Can Physiotherapy Make You Worse?

Physiotherapy is widely recommended for recovery after injury, pain management,  and improving mobility, but it’s natural to wonder, “Can physiotherapy actually  make things worse?”. Starting physiotherapy for the first time or returning after  a long break can be somewhat intimidating. Here’s what you should know about  why discomfort can sometimes occur, how to tell the difference between normal  and harmful pain, and what to do if your symptoms worsen during treatment.  

Why You Might Feel Worse After Physiotherapy  

In many cases, a bit of soreness or increased discomfort after physiotherapy  isn’t necessarily a bad sign. Instead, it can be a normal part of your body  adjusting and healing. Here’s why:  

1. Muscles and tissues are adapting  

- Physiotherapy often targets muscles that may have weakened or tightened  over time. Using them in new ways can lead to muscle soreness, similar to  what you feel after starting a new workout. Known as delayed onset muscle  soreness (DOMS), this usually appears within 24 - 48 hours and typically  fades on its own.  

2. Mobilizing restricted areas  

- Manual therapy techniques such as joint mobilization, stretching, or massage  can temporarily irritate sensitive tissues. While this might feel uncomfortable  initially, it often helps improve circulation, reduce stiffness, and restore  mobility over time.  

3. Correcting compensatory patterns  

- When you’ve lived with pain, your body often develops movement habits to  protect the painful area. As physiotherapy helps correct these patterns, you  might feel discomfort in new places as your body adjusts and relearns  healthier ways to move. 

When to Be Concerned  

While mild soreness following physiotherapy is normal, treatment should not  provoke sharp, severe, or progressively worsening pain. Immediately inform your  physiotherapist if you experience: sudden, intense pain distinct from your typical  discomfort; significant swelling, redness, or warmth in the treated area; new  neurological symptoms such as tingling, numbness, or weakness; or pain that  intensifies after successive sessions rather than improving. Early communication  ensures timely adjustments to your care plan, safeguarding your recovery  process.  

A professional physiotherapist will always monitor your response and adjust your  exercises or techniques if your symptoms suggest irritation rather than healthy  adaptation.  

How Physiotherapists Help Prevent Making Things Worse  

Qualified physiotherapists follow evidence-based practices to keep your treatment  safe and effective:  

1. Thorough assessment  

- Before starting, your physiotherapist will ask detailed questions about your  pain history, medical conditions, and lifestyle. They’ll also assess your  strength, flexibility, posture, and movement to create a plan tailored  specifically for you.  

2. Gradual progression  

- Physiotherapy should build up slowly. Rather than starting with high-intensity  exercises, you’ll typically begin with gentle movements and progress only as  your body adapts.  

3. Open communication  

- A good physiotherapist encourages you to share how you feel during and  after sessions. This helps them balance challenging your body while preventing  strain.  

4. Personalized approach 

- There’s no universal routine in physiotherapy. Your treatment should always  reflect your unique needs, goals, and limits.  

What You Can Do to Reduce Risk  

Your active participation is essential to ensuring a safe and effective  physiotherapy journey. To optimize your recovery, adhere to your  physiotherapist’s guidance regarding rest, prescribed exercises, and proper  posture. Avoid increasing repetitions, sets, or resistance unless explicitly advised  by your therapist. Promptly communicate any discomfort, excessive fatigue, or  concerns about specific movements. Remember that sustainable recovery requires  time and consistency. Prioritizing steady progress over excessive exertion will  yield the best long-term outcomes.  

Final Thoughts  

While temporary soreness after physiotherapy is possible, a well-structured,  professionally supervised program rarely exacerbates your condition. Open  communication is essential—inform your physiotherapist about your body’s  response so they can make safe, appropriate adjustments. If you have concerns,  discuss them during your initial session. A skilled physiotherapist will clarify  expectations and guide your recovery with expertise, care, and a focus on your  long-term progress.