Most People Don't Heal
Most people experience an accumulating series of aches and pains throughout their life. These aches and pains do not have to be a part of daily life. The problem is most people don't heal. They don't heal because they do not know how extensive the healing process really is. It is highly unlikely that a doctor frequently takes the time to describe the healing process to a patient, even though that information is a key factor in that patient healing. This a perfect representation of our healthcare system. We are very good at addressing pain and patients are highly managed in the short term, but our chronic care and interventions are sorely lacking. Nearly 60% of patients do not even complete their treatment plans with general practitioners, physical therapists and chiropractors, choosing to self-discharge instead. Think about that. The majority of patients do not finish their care plans. Doctors can complain all they like about bad patients who do not finish care, but most doctors, I would guess, do the same or worse. Many doctors do not even have a regular doctor themselves. The human experience is simply that if we stop seeing value in an experience we tend to stop that experience. Failing to see value in your treatment turns the treatment into a negative experience. You actually need a high value proposition to go to the doctor. For most patients going to the doctor has high barriers. It means taking time off from work/family, draining their bank account, sitting in a waiting room for 30 minutes to an hour and potentially exposing yourself to other sick people. It is understandable that people stop coming to care. I think doctors need to get much better at education so patients can find value in continuing treatments.
There are 3 stages of soft tissue healing. Inflammatory, Repair and Remodel. Soft tissues includes injuries to muscle, tendon, ligament and fascia for the purposes of this discussion.
The inflammatory stage is characterized by inflammation, pain and swelling. It can last anywhere from 2-10 days depending on how protected the area is. This is the stage where people typically seek out the aid of a doctor for care. For example, you slip and land on your back, it hurts so you call the chiropractor. People see lots of value of attending care in this stage because the experience is so negative.
The repair phase is typically a 6 week period in which the body is rebuilding tissue. Soft tissue that is torn, dead or damaged needs to be repair and the process is quite slow. People usually start thinking about leaving care in the middle of the repair phase. Tissue repair is usually associated with lowered levels of pain. As the phases progresses pain levels becomes less and less. For example, you go to the chiropractor and in the first few weeks experience 60-70% reduction in pain, but in week 4 pain reduction is only another 5%. This diminishing of pain reduction is a big driver in people leaving care. The lack of a large negative experience actually drives people from care. Usually you will hear stories like "yeah it was working for a while, but now it's just not improving."
Most people do not stay in care during the remodeling phase of injury. This phase is where the new tissue can develop the necessary strength or flexibility needed to serve its function. It terms of rehabilitation this is the most important stage of care. Without this stage you are highly prone to re-injury. If the stability or flexibility is not at pre-injury status or better, getting injured is just a matter of time. The stage can last between 6 weeks and 3 months post injury. Think about your own experience with the medical system. Have you ever been in care for 3 months? Likely not. This stage is key to completing the healing process, but it is rarely encountered by patients because it's not about pain. It's about function. It's about getting all the kinks out and getting your body back in pre-injury state. If you leave care before this stage is done you are doing yourself a disservice. This stage is not about frequent visits, but about formulating a home plan that you feel comfortable following and that will promote independence. Ironically, this stage is the most ignored, but most important. It might also be the easiest stage as a doctor might only need to see you once a month or once every two months to check progress and advance the home plan to the next stage.
Most people don't heal because they fail to complete the healing process. This reality of healthcare is costing time and money. Physical therapists and chiropractors know that the biggest risk factor in determining injury is whether you had a previous injury. If you left care early, I'm urging you to get back in touch with your health professional and make sure you have a plan to complete your healing process. Years from now your body will thank you.