Isn’t Therapy Supposed To Be Therapeutic?

I have been overweight for my entire life. It’s something I’ve come to terms with, and I don’t consider it to be the end of the world as long as it doesn’t prevent me from keeping an active lifestyle. I did a lot of damage to my body and psyche dieting in my youth and I don’t want to revisit those times, instead preferring to be as healthy as I can at the weight I happen to be at for the moment.

I also suffer from hypermobile joints. They make me overly flexible and occasionally give me pretty bad joint and muscle pain from overstraining them. They also put some limits on how physically active I can be, and I have to factor in recovery time every time I do something physically demanding. Again, I don’t consider it the end of the world, and after twenty years, I have a pretty good idea of how my body works and what I need to do to take care of myself.

I recently moved to a new town and have to deal with the hassle of finding a new physical therapist. I’ve put it off for too long, but after an intense period of getting my home in order and lifting heavy things, I can feel that I’ve overdone it and that I might need to change my PT routine a bit. I ask around, get a few recommendations, and make an appointment with a physical therapist who’s supposed to be an expert on my type of troubles. We have public healthcare in Sweden and this PT falls under that.

I’ve had a lot of bad experiences with members of the medical profession in the past, so whenever I meet someone new, I tell them that unless my weight is the direct cause of whatever medical issue I’m having at the time, I’d prefer not to discuss it.

Therapist: “Of course. Why don’t you tell me a little about what you’re dealing with?”

Me: “I recently moved into a new apartment and I’ve been carrying a lot of heavy boxes up and down the stairs, so my knees and shoulders are worse than usual, and my right hip is making this weird clicking sound that it hasn’t been doing before.”

Therapist: “Do you have an exercise program?”

Me: “Yes, I brought it with me. That’s my main reason for coming here. I want to know if there are any easier versions of these exercises that I can do while I wait for the pain to get better? I know I need to rest for a few weeks, but I don’t want to stop working out entirely.”

Therapist: *Looks at my program* “Oh, no, this won’t do at all. I’m going to give you some new exercises. How often do you do this program?”

Me: “I do the full one three times a week, and a shortened version every morning.”

The therapist shakes her head and starts compiling new exercises.

Therapist: “All right. You need to do this full program every day. We’ll go over to the gym and I’ll show them to you later. Now, I’d like to discuss your diet.”

I look at the program and I immediately see that this is not going to work for me. I asked for a lighter version of my normal program, but she’s given me a much tougher one and added several new exercises, including push-ups, which my last PT explicitly forbade me to do, ever, because my wrists can’t take it.

Me: “Sorry, I don’t think this is going to work. This whole program is going to take over an hour. I don’t have that much time every day. It’s also going to put too much strain on my joints, which are already hurting. That’s what I came here for!”

Therapist: “Well, honey, I know you don’t want to hear this, but your BMI is way too high. Unless you lose weight, you’re never going to get rid of the pain. I want you to do this program every day and add in at least thirty minutes of cardio every day, and now we’re going to talk about your diet. How often do you eat fast food?”

Me: *A little stunned* “Um, sometimes, I guess. But I prefer to cook for myself. Sorry, I think I said at the beginning of this appointment that I don’t want to discuss my weight.”

Therapist: “Yes, I understand that it makes you feel uncomfortable, but you need to face facts, honey. You can’t sit on your couch and eat fast food all day. You need to lose at least thirty kg or your pain is just going to get worse. How often do you eat vegetables? You know broccoli is very good for you, right? You need to eat more broccoli.”

Me: “I eat vegetables every day; I’m practically a vegetarian. Look, I know my weight doesn’t help matters, but I’m here because I’m in pain now, because I’ve overstrained myself, and I want to do something to make it better now, not in some kind of hypothetical future where I’ve magically lost thirty kg by eating broccoli. Can you help me with that or not?”

Therapist: “Honey, I can’t help you if you don’t want to help yourself. I’m telling you this for your own good.”

Me: “I am aware that I am overweight. I have been overweight my whole life. I’m not here because I’m overweight. I’m here because I have overstrained my hypermobile joints, and your solution to my problem is to overstrain them even more?”

Therapist: “I know it’s hard to hear, but you need to take better care of yourself. I want to help you do that, but you need to put the work in yourself!”

At this point, I realised that there was no way I would get through to this woman, so I just stood up and left.

I didn’t really feel like making a new appointment with another physical therapist after that, so in the end I just ended up modifying my exercise program myself, and after a few weeks of active rest, I could go back to my normal routine. I’m still overweight, I still have hyper-mobile joints, and eating broccoli (which I do quite often because it’s delicious) hasn’t cured me.