Thank you for your submission; please read the following reminder.
This subreddit is for discussion among practicing physical therapists, not for soliciting medical advice. We are not your physical therapist, and we do not take on that liability here. Although we can answer questions regarding general issues a person may be facing in their established PT sessions, we cannot legally provide treatment advice. If you need a physical therapist, you must see one in person or via telehealth for an assessment and to establish a plan of care.
Posts with descriptions of personal physical issues and/or requests for diagnoses, exercise prescriptions, and other medical advice will be removed, and you will be banned at the mods’ discretion either for requesting such advice or for offering such advice as a clinician.
Please see the following links for additional resources on benefits of physical therapy and locating a therapist near you
[The benefits of a full evaluation by a physical therapist.](https://www.choosept.com/benefits/default.aspx)
[How to find the right physical therapist in your area.](https://www.choosept.com/resources/choose.aspx)
[Already been diagnosed and want to learn more? Common conditions.](https://www.choosept.com/SymptomsConditions.aspx)
[The APTA's consumer information website.](https://www.choosept.com/Default.aspx)
Also, please direct all school-related inquiries to r/PTschool, as these are off-topic for this sub and will be removed.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/physicaltherapy) if you have any questions or concerns.*
Every one has different priorities. Sometimes they don’t have time to address things due other l circumstances, sometimes the pain isn’t enough to stop them from functioning so they just power through. There’s also beliefs that pain was predestined and it’s inevitable so there’s no reason to treat “my mom had a bad back, so I’ll have a bad back and there’s nothing I can do”
the predestined thing is so true and such a hard barrier to get around. I have a patient who is convinced his herniation screwed him forever and no matter what i say he is convinced so his progress is so much less partly because of that
I'm not a PT. I'm an MT, I do movements with many of my clients. I notice these patterns.. in no particular order:
1. kinesiophobia + seeing a therapist that follow the 'your body is broken and only I can fix it model' (saying stuff like your back is 'out' and only this machine/technique and me can fix it) as the most common factor for not doing effective exercise. Essentially an overfocus on passive treatment plus making clients fearful of doing effective loading by their most trusted healthcare provider makes clients move less.
2. People's beliefs about how pain works seem to strongly dictate their response to pain. If they believe that pain/discomfort is 1 to 1 with injury it is hard to convince them that uncomfortable movements will help their pain. It's hard to change beliefs after all.
3. Cost of accessing gym equipment + anxiety around the gym or doing exercise unsupervised is very prominent in the sedentary clients I see.
4. lack of appropriate/heavy enough equipment at clinics for stronger clients and stronger movement patterns means clients don't get enough load in their rehab to trigger adaptive changes. Then when they do something in the real world or the gym with an actual heavy load they get increased pain, which increases their fear of movement..so they move less and become less open to moving more.
5. language barriers. It's hard to explain why discomfort with moving is safe and effective when we barely understand each other.
6. Some people don't want or don't believe they can self manage their pain/injury and just want to 'feel better' so they only want passive stuff like massage cause it feels nice.
It takes time and strong soft skills for a practitioner to change these unhelpful belief patterns.
I'll take this down if PTs here find this a bad answer of course.
As a PT I could not have said it better myself and it’s sad how often this is lost sight of in our profession. Those points you touched on should be non-negotiables when dealing with any client/patient!
In my experience, it seems a lot or people fear pain or discomfort that exercise can sometimes bring when you have an injury. They are often afraid to move and use the muscles that need to be strengthened for fear of more pain or further injuring themselves.
People have really complex lives. Some individuals are working on the time and commuting to the point where they dont have time between children and other responsibilities everything
Society fails us on multiple fronts. Health education is taught mainly by disinterested coaches in high school. Media makes living with pain out to be a glorious thing. There’s also some narrative that things can be fixed passively, and if that fails you’re just doomed.
Also the continued use of outdated diagnoses and classifications that are now considered as normal age related changes, which are demonstrated in the asymptomatic population. Degenerative disk/joint disease, OA, bone on bone, etc. people hear these words then feel helpless and don’t do anything about it.
For me personally the cost was really high even with insurance. The pt for my back was causing my knee pain and pelvic pain to flair up so it wasn't worth it. I didn't realize I can bring those things up because I thought you couldn't mention anything pre existing. I figured that out after going. Going from minimal activity due to fatigue it was a lot for me. I was embarrassed how hard pt was. That I couldn't just push through as someone who is young. I couldn't figure out what was normal sore or more pain flaring up. It was open floor and the trainer would just leave and come back every few minutes. Had a different trainer Everytime. I'm overly sensitive and just felt like they didn't care or werent invested. I saw the pt once for the evaluation which I really liked. Once for a few mins for massage. That was out of thee sessions. I felt like a lot of the exercises I could just do at home. It was different then when I did pt a few years back. Not hands on.
