3 Key Facts for Smarter Chronic Pain Recovery: Pain Awareness Month
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September is Pain Awareness Month, a global campaign to bring attention to the challenges that people living with chronic pain face every day, as well as the science-backed strategies that can help improve your quality of life.
Repetitive stress injuries like Plantar Fasciitis and Tennis Elbow account for a significant portion of chronic musculoskeletal pain conditions. Lasting for months despite efforts and impacting daily lives, these conditions are frustrating, to say the least. However, the good news is that recovery is possible, with the right approach and consistent effort.
To honor Pain Awareness Month, here are three underrated facts about chronic pain recovery in the context of repetitive stress injuries, and how you can use them to guide your recovery. Let’s dive in.
When you have significant pain, the natural instinct is to avoid movement. The “old way” of managing conditions like Plantar Fasciitis and Runner’s Knee used to prioritize rest. However, lack of movement makes things worse; to make progress toward recovery, you have to incorporate deliberate movements in your routine.
Rest is a good strategy at the beginning of your recovery work. However, prolonged rest (or, sometimes, completely immobilizing your injured body part, as in the case of a common PTTD brace) has multiple negative impact on your recovery:
Eventually, resting for too long weakens your whole kinetic chain, which means your body loses the strength to manage the repetitive stress of even your normal, everyday movements (like standing, walking, or gripping).
Repetitive stress injuries happen when your muscles and other tissues (as a “team” that works together) don’t have enough strength to tolerate the load and stress of your activities - these injuries happen when load exceeds your capacity.
So, it makes sense that you’d want to (re)build your strength (capacity), so you can move through your day and favorite activities without injuries. That’s why in most cases of chronic musculoskeletal pain, movement is an integral part of the solution.
That said, it pays to be intentional about the load you put on your sensitive tissue. The key is to give the tissue the right kind and amount of stress. With intention, you have a better chance of building strength without aggravating pain or worsening your condition.
PTs like to think of it as variables: at the beginning of your recovery, when your tissue is quite sensitive and weak, you limit the amount of variables in your daily life, by reducing the types of activities, modifying activities, or wearing a brace.
As your tissue heals and you get stronger, you gradually (re)introduce more variables, such as:
More frequent activities or exercises
Higher intensity of activities
New exercises in your physical therapy exercise program
More complex exercises that load multiple tissues at once
Variables can be subtle. If you’re recovering from PTTD, for example, you may stick to wearing your most comfortable pair of shoes at the beginning, but realize that you can occasionally wear your less supportive sandals every now and then, as you progress.
For people recovering from Tennis Elbow, the main variable could be how many hours they spend at the computer, typing. For people with Plantar Fasciitis, walking on different surfaces (rocky trails vs. paved city streets) can be considered a variable.
By staying active and paying attention to the factors that change the stress on your healing tissue, you can make sure your movements are making a positive impact on your recovery.
In short, to accelerate your recovery from chronic injuries, keep moving, but smarter.
When you commit to taking control of your chronic pain, the very early stage of recovery can set the tone for the entire process. If you’re following an evidence-based treatment plan, whether guided by a physical therapist or a structured at-home PT program, you should be able to feel meaningful changes within the first week.
That doesn’t mean your pain will disappear overnight or your recovery will be linear. However, you should experience a significant reduction in intensity or frequency of pain within those first seven days. This early progress is key for two reasons:
It confirms that you’re on the right track, so you don’t waste your time and energy on ineffective treatments. In other words, if you have to wonder if a particular treatment is really working, it probably isn’t. If it’s working, you’ll know, pretty quickly.
A good way to know, for sure, is to quantify your pain every time you apply treatment (exercises, massage, etc.), using the tests that we use in our chronic pain quizzes, like the tennis elbow test, called Maudsley's Test.
When your pain drops noticeably, success gives you a motivational boost. This might sound like a minor thing, but it’s not. Chronic pain recovery takes time and consistent effort, and keeping your mental game strong is crucial.
It’s especially true when, like many of the Alleviate users, you’ve tried multiple treatments that didn’t work at all, or only brought temporary relief. Those disappointments make you skeptical, and it becomes harder to believe that you CAN get better.
So, it’s important to structure your treatment program so that you keep making tangible progress early, and as much as possible throughout your recovery. Competent PTs can design your treatment program this way, and it’s a defining principle or our all-in-one Systems and Guided Recovery Programs.
Unless you have PT training, it's tricky to design an exercise program that gets you a quick, belief-building success at the beginning, and guides you toward recovery, one challenge at a time. This is where our at-home physical therapy Systems come in:
They come with all the tools you need to recover at home, and are designed to give you a quick, tangible pain reduction within these crucial first 7 days. On average, users report a 20% pain reduction in 7 days, enough to make a real difference in your day-to-day life, and start building momentum.
This ties into the concept of controlling variables that we discussed earlier. By being intentional and deliberate, you give yourself a higher chance of making progress, which reinforces your belief in the treatment, which makes you want to stick to it - this is the virtuous cycle of treatment that works. ( More on that here.)
As it turns out, this is not just about your perception. When your early effort results in less pain, your brain actually rewires itself, better positioning you for more pain reduction and long-term recovery that sticks.
Chronic pain isn’t just about injured muscles, tendons, or joints. It’s also about how the nervous system interprets pain signals. When you’ve been hurting for weeks or months, your brain becomes sensitized to pain, continuing to flag activities as painful, even when the tissues themselves are well on their way to recovery.
This is why successful recovery requires more than just the tissue healing. You also need to retrain your brain. The way to do that is by creating a series of safe, pain-free experiences of movements - easiest to do by following a structured program, like our Systems for Plantar Fasciitis, PTTD, Tennis Elbow, and Runners Knee, or in-person physical therapy.
Each time you perform an activity that used to hurt, now without triggering pain, your brain learns that the danger is gone.
The same principle applies to physical therapy exercises. You start with easy movements that target just one muscle or tendon and give your brain a success story; then you move onto slightly more challenging movements with higher load or complexity, but still easy enough for your brain to get another experience of “oh, I did this and it didn’t hurt - cool,” and so on.
Over time, this helps your brain return to its “normal” state from “high alert” state, and restores confidence in your body’s ability to function.
Keep moving with intention: too much rest further reduces your body's capacity to tolerate the repetitive stress of your everyday activities. Incorporate intentional movements (progressive strengthening exercises) into your recovery work for best results.
Know if it's working within 7 days: significant pain reduction within the first 7 days is a sign that your treatment is the right one, and it boosts your motivation, which is important for chronic pain recovery that takes time and effort.
Rewrite the pain narrative: give your brain a string of experiences where movements don't result in pain. This helps your brain transition from the scared, high-alert state to a normal state, and you can move with more confidence as your injured tissue heals.
Luke Ferdinands, Physical Therapist & Co-Founder
A New Zealand-trained physical therapist with over 20 years of experience, Luke developed the Alleviate Method to bring the gold standard of physical therapy care to everyone's home. Luke leads the development of physical tools and digital physical therapy content, focusing on driving clinical outcomes for people with chronic musculoskeletal pain conditions like Tennis Elbow, Plantar Fasciitis, Runner's Knee, and more.
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