6 Reasons Your PT or Chiropractic Care Didn’t Work

You’ve been struggling with aches and pains that just don’t seem to go away, so you go to the professionals: doctors, physical therapists, chiropractors.  And for a time, these routes provide relief.  The only problem?  It doesn’t last.  A few months later, those aches start creeping back into your life, starting the cycle all over again.  If this scenario sounds all too familiar, you’re not alone. 

Below, we’ll dive into the 6 reasons your PT and Chiropractic care didn’t work, and what you can do today to get yourself on the right track.

But first, we’d like you to meet Korry. Korry’s a 35 year old office worker and dad who struggles playing with his 30lb child because his shoulder gets sharp pain every time he goes to lift her overhead. Korry has been dealing with this pain for over a year now. 


It all started during a game with his co-ed softball league. He went to throw someone out at first, and as the ball left his hand, he was hit with pain in his shoulder.  The pain wasn’t too bad, and Korry’s not one to cause a scene, so he just played through it. But when he woke up the next morning, he could barely lift his arm. There was SO much pain. 


Over the course of the next few weeks, the pain settles into a steady ache that never fully goes away. In fact, sometimes the most remedial things would set off his shoulder and the pain would spike again for a day or two.


Frustrated and fed up, Korry decides to finally see his doctor. His doctor takes X-rays, checks for swelling, and refers him out to a physical therapist that will work with his insurance. 


Great, some professional help I can afford, whew. My insurance will take care of it all and I can finally move on with my life.


After his initial check-in and assessment, his physical therapist lays out the plan: he’ll be better in about 8-12 weeks, seeing his physical therapist 3x/week to start and then backing off to 1x/week later. It’ll cost about $540 for Korry, after insurance covers the other $2,160.


Korry sees his PT for about 15-20 minutes every session and, although it is hard to tell, he thinks the treatment is working. The PT has him doing a lot of light band rotator cuff exercises that he believes will heal the supraspinatus. 


After the initial 3 weeks of 3x/week, Korry’s made enough progress to go down to just 1x/week. The PT gives him some bands and a couple of PDF documents that lay out the homework he should be doing in between visits. 


Motivated, Korry knocks out the homework every day, as frequently as recommended by the PT.  Korry is seeing progress!  After a couple weeks of that, feeling a little better, Korry stops taking the homework quite as seriously, skipping a session now and then.  Pretty soon, those skipped sessions add up until he’s rarely doing it, and when he does do it, there is very little focus and effort put into it. 


12 weeks later and the physical therapist has seen improvement across the board. Korry’s shoulder isn’t perfect, but it is better than before, so they agree he is ready.  Handy timing since his insurance company won’t cover another round for the remainder of the year. 


Korry is stoked to finally get back in the gym. He’s hated falling behind his peers on the team, and the extra weights he’s put on in the last three months off from the gym sure isn’t helping matters. He’s excited to get back into his routine so he can feel better for his daughter, who seems more demanding of his energy each day.


Korry hits the gym, but he knows to take it easy at first. So instead of his usually 225lb bench press for 8, he will settle for 185 today and that should do it. He treats the rest of his workouts the same way: a little less weight or fewer reps. He’s playing it safe.


After the first week of scaling back, Korry decides it is time to get right back to where he was. He begins to notice the ache that the PT had helped him get rid of is slowly creeping back, but what can you expect after three months away from the gym? He just needs to keep moving and things will be fine.


But by week 5, things are not fine.  Korry feels like his shoulder is just as painful as before his PT work, if not worse, and he can’t seem to explain it! He stops going to the gym, but the pain doesn’t seem to go anywhere. 


After many discussions at the old watering hole, his coworker convinces him that a chiropractor might be another affordable solution. Thankfully, his insurance company will help out with a monthly visit, but no more frequently than that. 


The chiropractor would like to see him 2x/week to start and then taper into 1x/month as symptoms subside. Each session costs $75, which is on par with the national average.


8 weeks and 16 sessions later, the pain has started to decrease! Finally a solution! He goes down to 1x/week, and similarly, he gets some homework to do from home. There are no fancy bands, just simple things from around the house. 


This time, Korry knows he is going to stick with the homework. He does it religiously. It is boring and repetitive, but overall pretty easy. To help him stay on track, Korry turns on some Netflix to pass the time. Schitt’s Creek is pretty funny! Wait, was that 3 sets? Or 2? I think it was 3. What rep am I on? 


And just like that, his chiropractic visits are over and he is back to pain-free living. Time to get back into shape! This time Korry tries a different approach. He goes to a CrossFit box down the road. He was told he was crazy and that they would leave him far worse off than anywhere else. But Korry likes a competitive atmosphere.  The CrossFit gym takes him through a 6 session ONRAMP, and then he jumps into classes 3-5x/week. So far things are going ok. 


One day, Korry goes to pick his now 35lb kiddo up and throw her overhead and catch her. Seeing her smile is a real thrill and there is no better way to connect than to be the cause of that smile! It is priceless. 


A familiar feeling in the shoulder sends his brain right back to that fateful throw to first base. Is it back? A quick rotation of his shoulder. No, it is still good. Well last time it was worse the next day. We will see. Playtime is over, laughing turns to crying, and now he is reaching for the remote to turn on some Octonauts to settle the child down.


The next day, the pain is not worse, but it is definitely still there. This pattern of pain continues and as it does, it begins to cast shade over other areas of Korry’s life. He’s gained weight again, partly because he isn’t making it into the gym anymore, and partly because he has replaced that healthy habit with some less ideal alternatives.  The mental demand of his job is exhausting, as he tries to suppress the looming feelings of inadequacy that have been building. He uses up all of his patience at work and by the time he gets home he feels he is at his wits end, which causes him to become short with his wife and family more often than he would like.


