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When Physical Therapy Makes It Worse: Navigating the Ups and Downs of Recovery

The journey to recovery through physical therapy is filled with highs, lows, and unexpected turns. While the goal is to experience continuous improvement, there are moments when physical therapy makes it worse before they get better.

During these challenging times, doubt can creep in, and the question arises: “Is this setback a step in the wrong direction?”

So, if you’ve ever questioned why physical therapy hurts, join me as I uncover the truths behind these moments and provide insights on turning setbacks into stepping stones toward your ultimate goal of improved health and mobility.

Factors Contributing to Worsened Symptoms

Experiencing worsened symptoms during physical therapy can be disheartening, but it’s important to remember that setbacks are a natural part of recovery.

Several factors can contribute to these temporary setbacks, each offering an opportunity for learning, change, and progress.

Let’s explore some of the key factors that might lead to worsened symptoms during physical therapy:


Pushing your body too hard or attempting exercises beyond your current capacity can increase discomfort. While it’s essential to challenge yourself, overexertion can trigger muscle fatigue, strain, and even temporary setbacks in your recovery journey.

Introduction of New Exercises

When your physical therapist introduces new exercises or techniques, your body might respond with initial resistance. These new movements can target different muscle groups or patterns, causing temporary discomfort.

Muscle Memory and Adaptation

Muscle memory can sometimes lead to initial discomfort as your body adjusts to new movements and exercises. Muscles that have been inactive or underutilized for a while might react with soreness as they are reintroduced to activity.

Temporary Inflammation

Engaging in physical therapy can lead to minor inflammation in the muscles and joints. This inflammation is a natural response to the stress placed on your body and is part of the healing process. But it can also result in temporary discomfort.

Individual Variability

Everyone’s body responds to physical therapy. Some individuals might experience rapid progress, while others might encounter more setbacks. Genetics, medical history, and health can influence how your body reacts to therapy.

Healing and Tissue Repair

As your body repairs and strengthens muscles and tissues, there can be moments of discomfort. Microscopic tears in muscle fibers occur during exercise and contribute to the body’s healing process. This repair can sometimes lead to temporary soreness.

Unmasking Underlying Issues

Physical therapy can sometimes bring underlying issues masked by inactivity to light. As you become more active, these issues might manifest as discomfort or pain. While this can be unsettling, addressing these issues is a crucial step toward long-term recovery.

Psychological Factors

Mental state and emotions can influence physical experience. Anxiety, stress, or a negative mindset might amplify your perception of discomfort.

Learning relaxation techniques and managing stress can help mitigate the impact of psychological factors on your physical progress.

The Emotional Aspect of Setbacks

Embarking on a journey of physical therapy is not about mending the body; it’s a testament to the strength of the human spirit.

Yet, amid the sweat, determination, and hard work, a side of recovery often remains unspoken – the emotional rollercoaster accompanying setbacks.

When setbacks occur, and progress seems to falter, it’s natural for a cascade of emotions to follow. These emotional responses testify to your investment in your well-being and genuine desire to overcome the challenges before you.

Let’s delve into the emotional aspect of setbacks and shed light on the feelings that often arise:


Setbacks can evoke a sense of frustration. After putting in significant effort, it’s disheartening to feel like you’ve taken a step back. This frustration is a sign of your dedication and a yearning for progress.


Impatience often accompanies setbacks. You’ve set your sights on a goal, and setbacks can make the journey feel longer than anticipated. Remember that healing takes time, and setbacks are temporary detours.


Setbacks can lead to self-doubt. You might question your abilities, the effectiveness of the therapy, or even your commitment. These doubts are a natural response to adversity but should be countered with reminders of your achievements thus far.


Disappointment can surface when your expectations aren’t met. Acknowledging this feeling while recognizing that setbacks are opportunities to adjust and grow is important.


Setbacks can trigger anxiety about the future. Worries about prolonged discomfort or the potential for further setbacks can be overwhelming. Remember that setbacks are part of the healing process and don’t define the entirety of your journey.

End Note

As you navigate the complex world of physical therapy, remember that setbacks are not signs of defeat but rather moments of growth.

The emotional responses they evoke are a testament to your dedication and your humanity. Every frustration, doubt, and disappointment reflects your commitment to your own well-being. 

See you in my next post…’til then, be healthy and live fully!

Dr. Lex Gonzales
Dr. Lex Gonzales, PT, DPT has been a physical/physiotherapist for over 24 years and is an award-winning author and keynote speaker. On he provides quality information and practical solutions you can use to improve your health and function.