Should I Move?

When someone seeks help it is usually because they are unable to recover on their own. They try different strategies but they do not feel much better. As pain lingers our body does not get “used to the pain” it actually starts to tell you the pain is worse than it really is. This is called central sensitization. In short this is when the body thinks it is in more danger than it really is. More danger turns into more avoidance. To the extreme this means people end up in bed when they should move. Knowing when that is can help begin your first steps to recovery.

A Good View But Not Off The Ledge

There are many metaphors that describe how much someone should move. As someone who is afraid of heights I always struggle getting close to a ledge. Even if there is a handrail or guardrail my brain does not allow me to trust it. This only becomes a problem when the “view is amazing.” This turns into a difficult decision; either I miss out or I work past my fear and inch toward the edge. But what if someone else showed me the safety of getting close and where it might become dangerous. This is where physical therapy can help you learn to move again.

Fear Is A Friend Until It Stops Us From Living

Danger signals, just like fear, change our brain. Fear of heights may not be a problem but if you are a skydiving instructor the fear will literally ground you. Just like fear however we can slowly learn to rewire the danger signals to reduce our pain and allow us to enjoy life again. Physical therapy helps people understand when they should listen to the danger. This allows people to work their way closer to the edge without going over. As an added benefit we help you do it faster and in a way that limits any setbacks. We do not leave you cowering in the corner or back in bed thinking all hope is lost.

PT Does NOT Mean Pain And Torture

When I first graduated this was a common joke I would make. As I became more educated I learned that this does a disservice to what PT does for a patient. For the vast majority of patients pain is not the goal. No pain no gain is incorrect. What I help patients do is understand their pain, learn their limits, and help them return to the things they love. I help patients know pain to know gain. Understanding pain is key and as an expert in helping patients understand their pain I do multiple things


  1. Know when to move
  2. Know how to move
  3. Know what to move
  4. Know where to move
  5. Know why to move

I stopped telling people what they had to do years ago. I now help people answer the question themselves while helping them along the way.

Dr. Bryan Nichols