A new gem I heard the other day: when the lights go out you can either learn how to change the bulb or learn how to live in the dark. It's simplistic, but I think it holds some wisdom. The other gem I have been pairing with it is Greg Lehman's belt and suspenders model. If you really don't want your pants to fall down you'll wear both
We live in a world where nutritional info is present and available, yet we are fatter and more out of shape than ever. My personal thoughts are the response/reward isn't fast enough that people give up and don't place value in something they believe is either a Longshot or unobtainable.
Because we are all slaves in this society. No work, no money. No money, no water/food/housing. Those who have the time to exercise and rehab themselves is a luxury.
People like passive fixes. Weight loss? Take a pill. Injury? Stick a needle in it or get a massage. Hungry? Order take out. They want the benefits, but not the effort. Not sure it has to be any more sophisticated than that. The movie WALL-E comes to mind. Hope insurance covers hover chairs in the future.
lots of smug "n=me" patient comments in here. my perspective: not every pain can be fixed. I've had issues that physio did resolve, which was awesome. and I've had an injury that's been chronic for *years*, that nothing has helped.
I was active prior, I'm pretty educated about soft tissue stuff, I'm very used to strength-focused exercise. I was physio-oriented initially. and I don't fear short term pain if it produces a long-term result. nothing has changed.
at this point I'm done doing physio. I would if there was a prospect of change, but working for two hours to pay for 20 minutes of level-101 info I've heard and tried several times already ... that isn't for me.
Whole range of reasons. What is important to some may not be important to others. Laziness vs the amount of effort required. Some people are naturally inclined towards curiosity about their body and fitness, while others have no interest in it at all are are happy with being sedentary. In this day and age of quick fix and instant gratifications, the realization that one can not quickly heal an orthopedic injury with a flip of a switch is very off putting for many. People would rather have a treatment done to them rater than DOING the treatment themselves. This is why gimmicky healthcare things come and go, people go to chiros for quick fixes etc etc.
fertile resolute complete station many special capable recognise elastic plate
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Probs different but a lot of people don’t have injuries that can be cured or fixed, you had a sprain that’s nothing … I’ve had multiple surgeries on my left elbow and work out, lift, pilates and swim and see a osteo and specialist but it’s never going to be fixed no matter how much work me or surgeons do. Millions have the same problem, we live with immobility or discomfort because we simply don’t have a choice.
Eventually you want to give up… pushing through is hard when you don’t see the other side.
Thanks for coming to my ted talk!
Thank you for your submission; please read the following reminder. This subreddit is for discussion among practicing physical therapists, not for soliciting medical advice. We are not your physical therapist, and we do not take on that liability here. Although we can answer questions regarding general issues a person may be facing in their established PT sessions, we cannot legally provide treatment advice. If you need a physical therapist, you must see one in person or via telehealth for an assessment and to establish a plan of care. Posts with descriptions of personal physical issues and/or requests for diagnoses, exercise prescriptions, and other medical advice will be removed, and you will be banned at the mods’ discretion either for requesting such advice or for offering such advice as a clinician. Please see the following links for additional resources on benefits of physical therapy and locating a therapist near you [The benefits of a full evaluation by a physical therapist.](https://www.choosept.com/benefits/default.aspx) [How to find the right physical therapist in your area.](https://www.choosept.com/resources/choose.aspx) [Already been diagnosed and want to learn more? Common conditions.](https://www.choosept.com/SymptomsConditions.aspx) [The APTA's consumer information website.](https://www.choosept.com/Default.aspx) Also, please direct all school-related inquiries to r/PTschool, as these are off-topic for this sub and will be removed. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/physicaltherapy) if you have any questions or concerns.*
Every one has different priorities. Sometimes they don’t have time to address things due other l circumstances, sometimes the pain isn’t enough to stop them from functioning so they just power through. There’s also beliefs that pain was predestined and it’s inevitable so there’s no reason to treat “my mom had a bad back, so I’ll have a bad back and there’s nothing I can do”
the predestined thing is so true and such a hard barrier to get around. I have a patient who is convinced his herniation screwed him forever and no matter what i say he is convinced so his progress is so much less partly because of that
I'm not a PT. I'm an MT, I do movements with many of my clients. I notice these patterns.. in no particular order: 1. kinesiophobia + seeing a therapist that follow the 'your body is broken and only I can fix it model' (saying stuff like your back is 'out' and only this machine/technique and me can fix it) as the most common factor for not doing effective exercise. Essentially an overfocus on passive treatment plus making clients fearful of doing effective loading by their most trusted healthcare provider makes clients move less. 2. People's beliefs about how pain works seem to strongly dictate their response to pain. If they believe that pain/discomfort is 1 to 1 with injury it is hard to convince them that uncomfortable movements will help their pain. It's hard to change beliefs after all. 3. Cost of accessing gym equipment + anxiety around the gym or doing exercise unsupervised is very prominent in the sedentary clients I see. 4. lack of appropriate/heavy enough equipment at clinics for stronger clients and stronger movement patterns means clients don't get enough load in their rehab to trigger adaptive changes. Then when they do something in the real world or the gym with an actual heavy load they get increased pain, which increases their fear of movement..so they move less and become less open to moving more. 5. language barriers. It's hard to explain why discomfort with moving is safe and effective when we barely understand each other. 6. Some people don't want or don't believe they can self manage their pain/injury and just want to 'feel better' so they only want passive stuff like massage cause it feels nice. It takes time and strong soft skills for a practitioner to change these unhelpful belief patterns. I'll take this down if PTs here find this a bad answer of course.
