“Why am I not getting better?”

pain-knee“Why am I not getting better?”

Fortunately, it’s not something I hear TOO often in my practice, but it does happen. Often it’s because I need to change my approach or the client isn’t doing his or her part.

But sometimes you are doing all you think you should be to heal an injury, and it just doesn’t seem to improve, or not quite as fast as you see other’s recovering from similar problems. Myriad individual factors affect recovery times, including your particular anatomy and physiology, your age, your job and your activity level (or lack thereof). But there are a few common pitfalls that can slow recovery from injury.

foot pain physical therapyYou’re doing the same thing that got you injured in the first place

Whether it was the repetitive motion of the keyboard or a clean-and-jerk that injured your wrist, continuing to perform the same activity without modification or protection will ensure that you stay hurt. This seems like a no-brainer, but in my experience, most injuries are related the things you do most – and work ranks #1 for most of us. If it’s prolonged sitting causing your neck pain, you can’t continue the same behavior and expect it to improve, even with treatment.

You’ve stopped training altogether

Stress is stress. Mental, emotional, injury, and exercise are all interpreted by your body as STRESS. So adequate rest is important for recovery; however so is adequate movement. You may need to modify, substitute or scale exercise, but too much rest is as bad as not enough.

Your eating sucks

Optimal nutrition for recovery includes limiting the processed crap, sugars and refined carbs and bad fats. Also, early on in an injury is not a good time to be operating at a calorie deficit. A diet high in trans-fats and omega-6-rich vegetable oils increases inflammation. Omega-3 fats have an anti-inflammatory effect, and these anti-inflammatory fats don’t interfere with the repair and regeneration of the injured tissue. Enough protein is also critical.

Booze could also be a culprit. Alcohol slows muscle development, dehydrates the body, depletes energy, increases inflammation. Plus it negatively impacts sleep.

You’re not sleeping well or enough

If you don’t sleep you can’t heal. Ensuring athletes gain an appropriate quality and quantity of sleep may be important for optimal athletic performance. Poor sleep may reduce the production of
an anabolic endocrine environment and thus delay wound healing.


Arnold, M., & Barbul, A. (2006). Nutrition and wound healing. Plastic and reconstructive surgery117(7S), 42S-58S.

Byrne, A., & Byrne, D. G. (1993). The effect of exercise on depression, anxiety and other mood states: a review. Journal of psychosomatic research37(6), 565-574.

Cole-King, A., & Harding, K. G. (2001). Psychological factors and delayed healing in chronic wounds. Psychosomatic medicine63(2), 216-220.

Kiy, A. M. (1997). Nutrition wound healing. A bio-psychosocial perspective. The Nursing clinics of North America32(4), 849-862.

Butler, David S; Moseley, G Lorimer; Explain Pain:(Revised and Updated); 2013 Noigroup Publications

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