23 Hard Truths About DIY Physical Therapy

In News by Royce Bowman, PT, Director

Considering DIY physical therapy? Before you start, here are 23 reasons why you should re-consider.

Self Diagnosis of Musculoskeletal Disorders

Without proper medical training, you’ll be challenged to accurately self diagnose your musculoskeletal injuries. The internet, filled with medical misinformation and generic symptoms, can be misleading.

Of course, many people look for information or know someone who jumps on Google/WebMD to self diagnose. Before you know it, they develop 5 diagnoses that fit their symptoms. Unfortunately, you might mistake a severe condition for a minor one, or vice versa.

Also, self-diagnosing can lead to anxiety, especially when one starts researching and finding all possible diseases and conditions associated with their symptoms. This can lead to “cyberchondria,” a state of anxiety resulting from excessive health-related internet use. Come to me and let’s get your diagnosis right!

Ineffective DIY Physical Therapy

Even if you correctly identify your condition, your chosen treatment may not be effective. There’s no “one size fits all”. Often, what I see with self help advocates are general ideas for non specific problems. Then, it’s left up to the patient to figure out their issue.

DIY physical therapy

Here’s one example. A do it yourself person may be doing exercises for what they think is bicep impingement. In reality, their problem is a rotator cuff strain. Specificity is the key to getting well. Recently, I saw an article recommend a series of hip strengthening exercises for seniors. In particular, one general exercise, for many seniors, could lead to falling injuries or knee pain.

When I explain a treatment plan to a patient, I tell them the treatment is specific to their problem and overall health condition. Proper treatment requires understanding of the condition, its causes, and how various treatments affect the condition.

Worsening Musculoskeletal Injuries

Improper treatment can worsen your condition, leading to increased pain, prolonged healing time, or even permanent damage. This is particularly true with musculoskeletal injuries.

Ignoring Underlying Kinetic Chain Issues

We help identify and address underlying issues in your kinetic chain that can cause or exacerbate your condition. Without professional guidance, you might treat the symptom without addressing the root cause, which leads to recurring problems.

DIY Physical Therapy and Risk of Complications

Some treatments, particularly exercises and stretches, can be harmful when done improperly. You might injure yourself or cause further damage to the affected area.

Let’s look at home treatment of sciatica.

Without proper diagnosis, the lower back pain could be from a herniated disc. Or, the pain can be from a degenerative disc. Both issues present similar symptoms. An expert has to figure out what’s causing the sciatica pain, and determine what exercises or sciatica stretches a person should do.

When a lay person self diagnoses and start doing spine flexion exercises, that’s going to make the herniated disc pain worse. As you bend the vertebra forward, the disc pushes outwardly, toward the nerve. You’re doing the opposite of what you should be doing. In the end, you exacerbate your symptoms and make the pain worse.

Delay in Recovery

Due to ineffective treatment or worsening of the condition, you may experience delays in your recovery process. In some cases, this can result in long-term consequences such as chronic pain or disability.

Let’s return to sciatica. When you exacerbate sciatica symptoms, often, the nerve pain travels further down the limb. If it’s centralizing, it’s retracting back up to the source of the pain. In other words, moving back up the limb towards the epicenter of the pain. When you’re doing the wrong thing, the nerve pain peripheralizes and that’s a bad thing. On top of that, if you continue to add pressure to the nerve root, you could end up with motor strength or muscle weakness. This could lead to falls.

Before I became a physical therapist, I developed a herniated disc in my back. I tolerated the pain, but one day, while stepping out of a shower, my leg was too weak and I fell. Not knowing what to do or who to see, I ended up in surgery to remove that part of the disc that was pinching my nerve.

Risk of OTC Pain Med Addiction

For conditions involving pain, there’s a risk of becoming dependent on over-the-counter pain medication. Often, this leads to long-term health problems such as liver damage, kidney problems, gastrointestinal issues, and more.

Overlooking Serious Health Issues

Some musculoskeletal issues may be symptoms of serious underlying diseases such as cancer, neurological disorders, autoimmune diseases, etc. Self-diagnosis and treatment could potentially delay the detection and treatment of these serious conditions.

I’ve treated a patient for low back pain who wasn’t responding to treatment. As I ruled out various back pain causes, we eventually arrived at what appeared to be a more serious issue. I advised the patient to get additional studies done. We found the back pain was caused by a cancerous mass by the spine. Indeed, certain musculoskeletal pains can be caused by internal organs. Again, that’s one thing self diagnosis can’t find.

Lack of Progress Monitoring

With the help of Bowman PT staff, we monitor your progress over time. As needed, we adjust your treatments to get you the best results in the shortest amount of time. I can see if you’re improving, stagnating, or even worsening. Even better, we have therapy equipment, like Genuease, that let’s you see your progress.

