Healing Isn’t Linear: How to Navigate Setbacks
Are you recovering from an injury and suddenly experiencing more pain?
You’re not alone.
Many people expect a smooth recovery, only to be surprised by setbacks, flare-ups, or pain that seems worse than before.
But here’s the truth: healing isn’t linear.
The goal of this blog is to explore the non-linear course of healing typically takes, why setbacks happen, and give you some actionable tips to navigate a setback with confidence.
Healing isn’t linear: common causes of setbacks during injury recovery
Some of the most common setbacks I see with patients as they’re healing from injury or recovering from chronic pain include:
Too much, too soon
All-or-nothing
Belief that pain equals damage
Mismatched expectations
Let’s dive into each one of these common causes of setbacks.
Too much, too soon
Simply put, pushing too hard can slow your recovery process.
Very often as your pain decreases and your movement improves, so does your confidence.
With increased confidence, you get back into activity, but return at a level (intensity, duration, or frequency) that your body and your tissues (bone, muscle, tendon, ligament) or nervous system aren’t ready for yet.
You do too much, too soon and end up with pain again.
We often refer to this as a “boom-bust cycle” that leads to:
Frustration
A desire to push through adopting the “no pain, no gain” mentality
Or, on the other end of the spectrum, fear and avoidance of movement
All-or-nothing
The problem with an all-or-nothing approach to healing is that it can result in avoiding returning to activity until you think you’re able to go all in.
But, if you don’t give yourself a chance to build up your tissue (bone, joint, muscle, tendon, ligament) and nervous system capacity to handle the stresses of your chosen activity, you’ll very often end up with a setback.
For a lot of runners I work with, this shows up as avoiding running completely due to their pain or injury then expecting to be able to return to their prior “short” run, often 2 or more miles, without building up to it.
When you really look at this “short” run and consider each step a repetition, that’s a lot of reps and they haven’t appropriately conditioned their body to return that load.
When you take a more gradual, graded approach to return to activity:
Using run-walk intervals
With specific guidelines for progression
You give your body time to adapt to the load and can progress with fewer setbacks.
Belief that pain = injury
Maybe you’ve always thought that if you have pain, it must mean you have an injury.
Let me assure you, this is totally normal and such a common belief!
While pain is an important signal to pay attention to, it’s literally your nervous system and brain's way of getting your attention, it doesn’t always mean you have an injury or tissue damage.
When it comes to pain, it’s often necessary to zoom out and look at what’s happening in all areas of your life - stress, nutrition, sleep, illness, hydration, support structures, etc.
You can learn more about the link between stress and pain here: Does Stress Cause Pain in the Body?
Here’s a relatable example that highlights that pain does not always mean you have an injury:
Recall a time when you’ve had the flu and were forced to lie around for a few days.
At some point you probably started to feel some aches and pains in your body.
But, you’ve literally been lying around, so it’s highly unlikely you injured yourself.
So, why do you have pain?
Simply, your system is overloaded, the lack of movement is contributing to your experience of pain and is signaling your brain to do something about it:
Change your position
Try some light movement
Hydrate
Make sure you’re nourishing your body, etc.
Untangling the belief that pain equals injury isn’t easy, but it is an incredibly valuable step in navigating a setback.
Mismatched expectations
In the injury recovery process, I think it’s important to set realistic expectations.
Maybe you expected a straight line from the start of healing to painfree activity.
If so, it makes sense that a setback feels devastating.
But the reality is, just like working toward any goal in life, the healing process is not linear and there will be ups and downs along the way.
In fact, as much as it sucks, I think these setbacks or flare-ups can be a positive.
Let me explain.
If you were in pain or afraid of moving your body, you never would have even tried getting back into activity.
The fact that you felt confident enough to do activity without hesitation means you’re on the right track.
Even though your body wasn’t quite ready for the level of activity you did and you experienced a setback, you already have evidence that your body is resilient, that it will heal, and you can trust that you’ll be able to get back to feeling better.
As a bonus, you have more information than you did before!
You now know what “too much” is at this moment in your healing and you can make corrections to take smaller steps as you return to activity.
How to Navigate Setbacks and Pain Flare-Ups With Confidence
Here are a few actionable tips you might try when you experience a setback or flare-up of pain and the frustration and fear that often comes with that:
Remind yourself that your body is resilient and that your pain improved once already so you can trust that it will again
Move your body gently in ways that feel good and create feelings of safety
Breathe - full, deep breaths all the way into your belly with a long, slow exhale to help calm your nervous system
Get yourself back into physical therapy so you can receive the support you need to navigate your setback
Key Take-aways
Healing isn’t linear, flare-ups and setbacks are an inevitable part of the healing process.
Setbacks most commonly happen when we do too much, too soon, get stuck in all-or-nothing patterns, believe that pain means there’s tissue damage, and when we have mismatched expectations about the recovery process.
You don’t have to navigate your injury or chronic pain recovery alone.
If you’ve been struggling with pain, setbacks, or uncertainty about your next step on your healing journey, that’s a sign that you might benefit from working with a holistic physical therapist.
Support for Navigating the Ups and Downs of Healing
I offer holistic physical therapy at Orchard Physical Therapy + Coaching in Bend, OR and pain recovery coaching online to guide you through the ups and downs of healing and create a clear plan to so you can move forward with confidence. Contact me to find out more about working together.
Disclaimer: this post is intended for informational purposes only and is not medical advice. If you are experiencing pain, it is always in your best interest to consult with your medical doctor and/or your physical therapist.
