Why Does My Pain Keep Coming Back?

Introduction: The frustrating cycle of recurring pain

You started having back, shoulder, or knee pain... You took a few weeks off from activity, let it rest, maybe even used some ice and tried a few stretches you found on Instagram.

You start feeling better, so you head back to the gym, go back out to play pickleball, or even just run around at your kid’s practice.

But your pain comes right back, and you feel frustrated and discouraged.

If this sounds familiar, the problem may not be that you didn't rest enough or give the injury enough time to fully “heal.” Instead, there may be other factors contributing to your pain that were never addressed before you returned to activity.

Rest may have helped calm down your symptoms, but it didn't necessarily address the mobility, strength, movement, or activity-related factors that contributed to the problem in the first place.

Here are 4 common reasons your pain continues to come back:

1. You only addressed your pain and symptoms

Reducing pain is step one. Addressing symptoms often means using ice or heat, light stretching, rest, massage, medications, injections, etc. These treatments can be effective in decreasing pain and providing relief, but that relief may only be temporary.

There may be other factors contributing to the problem that haven't been addressed. These can include, but are not limited to:

• Mobility limitations

• Movement patterns

• Strength deficits

• Impaired stability

• Training errors

• Stress

• Sleep

• Nutrition and hydration

Reducing pain is very important, but if that's the only action you take, it's not surprising when the pain eventually returns.

This is especially important with chronic or recurring pain. If you want to create a long-term solution, you need to look beyond the symptoms and identify the other factors that may be contributing to the problem.

2. Rest helped you feel better, but did not prepare you for the return to activity

Rest can be an important part of recovering from pain or an injury. Temporarily reducing or modifying the activities that aggravate your symptoms can give your body time to calm down and help you start feeling better.

The problem is when rest becomes the entire rehab plan.

If your knee only hurts when you run, taking a few weeks off from running may make your knee feel great. If your shoulder hurts when you lift weights, avoiding the gym may decrease your pain. But feeling better because you stopped doing the activity is very different from preparing your body to handle that activity again.

During that time off, you may not have improved the strength, mobility, stability, or overall capacity needed for the activity you want to return to.

So what happens?

You rest → your pain decreases → you feel better → you return to your normal activity → the pain comes right back.

Instead of relying on rest alone, your recovery should include gradually rebuilding your body's ability to handle the demands you're placing on it.

Rest can help calm down your symptoms, but progressive movement and strengthening are what help prepare you to get back to doing what you love.

3. You went from feeling better to doing too much, too quickly

Once your pain starts to improve, it's tempting to jump right back into everything you were doing before.

Your knee feels better, so you go back to playing two hours of pickleball. Your back hasn't bothered you for a few weeks, so you return to your normal workouts. Or you finally feel good enough to run again, so you immediately go back to your previous mileage.

The problem is that feeling better doesn't always mean your body is ready to handle the same amount of activity it was doing before.

After a period of pain or decreased activity, your body's ability to tolerate certain movements, loads, or volumes of exercise may have changed. Going from very little activity straight back to 100% can be a significant jump in demand.

This is why returning to activity should be a gradual process.

Instead of using pain as the only measure of whether you're ready, your rehab should progressively prepare you for the demands of what you want to get back to. This may mean gradually increasing your weights in the gym, building your running mileage, increasing how long you play a sport, or slowly returning to more challenging movements.

The goal isn't just to feel good enough to return to activity. It's to make sure your body is prepared for the activity you're returning to.

4. You stopped rehab as soon as the pain went away

Pain relief is an important first step, but if your goal is to return to an active lifestyle, your rehab shouldn't stop there. You need to make sure your body has the mobility, strength, stability, and capacity to handle the things you want to do.

This is where rehab should start to look less like traditional “rehab” and more like training.

Exercises should become progressively more challenging and specific to your goals. If you want to return to running, your body needs to be prepared to absorb and produce force repeatedly. If you want to lift weights, you need to progressively build your strength back up. If you want to play golf or pickleball, you need to prepare your body for the rotation, speed, and repeated movements that those sports require.

Your rehab should ultimately help you transition from “I don't hurt anymore” to “I feel strong, confident, and ready to do the things I love.”

Getting out of pain is only the beginning. The ultimate goal is to build your body back up so you can move better, stay active, and perform at your best.

So, How Do You Break the Cycle?

If your pain keeps coming back, doing more of the same probably isn't the answer.

Long-term improvement requires looking beyond your symptoms and understanding what your body needs to get back to the activities you love.

That's exactly why I created a 3-step process at Osborne Performance. The goal isn't just to get you feeling better. It's to help you build your body back up so you can return to the things you love with strength and confidence.

Step 1: Get Out of Pain

The first step is understanding what's going on and getting your symptoms under control.

This starts with a comprehensive evaluation to identify the factors that may be contributing to your pain. From there, we develop a plan that may include activity modifications, hands-on treatment, targeted exercises, and progressive movement to help decrease your symptoms while keeping you as active as possible.

Getting out of pain is important, but it's only the first step.

Step 2: Move Better

As your pain improves, we shift the focus toward addressing the limitations that may have contributed to the problem in the first place.

This could mean improving mobility, building strength, improving stability, or working on specific movements that have been difficult or painful.

The goal during this phase is to not only help you feel better, but to improve how your body moves and increase what it is capable of handling.

Step 3: Perform at Your Best

This is where we bridge the gap between rehab and getting back to the things you actually want to do.

Your exercises and training become more specific to your goals and the demands of your activities. Whether you want to return to the gym, run, play pickleball, golf, hike, or simply stay active with your family, we progressively prepare your body for those demands.

Because ultimately, success isn't just being pain-free.

It's being able to do the things you love with strength, confidence, and without constantly worrying about your pain coming back.

Tired of Your Pain Coming Back?

If you've been dealing with pain that improves for a while but keeps coming back, it may be time to take a different approach.

At Osborne Performance, the goal is to understand what's contributing to your pain, address the limitations that may be holding you back, and build a plan that gets you back to doing the things you love.

If you're ready to get out of pain, move better, and perform at your best, schedule a complimentary Discovery Call.

We'll talk about what's been going on, what you've tried so far, and what you want to get back to. From there, I'll let you know if I think Osborne Performance is the right fit for you.