Lack of Motivation and Accountability

Physical therapy can be a challenging and long process. We’ve found not having someone to guide and motivate you, you might not stick to the path you need for proper healing. If you are unsure of your progress, or lack of, you’ll find it difficult to stay motivated.

Lack of Equipment

We often use specialized equipment, such as a lateral trainer or Genuease, to specifically address your rehabilitation. This type of equipment is typically not available for general use at home or in a gym. Attempting to use household items as substitutes can be dangerous and ineffective.

DIY physical therapy

Incomplete Physical Rehabilitation

Once you start feeling better, you may want to stop your DIY physical therapy process before a full healing has occurred. This leaves you vulnerable to re-injury. When you’re an athlete, before returning to your sport of choice, you should have 100% clearance from your PT to prevent re-injury.

Pain Anxiety and Injury Depression

Dealing with injury and physical therapy can have significant emotional and mental aspects, which a physical therapist is trained to recognize and address. Ignoring these aspects can hinder recovery. Chronic pain leads to neuro chemical dysfunction, and which can make you experience more pain, anxiety, depression. All of these things are counter productive to healing,  improving, and getting better. Also, you can fall victim to a negative spiral which can lead to needing psychological help.

Safety Concerns

Certain conditions may require specific precautions during physical therapy to prevent further injury. Without professional guidance, you might be unaware of these precautions. For example, if you have surgery to reattach a torn tendon or ligament, there are specific protocols you must follow to keep from negatively affecting your surgery.

Lack of Manual Therapy

Certain physical therapy treatments require hands-on manipulation by a trained professional. These can’t be done effectively when you’re on your own.

DIY physical therapy


DIY Physical Therapy and Over Exertion

Without professional guidance, you may push yourself too hard and too fast in an effort to recover quickly. This over exertion can lead to further injuries or complicate existing ones. We refer to this as the “Too Much Too Soon Factor.”  We are expert at prescribing the right amount of activity for where you are at in your recovery.

Neglect of Comorbidities

Physical therapists consider comorbid conditions (the presence of one or more additional conditions occurring simultaneously with a primary condition). If you attempt self-healing without considering these comorbidities, you could inadvertently worsen these other conditions. For example, a leg length discrepancy may be your primary problem, but can turn into low back pain, hip bursitis, or IT band syndrome.  Once we fix your leg length discrepancy, your comorbidities go away.

Inappropriate Pain Management

Pain is a complex phenomenon and requires a multi-modal approach for management. Self-healing can often lead to the improper use of pain management strategies that could have adverse effects.  A simple illustration would be somebody who thinks that you always use heat on an injury. Or, you always use ice. Well, ice slows down nerve impulses and heat speeds up those same impulses. If you’ve got an acute injury, you don’t want to use heat on the injury right away because that can increase swelling and internal bleeding. The proper use of modalities and treatment sets the stage for healing.

Poor Posture or Movement

Certain conditions require you to maintain specific postures or make certain movements to promote healing and prevent further injury. Without the trained eye, you may not realize you’re doing these incorrectly.

Dehydration or Nutrition Mismanagement

Healing requires proper hydration and nutrition. A physical therapist can give you advice tailored to your condition and treatment. Attempting to self-heal without this guidance may lead to poor nutrition or hydration, hindering recovery. Often, chronic swelling may be from not drinking enough water.

Missing Out on Advancements in Physical Therapy

The field of physical therapy continually advances with new treatments and methodologies. Physical therapists stay updated on the latest research, techniques, and equipment. Without their expertise, you could miss out on benefits from these advancements. When appropriate, you may benefit from newer techniques such as dry needling or blood flow restriction.

Lack of a Holistic Approach

Physical therapists don’t just focus on the site of injury or pain. They consider the whole body and how different systems may impact your condition and recovery. Self-healing may fail to address this holistic perspective. PT’s get extensive education in Differential Diagnoses skills. As mentioned previously, you may present with low back pain but, in fact, may have a more serious issue.

Poor Management of Chronic Conditions

If you have a chronic condition, self-management without professional guidance could lead to a cycle of symptom exacerbation, pain, and poor overall management.

To sum up, while there are certain minor conditions or preventative measures that can be handled independently, most physical therapy should be overseen by a professional.

Even if you’re using physical therapy techniques at home, it’s important to do so under the guidance of a trained professional. We can ensure you’re performing exercises correctly, progressing at a safe rate, and not inadvertently causing further harm.

Self-healing, without professional guidance, runs the risk of ignoring a serious condition, treating the condition improperly, or causing further harm. If you have a physical condition that you think might benefit from physical therapy, the safest and most effective route is to consult a healthcare provider.

Don’t suffer with your musculoskeletal pain or injury. Get treatment in 24-36 hours. Call  Friendswood (281) 482-7380 or River Oaks (832) 409-6390