In this article, Steph Davies (Musculoskeletal Specialist Physiotherapist and Director at Sports Physio Hwb) explains how:
You can help your injury improve yourself with your every day actions at home and at work
Why some days can be great with hardly any pain and other days terrible
When to seek professional help
All too often, there's a baffled new patient sat in front of me in the consulting room, explaining that they don't understand why they will sometimes have a day with hardly any pain at all, and then a few days later they can hardly walk / work / run etc. Or the worst pain might come when they are doing nothing but sitting on the sofa watching TV in the evening. How can sitting on the sofa cause pain!?
And there's actually a surprisingly simple explanation for this 95% of the time that has nothing to do with physio or any other kind of treatment - delayed onset of symptoms. Let me explain.
Taking control of your own injury
Many 'overuse' type injuries that haven't involved any obvious trauma or accident (for example tendinopathies - aka tendonitis, some cases of joint arthritis or 'wear and tear', bursitis) can actually feel a bit better when they are warmed up and the circulation is flowing, and worse later in the day, the next day or even the day after that. In fact, in one study on the achilles tendons of uninjured marathon runners showed that the greatest structural change in the tendons on ultrasound scanning was 7 days after the race - more so than only 2 days after the race. So clearly, the activities that you might have been doing in the preceding days to the 'bad day' may have had a part to play. Typical examples here in West Wales would be a day or so of digging, shovelling, log splitting, livestock handling or long walks with the dog - which might have felt OK at the time, but resulted in a few days of horrible pain later on in the week.
Bad days
So with this in mind, it helps to think back about the physical activities that you have been doing leading up to your bad day. For a knee, ankle or foot - were you on your feet a lot? For a lower back - were you leaning, bending or lifting a lot? For a shoulder - reaching up? If so, think about how you can modify this to reduce the load, get some help, or leave the job for another time when you're not injured!
Good days
Likewise, if you're able to have a 'good day' then it has got to be repeatable! Do similar detective work to discover what led to a 'good day' and try to repeat it. When soft tissue is irritated, it can take a good few weeks to months to settle down, so the more 'good days' you can have in a row, the more repair, recovery and injury resolution will be happening. Then the next time you do that aggravating job, it won't be so bad any more - so long as you pace yourself and take regular breaks at first. MOST people give themselves a bad day because they go back to their aggravating activity the minute they have a good day - and the injury isn't ready yet. At least 2 weeks of good days in a row is a good aim.
When to seek help
Of course, if you haven't seen a health professional yet, unless it has fully resolved and is back to 100% within 2 weeks, it's worth getting a proper diagnosis for your injury to check that it isn't anything more serious that needs further investigation or onward referral to a surgeon. It's also important to seek help if you feel like things are steadily worsening, or you just can't get to grips with helping it get better. We can help give you a diagnosis, and unpick all the activities you do each day to work out the stresses and strains it puts on your body - also how to balance that out with specific stretches or exercises, or even other jobs that you could do that would even out the load.
If you'd like our advice, then please book a consultation - this can either be face to face or online - and we can assess your injury, give a diagnosis, treatment (including hands on therapy where appropriate for face-to-face patients), and a personalised rehab plan to get you back on track and doing the things you enjoy.
Hope that helps!
References
Lucas Maciel Rabello, Iris Sophie Albers, Mathijs van Ark, Ron L. Diercks, Inge van den Akker-Scheek, Johannes Zwerver; Running a Marathon—Its Influence on Achilles Tendon Structure. J Athl Train 1 February 2020; 55 (2): 176–180. doi: https://doi.org/10.4085/1062-6050-49-19
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