The process has failed Korry from getting out of pain and STAYING out of pain, and now he feels like he can never get back to the active life he once had. That is just getting old, right?


There are 6 reasons why the process has failed for Korry, and why it has failed for so many well intentioned people just like him:


1.Boring homework:   

Homework is difficult to do on a consistent basis. People often lack confidence that they are doing the movements correctly, leading them to avoid it altogether. And for the ones who do power through the uncertainty, boredom takes over. This boredom makes them easily distracted and complacent, so the effort is no longer even effective. And when the motivation wanes, most just stop doing homework altogether.


2.Session package built for insurance and not the individual:   

Insurance companies do not care if you can throw a softball or toss your kids overhead. In fact, they would probably rather you not. They care if you can do your activities of daily living with a tolerable pain level.  Insurance might be well intended, but there is no doubt that it is not working for the vast majority of us. Korry might have needed PT for an additional 8 weeks in order to give him the time he needed to totally recover. But because insurance was the deciding factor, not what was best for Korry, he was discouraged from continuing treatment.


3.Too specific:   

To get Korry out of pain, all of the treatment was focused in one specific area. This focus is great for recovery, but it certainly does not help the individual with the transition back to normal life. That level of tunnel vision meant Korry was never able to practice the more complex movements that he was going to be going back to. Additionally, it also prevented the PT from exploring other areas where the root of the problem may have been. Perhaps this whole situation could have been avoided if Korry knew how to breathe with proper mechanics and brace for specific movements. Maybe Korry also needed to work on sleeping the appropriate amount or eating the right diet.  With too narrow a focus, the big picture can be missed.


4.Limited accountability:   

The PTs and Chiropractors, even the good ones, aren’t set up well for frequent conversations and check-ins with the people they are serving. If they are to remain profitable, they need to see a set amount of people. That means less time spent doing things like checking in with clients throughout the week. In order to be successful, the PT might have needed to check in with Korry daily to make sure he was doing his homework and working on improving his lifestyle. But since Korry only got a check in once per week, and then never once his sessions were up, the lack of accountability allowed him to drop off on his homework, and he didn’t make the progress he needed to.


5.Regressed fitness level:   

PTs and Chiropractors need to take as much control as they can. They are not  likely to prescribe workout routines designed to keep your fitness levels up because of the added risk this unsupervised regime could have to your specific problem. It is easier to just eliminate fitness stuff altogether so that they can ensure you are doing only the right things during their care, as much as possible. In some cases this even leads to treating people as if they are truly FRAGILE, when the opposite is largely the reality.  Korry never learned how to keep his fitness level up while working smartly while his shoulder pain persists.  So when he went back to the gym, he was left guessing at how to improve his fitness while staying out of pain.


6.The inevitable cycle of pain:   

Number 5 leads directly into this. Once you are done with your package of visits and you’re (hopefully) pain free, you’re sent out into the world again.  There is no playbook to take you from where you are now back to your former potential. In many cases, the individual is fine and the cycle won’t continue. But more often than anyone would like, this cycle does happen. We just heard Korry do it multiple times! Many people need a more dedicated plan that they simply do not have the time or knowledge to create on top of the other responsibilities in their life.  So they are left guessing.


These are 6 common reasons why PT and Chiropractic care fails for some, but there’s also a 7th reason holding people back from reaching their goals and eliminating their limitations.


Reason #7: COST

The route Korry took cost him $1,400 after insurance.  But emotionally it cost him much more. It cost him a fitness level that would allow him to feel confident in his body and abilities, which leads to more bad decisions around the lifestyle and worse yet more frustration. With more frustration, his ability to adapt to his surroundings using a balance of emotion and logic leaves him responding very one sided, inflicting a lot of damage into his relationships. This could end up costing far more for Korry if those habits continue down that path. We are talking costs in therapy, divorce, career shifts, and more. 


People spend $50,000 + on education, $300,000 on a home to call their own, and multiple times of $20,000 (per vehicle) or more on vehicles to get them from A to B comfortably.  People spend $5,400+ per year on a health insurance system that is really only doing a great job if a catastrophic life event happens. Rarely are healthy people in need of that much to see their doctor twice a year. Even low balling these numbers, we are still at a cost of $700,000. More realistically it’ll be closer to cool $1 Million.  Shouldn’t your money that you invest actually make you feel better. Aren’t you worthy of leading a life of opportunity, confidence, and fulfillment?


You have one vehicle to move about the world in, you need to make smart investments in it if you want it to be there for you in the beginning, middle, and end.


At Principia, we set ourselves up differently than the typical PT or chiropractic office. 

We look at the individual as a whole, keeping the focus broad enough to see the whole picture.  We look at lifestyle, previous experiences, and future goals when laying out a framework for recovery.  We rarely assign fitness homework, because we know it is only truly effective when done correctly, consistently, and with the right intention.  Instead, we work those movements into your daily program at the gym.


What was their past and present lifestyle?  Where is the low hanging fruit? We rarely assign fitness homework. It is done in a gym so we keep those lives separate. Home is for comfort and vulnerability as much as possible. We prescribe sessions more based on results and progress and less on problems. In other words, you don’t move on just because you are out of pain, you move on because you are out of pain and the next progression will afford you with more opportunity to drill, keeping it off with added intensities, frequencies, or movements. We check in regularly. Almost daily! We want to make sure you are getting everything done and progressing as quickly as we can. We are always pivoting as a team to build the best version of you as quickly as possible. We keep your fitness level on the incline even when we are getting you out of pain! You can never fall back into the cycle of pain because the daily interaction with your coach makes those pivots happen before they come to a head. And in those scenarios where a set back happens, your coach is right there to make sure your focus is on the right things and it doesn’t send you spiraling.

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