what can a butterfly teach us about physical therapy?

An old monk is walking in the woods. The forest is lush with budding trees, sunlight shines through the leaves casting a green glow on the dirt path. The monk strolls along taking in the sights and sounds of a warm spring morning. Just off the trail, between the branches of a young tree, he catches sight of a small cocoon. Eager to see the butterfly inside, he reaches out and gently removes the cocoon. Cradling the tiny, white object, he lifts it to his lips and slowly breathes a steady stream of warm air.  He is attempting to mimic the warmth of the sun. After a few minutes of this, the cocoon opens. To the monk’s surprise, what emerges is not a beautiful butterfly. Instead, what he finds is underdeveloped and malformed. The butterfly takes a few breaths before quickly passing away. 

Nature has its own pace. It is not always wise nor in our best interest to rush it. 

I came across this story while reading Zorba the Greek by Nikos Kazantzakis. As I read these words, I began to think about a nagging knee injury. Have I been acting like the old monk? Wishing to speed up nature, rush the healing process and get to the good stuff at the other side? 

This attitude makes us desperate for a cure. This desperation facilitates so much that is wrong with my profession – physical therapy. It is easy to find a PT willing to promise a quick fix. They claim, “I can get you better! We just need to ____.”  Fill in the blank with; poke it with a needle, throw some cups on it, rub it a special way, or realign bones.

Sadly, there is poor evidence that any of these interventions can speed up recovery. More often, they leave us disappointed, frustrated, and wondering if there is something else “wrong.” Just like the monk things don’t turn out as planned. 

We cannot rush nature. Our body has its own ability to heal and adapt. As a PT this takes a lot of the pressure off. Instead of an operator “fixing” you, my job becomes more interactive. If I can’t rub, cup, or poke your body into healing, what can I do?

As a physical therapist, my job is to listen to your story and make sure it matches reality. Then I can help you get back to doing what you love. First, I need to be in a position to help you understand what’s going on. This begins with a conversation during which you are given the space and time to share your story and how it has affected your life. 

Next, a physical assessment guided by our previous conversation is performed. Watching you move and testing your strength we can get a glimpse into your unique body. Throughout the process, I will talk you through the findings and explain their relevance. 

Most importantly, I will help you understand what’s going on, answer any questions and clear up any confusion about your injury. This will help you change the story you are telling yourself. If you are anything like me, your mind is always going to the worst-case scenario. That little knee pain I’ve been feeling? My mind goes straight to – this is going to end my season, I am done for, I’m going to need surgery… 

Following a good discussion and assessment, I can give you a better understanding and a more realistic story. 

New understanding in hand, we can move forward with an active approach to managing your injury. Unfortunately, it is unlikely there will be a magical, quick fix. Instead, I will help guide you through a combination of activity modification, exercises (local and general), sleep, and nutrition recommendations. This will also help improve your overall health and well-being. For each person, this will look different. 

The goal is shifted from “fixing” you, to helping your body heal and adapt through general movement, specific exercise and healthy lifestyles. We can not rush this. The foundation is a better understanding of what’s wrong. This gives you the confidence to move and commit to the rehab plan. On top of this, we slowly build a stronger athlete better able to tolerate the demands of running. 

We all have that old monk inside us. The desire to speed things up. Just like with the monk and the butterfly rushing things is not the way. Instead, take control of your injury. Change the story. Get stronger. Get healthier.

As always, let me know what you think about the newsletter. If you have any questions please reach out. 

Run Faster, Feel Better, 

Jimmy

redefine-pt.com

Side note: There is nothing wrong with passive interventions i.e. dry needling, cupping, massage, or joint manipulations. These can be helpful but they are no substitute for more active interventions such as movement. Passive interventions can provide temporary relief. But I like to think of them as the seasoning you add to the meal. They are NOT the meat and potatoes of what gets you better. That belongs to education and movement. 

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