Should I Be Loading or Protecting an Injury?

Should I Be Loading or Protecting an Injury?


One of the biggest challenges both the physiotherapist and the patient face, is how far to push into pain. Some patients require protection from the “No Pain No Gain Approach”, whereas others need to stop avoidance behaviours. Today’s blog post with summarise the information a physiotherapist will consider before formulating the appropriate treatment plan. 

Patient Behaviours 

It’s not uncommon for patients to display psychosocial behaviours pertaining to their injury. This may be hyper-vigilance to symptoms, fear avoidance patterns or a preference to passive treatments (such as massage or manipulation).

Such patients often respond well to graduated exposure to load, whether it be functional tasks or prescribed rehabilitative exercises. This helps to break negative thought patterns associated with movement and exercise.

Time Since Injury 

Acute to Sub-actue injuries are normally still painful. This pain can be useful, as the tissues are still undergoing repair. It wouldn’t be approproate to start jogging on a recently sprained knee, for example. 

In contrast, if you’ve had a stiff neck for 2 years following a car accident, it’s certainly wise to start moving. Even if it initially causes pain. 

There is one exception to this rule: Post-surgery. After a surgery, there is only a small window of time to regain full range of movement. A physiotherapist must push a patient to the edge of their pain routinely, to ensure a full recovery. 

Client Goals 

Patients come in all forms. Some are active, whereas others are sedentary. Although exercise based rehabilitation is suitable for all, different goals can be achieved through different methods.

Patients with movement or performance based goals are more likely to endure pain during their exercises.  Slower loading approaches can be taken with those who just want to get rid of their symptoms.

If you’re unsure as to whether you should be loading your injury, book a free initial physiotherapy consultation by clicking here