What I Wish I Knew Then

One of my friends recently met someone who is coping with back pain and just starting out on her journey to find some help. My heart goes out to anyone with any type of muscular pain. It's certainly not easy. So what would I tell someone like this, or anyone who is beginning (or continuing) to deal with a sore neck, back, knees, elbow or whatever else?

Get a second opinion, or third or fourth.
Most people whom my physio treats have had at least one failed treatment. I certainly did. The sad reality is that there is a wide variation in the quality of physiotherapists (physical therapists) or medical practitioners of any sort out there. Make sure to find someone you are comfortable with on a personal level and who makes you feel confident in their abilities. They should also be able to express exactly what is wrong with you, how they plan to fix it and what the long-term plan is. Most muscular pain – typically caused by an imbalance in the musculoskeletal system – can be treated. You shouldn't have to keep going to see someone for the rest of your life. Also, be sceptical of practitioners who say things like "you need to get stronger" without actually helping you to do that. Getting stronger is no good if it's not targeted at the specific muscle groups that correct the imbalance.

Just because a pain is in one place it doesn't mean that's the root of the problem.
I had severe hand, elbow and neck pain. I had extremely tight muscles in my arms, but that wasn't the root of the cause. The problem was the alignment in my neck and shoulders. There was nothing wrong with my hands and arms! Even tennis elbow may not be caused directly by a problem with your elbow. Funny enough, you may actually need to strengthen your legs to run to the ball faster instead of reaching further to hit it and therefore straining your shoulder/elbow.

Evaluate your posture.
When the pain first hit me I was totally in the dark about what was causing it. Someone I worked with took one look at me and said, "Your neck hurts because you don't sit up straight." I was really taken aback and thought, that's not possible, that's too simple an explanation. Turns out, essentially, he was right. An older colleague from the time when children were taught to sit and stand up straight, seems he actually knew more about the body than the first physio I went to see. So look at how you're standing and sitting. Also, take a look at the way you walk. Your feet should be straight, your bum tucked under, your strides should be long (short strides can indicate stiff hips) shoulders shouldn't be hunched forward and the chin should be tucked in, not sticking out ahead of the rest of you. It's simple stuff, but very important.

Know your body type.
Are you bendy, flexible? No problem touching your toes? It may be hard to tell, but flexible people, known in the medical world as hypermobile (which is what I am) are more prone to muscle imbalance problems. It's because our ligaments are longer than other people's and we need more strength to keep everything in place. While stiff people have other problems, one advantage of being less flexible is that getting stronger isn't necessarily a part of your treatment – you only need to stretch out the overly stiff parts. Hypermobile people, on the other hand, have to get strong enough to hold their posture in place properly. It's definitely helpful to know where you stand when seeking treatment.

Avoid surgery.
Surgeons like to do surgery. But before you let anyone cut into you, know that even when you have some sort of surgery to eliminate pain (hip, knee, slipped disc, etc.) you STILL have to do physio work to correct the muscle problem that got you into trouble in the first place. Surgery should be a very last resort. And sometimes doesn't even help. Which is why it's worth attempting to correct the muscle imbalance before going under the knife.

Be sceptical of some alternative therapies.
I'm a big fan of acupuncture, but I don't think it would have ever fixed my problem. There are other therapies that people try, like massage, that may alleviate symptoms but don't usually get to the root of the problem. If you have tight muscles and need regular massages, or a chiropractor to crack things constantly, something isn't right. Fixing the muscle imbalance is usually cheaper in the long run. The thought of getting a massage doesn't even interest me anymore as I don't ever need one. The exercises work much better.

A pain that isn't that bad now may still be worth fixing.
You may be able to get by now, but trust me, that neck ache or knee twinge will probably only get worse (sorry – it's the truth!). I had twinges in my arms/hands for years before the pain got nuclear. A pain in the same place all the time isn't just a coincidence, there's something you're doing to cause it. Fix it now when it's easier to sort out and feel much better later (also, save money on painkillers, future physio trips etc.). And improving your posture is a long-term investment. You don't necessarily need to walk all hunched over when you're 80.

Don't give up.
Fixing a long-term problem (most pain only occurs after quite some time) isn't easy. It's hard work. Including finding the right practitioner, doing the exercises, and dealing with setbacks. It took me at least a year to find someone right to treat me and then the better part of four years to get better (I had some complications, however, so don't let that discourage you too much). Hang in there. There is a life without pain.


I'm still looking for books to recommend to people with muscular pain. I haven't found any that are good enough just yet, although I've got a few that I'm evaluating right now. I can't refer everyone in the world to my physio, so would like to have a good resource page on this site.

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