Whenever we assess a new patient, we ask about “aggravating factors” and “easing factors”. Essentially, we want to know about the activities that make your symptoms worse and the activities that make your symptoms better. A common example would be back pain that worsens with sitting, and reduces when walking or moving about. The behaviour of your symptoms in response to particular activities is very useful information. It helps us to plan and structure what we refer to as Activity Modifications.
Our experience has been that the best treatment outcomes occur when we are able to identify and alter the performance of activities that we suspect are driving your symptoms. Activity Modification considers four aspects of any given activity:
- how the activity is performed (biomechanically)
- how long the activity performed for (duration)
- how often the activity repeated (frequency)
- how much load is associated with the activity (intensity)
The most common scenario we see in our clinic is the one in which a patient has recently begun something new- such as a new gym program or a new sport or some sort of physical challenge that is out of the ordinary e.g. moving house or nursing a new baby. Sometimes, it is difficult to identify activities that might be driving your symptoms. In all cases though, we think there is value in making an effort to consider how your daily routine might be contributing to your symptoms. In fact, in the absence of such an effort, our view is that other treatment options are likely to only bring about short term relief.
Activity modifications can be simple. Very often all we need to is alter the intensity, frequency or duration of tissue loading. A person who has had an onset of shoulder pain following a recent increase in time spent swimming laps, will probably benefit from a reduction in either the duration or frequency of swimming sessions. In other scenarios things can be more complex- especially if the identified “aggravating activity” is an essential activity for one’s occupation or sport. An electrician for example, can’t simply “back off” kneeling or using ladders etc. In these situations we rely upon our knowledge of biomechanics and tissue load tolerance to vary how the activity is performed. If we can provide you with 3 or 4 alternative ways to complete an activity or task, chances are the activity will not continue to be problematic.
Most often, the need to modify activities is only temporary. By this we mean that most often, symptoms arise from the addition of a new activity or the increase in either the duration, intensity or frequency of an activity. It stands to reason then, that most often, the solution is straight forward. There are however scenarios where modifying a particular activity is not sufficient to bring about a resolution of symptoms. This is usually because the symptoms are longstanding or chronic in nature. We don’t expect to see a rapid reduction in symptoms with activity modification in the scenarios. In these situations, it is important to reconsider your goals as they relate to the activity in question. Full resolution of symptoms is still common, but progress is slower. Occasionally, full resolution is not achieved, and patients have to come to terms with the possibility that a particular activity simply cannot be performed as much or as often or as intensely anymore. This could be a trivial fact for some people, or life altering dilemma for others.
If you’re injured, recovering from surgery, or dealing with an ache or pain that isn’t subsiding, call us on 9665 9667. We can carry out a thorough assessment of your musculoskeletal system and put together a treatment plan that incorporates manual therapy, exercise and addresses your occupational, recreational or sporting activities with a view to their potential contribution to your symptoms.
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