences.
Yes, sometimes physical therapy doesn’t work. But there’s almost always a reasonable explanation for it. In this article, we’ll explore those reasons and answer the burning question: Why physiotherapy doesn’t work?
7 Reasons Why Physiotherapy Doesn’t Work for Some People
There are a ton of reasons why physiotherapy doesn’t work sometimes. It could be because of the physical therapist, the patient, or factors that are out of your control.
Here are some of the top reasons why physiotherapy doesn’t work. Remember, this list is not exhaustive:
1. You’re Not Following the Program
A reason why physiotherapy doesn’t work for you may be that you’re not following your program as prescribed.
You might think you’re doing the exercises correctly, but there might be some critical steps that you’re missing or you’re skipping too many sessions which are delaying your recovery.
Another issue we commonly face in physiotherapy outpatient departments is that patients fail to follow the home exercise programs, which are extremely effective for quicker and long-lasting recovery and a crucial part of the overall rehab program.
Just think about which will be more effective: the one-hour in-clinic exercise session or the work you do for the rest of the 23 hours?
What’s the solution?
To fix this issue, simply stick to the program even when you don’t feel like it. Trust me, it’ll be worth it.
If you’re not following the home exercise program because you’re afraid of doing it wrong, then ask your physiotherapist to assess you while you perform the exercises on your own.
You can do that in the clinic so your physiotherapist can help you optimize your movements and correct any issues, no matter how small. That’ll give you better results from your home exercise program.
You can also ask your physiotherapist to give you a PDF of the instructions you have to follow at home or share videos of the exercises.
Don’t feel like you’re burdening your physio by asking them to help you out this way.
I can say from personal experience that I appreciate patients who ask me to check their posture during exercises or suggest alternative exercises. That’s because it shows me that they are actually following the program and are committed to their recovery.
Physiotherapy is hard work. If you want to see results, you have to be prepared to put in the work. Also, don’t forget to do your homework too.
2. You Didn’t Complete Your Exercise Program
Too often, patients stop doing their exercises as soon as they start feeling better. That can reactivate your injury and bring back the pain. When that happens, such patients claim that physiotherapy didn’t work for them.
Your injury often remains unhealed even after your pain goes away. The physiotherapy programs are designed to help your injury heal completely. Our goal is to get you to the most healthy version of yourself.
So if you want to get rid of the pain for good, don’t ditch your exercises as soon as you’re pain-free. You have to remember that your rehab has to continue for long after your pain goes away. Always continue the program for its original duration.
3. Your Rehab Program Isn’t Property Tailored to Your Condition
Each person’s body is different, their activity levels are different and so are their goals, home environments, level of motivation, etc.
That fact requires physiotherapists to design personalized rehab programs by keeping the individual patient’s specifications in mind.
But it doesn’t always happen. Some physios repeat the same program for different patients complaining of relatively similar issues. When that happens, patients don’t recover as fast or as efficiently as they should.
For instance, if your rehab exercises are of lower intensity than what you can need, then you’ll be delayed in returning to your target activity level for which you’re doing the rehab. (Reference)
Also, you might be following the wrong physical therapy program. This issue begins at the time of diagnosis. When you’re not diagnosed correctly, there’s a high likelihood that your treatment won’t be appropriate for your condition as well.
How can I make sure it doesn’t happen to me?
If you feel like your physiotherapy program isn’t challenging enough or too easy for you, then have a conversation with your therapist and tell them how you feel.
It could just be that your physiotherapist is unaware of how fast you’re progressing. In that case, you could bring it to their attention and then start a program more suited toward your goals.
4. Your Long-Term Treatment Isn’t Physical Therapy
Some medical conditions, such as knee arthritis, are effectively managed by physical therapy. But if you’re coming to a PT when the arthritis is really bad, then you’re probably not going to benefit from the treatment. In that case, you might require surgical management.
If physiotherapy doesn’t work for you, then you need to ask your PT if you’ve joined too late or if you should consider other treatment options.
Also, physiotherapy isn’t meant to treat every medical condition. If you’re doing physio for something that’s outside of the field’s scope, then it’s not going to work for you.
Sometimes physicians and surgeons recommend physiotherapy only to make your condition a little better, decrease pain intensity or get you in the optimal shape for medical or surgical management. This approach is common in pregnancy and before knee replacement surgeries.
5. You Might Have Unrealistic Expectations
Physical therapy isn’t a magic pill that will fix you instantly. It requires time to work (much longer than most people realize).
If you have some underlying complications, then your recovery might be further delayed or you might not return to the same activity level as before.
It’s wise to manage your expectations by talking to your physiotherapists about them. A good physio will discuss all possibilities with you and counsel you on the level of recovery you should expect.
Also, you shouldn’t expect someone else to fix you. As physiotherapists, our job is to help your body heal itself and guide you on the best rehab approaches. But the ultimate effort has to be yours.
Oftentimes, patients think that physiotherapists will fix them and they become dependent on the passive therapy that they receive in physiotherapy clinics.
So when they leave the clinic after their appointment or at the time of discharge, their pain comes back. That’s due to a psychological response because such patients aren’t confident that they can manage their conditions actively. (Reference)
To fix this issue, you can try to gradually decrease your visits to the PT clinic instead of suddenly stopping.
You can also stay in touch with your physiotherapist over email, phone or any other platform that you prefer. That way, you can ask them questions or share updates to confirm if you’re on the right path.
It should also help you mentally detach from passive therapy and trust yourself to move again.
6. You’re Not Working On Your Goals
Progress in physiotherapy means different things to different people. For an active 70-year-old with an ankle injury, recovery would mean being able to jog again. But for a sedentary 70-year-old with an ankle injury, relief from pain might be the goal.
Some physiotherapists will assume goals based on your age or activity level and start working towards that. But that might leave you disappointed. (Reference)
So how can I avoid this?
You have to communicate what you want to achieve from physical therapy.
Telling your physiotherapist your goals helps both of you. It allows your therapist to design an appropriate program and progress you accordingly and helps you achieve your goals.
Also, each physiotherapist has a different approach. Some are machine-focused while others are active rehab and exercise based. You have to find someone who’s willing and experienced to work with you toward what you want, in the way that you prefer.
7. You’re Only Focused on Setbacks
Do your biceps immediately grow after lifting a dumbbell just once? Obviously, no.
Similarly, your body needs time to adapt to a physiotherapist rehab program. It’s also possible that during this adjustment period, you’ll experience flare-ups and setbacks that’ll make you think that you’re back to square one.
Learn to stay consistent even through these speed bumps.
Talk to your physiotherapist about what you’re experiencing. Better yet, ask your PT if you should expect any setbacks and mentally prepare for them.
Don’t think of setbacks as permanent nor be discouraged by them. Look at them as temporary hiccups that you should work to overcome on your road to recovery. Take care of yourself on the bad days but don’t lose sight of the bigger goal.
The Takeaway
While there are people who’ve had unpleasant experiences with physiotherapists, there are many others who’ve found relief with physiotherapy.
So you shouldn’t generalize and say physiotherapy doesn’t work. Instead, try to find the root cause of why you’re not improving by talking to your physiotherapist and seeking a second opinion.
Disclaimer: This article is for informative purposes only. We provide well-researched and authentic information. Do not consider this personalized health advice. Please contact a licensed healthcare professional for medical issues and health concerns.