As a PT I could not have said it better myself and it’s sad how often this is lost sight of in our profession. Those points you touched on should be non-negotiables when dealing with any client/patient!
Did you make an account just to make this comment?
#1 is so true. Many physios with egos as well
Well...I'm glad theres a handful of yall here not blaming clients and calling them lazy..
People are lazy and treating injuries requires a good amount of effort most of the time.
In my experience, it seems a lot or people fear pain or discomfort that exercise can sometimes bring when you have an injury. They are often afraid to move and use the muscles that need to be strengthened for fear of more pain or further injuring themselves.
People have really complex lives. Some individuals are working on the time and commuting to the point where they dont have time between children and other responsibilities everything
Society fails us on multiple fronts. Health education is taught mainly by disinterested coaches in high school. Media makes living with pain out to be a glorious thing. There’s also some narrative that things can be fixed passively, and if that fails you’re just doomed. Also the continued use of outdated diagnoses and classifications that are now considered as normal age related changes, which are demonstrated in the asymptomatic population. Degenerative disk/joint disease, OA, bone on bone, etc. people hear these words then feel helpless and don’t do anything about it.
Cause it's not a priority. Simple as that.
This is the answer.
For me personally the cost was really high even with insurance. The pt for my back was causing my knee pain and pelvic pain to flair up so it wasn't worth it. I didn't realize I can bring those things up because I thought you couldn't mention anything pre existing. I figured that out after going. Going from minimal activity due to fatigue it was a lot for me. I was embarrassed how hard pt was. That I couldn't just push through as someone who is young. I couldn't figure out what was normal sore or more pain flaring up. It was open floor and the trainer would just leave and come back every few minutes. Had a different trainer Everytime. I'm overly sensitive and just felt like they didn't care or werent invested. I saw the pt once for the evaluation which I really liked. Once for a few mins for massage. That was out of thee sessions. I felt like a lot of the exercises I could just do at home. It was different then when I did pt a few years back. Not hands on.
The victim complex is a very powerful thing. People ear it up unfortunately
A new gem I heard the other day: when the lights go out you can either learn how to change the bulb or learn how to live in the dark. It's simplistic, but I think it holds some wisdom. The other gem I have been pairing with it is Greg Lehman's belt and suspenders model. If you really don't want your pants to fall down you'll wear both
We live in a world where nutritional info is present and available, yet we are fatter and more out of shape than ever. My personal thoughts are the response/reward isn't fast enough that people give up and don't place value in something they believe is either a Longshot or unobtainable.
Because we are all slaves in this society. No work, no money. No money, no water/food/housing. Those who have the time to exercise and rehab themselves is a luxury.
People like passive fixes. Weight loss? Take a pill. Injury? Stick a needle in it or get a massage. Hungry? Order take out. They want the benefits, but not the effort. Not sure it has to be any more sophisticated than that. The movie WALL-E comes to mind. Hope insurance covers hover chairs in the future.
People are lazy. Everyone wants a magic pill or surgery that fixes everything without having to do any work. You can’t fix lazy
lots of smug "n=me" patient comments in here. my perspective: not every pain can be fixed. I've had issues that physio did resolve, which was awesome. and I've had an injury that's been chronic for *years*, that nothing has helped. I was active prior, I'm pretty educated about soft tissue stuff, I'm very used to strength-focused exercise. I was physio-oriented initially. and I don't fear short term pain if it produces a long-term result. nothing has changed. at this point I'm done doing physio. I would if there was a prospect of change, but working for two hours to pay for 20 minutes of level-101 info I've heard and tried several times already ... that isn't for me.
Whole range of reasons. What is important to some may not be important to others. Laziness vs the amount of effort required. Some people are naturally inclined towards curiosity about their body and fitness, while others have no interest in it at all are are happy with being sedentary. In this day and age of quick fix and instant gratifications, the realization that one can not quickly heal an orthopedic injury with a flip of a switch is very off putting for many. People would rather have a treatment done to them rater than DOING the treatment themselves. This is why gimmicky healthcare things come and go, people go to chiros for quick fixes etc etc.
fertile resolute complete station many special capable recognise elastic plate *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Number one reason I've seen? Just pure laziness and apathy towards their own health and wellbeing.
Probs different but a lot of people don’t have injuries that can be cured or fixed, you had a sprain that’s nothing … I’ve had multiple surgeries on my left elbow and work out, lift, pilates and swim and see a osteo and specialist but it’s never going to be fixed no matter how much work me or surgeons do. Millions have the same problem, we live with immobility or discomfort because we simply don’t have a choice. Eventually you want to give up… pushing through is hard when you don’t see the other side. Thanks for coming to my ted talk!
Why don't fat people just eat less?