One of the most common frustrations I hear from patients is this:
“I’ve done the stretches, I’ve rested, I’ve tried insoles or treatment… but the pain just keeps coming back.”
If that sounds familiar, I want to reassure you straight away, you’re not doing anything wrong.
In fact, many of the people I see in clinic have done all the “right” things. They’ve followed advice, taken time off activity, eased back gradually, and still find that pain either never fully settles or returns as soon as they try to do a bit more.
So why does this happen?
Pain isn’t always about damage
A common assumption is that ongoing pain must mean something is badly damaged. In reality, that’s often not the case.
More commonly, pain hangs around because a particular area is being loaded in a way it can’t currently tolerate. That load might be subtle, repetitive, and not obvious at all.
Pain can persist even when:
– Scans look normal
– Swelling has settled
– Strength seems “okay”
– You’ve rested for weeks or months
This is because pain is often less about a single structure being injured, and more about how force is moving through your body.
Why pain often comes back when you return to activity
A pattern I see a lot is this:
Pain improves with rest… but returns when activity increases.
That usually tells me the underlying driver hasn’t been addressed.
Common contributors include:
– Changes in gait or movement patterns, often without you realising
– Reduced strength or control somewhere else in the chain
– Footwear altering how force is absorbed
– A nerve being irritated rather than a muscle, tendon or ligament being injured
– Activity levels increasing faster than your current capacity
If the same tissues keep being overloaded in the same way, symptoms will often return, no matter how many times they’re “settled down”.
Why treating the painful area alone doesn’t always work
Another common frustration is when treatment focuses only on where the pain is felt.
For example:
– Heel pain that’s treated like plantar fasciitis, but is actually nerve-related
– Hip pain where the hip joint itself is fine, but the load is coming from below
– Ball of foot pain that’s padded, but the reason for the overload isn’t addressed
– Shin pain where the shin is the victim, not the cause
Pain is very good at drawing attention to itself, but it doesn’t always point to the real source of the problem.
What a musculoskeletal actually changes
This is where a more thorough musculoskeletal assessment can make a big difference.
Rather than asking “where does it hurt?”, I’m usually more interested in:
– When it hurts
– What activities bring it on
– What settles it
– How load is moving through your foot, ankle, knee, hip and pelvis
– Whether symptoms feel more mechanical, inflammatory or nerve-related
In some cases, gait analysis helps add another layer of understanding, particularly where pain keeps recurring or performance matters. This isn’t just for athletes, everyone has a gait, whether you’re running, walking, working on your feet or training in the gym.
Often, once the main driver is identified, the plan becomes much clearer and far less trial-and-error.
Where treatments like laser therapy fit in
People often ask about treatments such as laser therapy, and whether they’re “worth it”.
Used in isolation, no treatment is a magic fix. Where therapies like MLS laser can be very helpful is when they’re used as part of a wider plan that includes:
– An accurate diagnosis
– Appropriate load modification
– Rehabilitation and strengthening
– Footwear or orthotic advice where needed
In those situations, laser can help reduce pain and calm irritated tissue or nerves enough to allow proper rehab to take effect.
The common thread I see in clinic
-Many of the patients I see aren’t new to treatment.
-They’re new to having the right problem identified.
-Once the underlying driver is understood, progress often becomes quicker, more predictable, and far less frustrating.
If this sounds familiar to you, if you’ve been dealing with foot, ankle, leg or hip pain for a few months, especially if it keeps returning when you try to be more active, it’s often a sign that something has been missed rather than something being “wrong” with you.
Sometimes, the most helpful step isn’t another treatment, but a clearer understanding of what’s actually going on.
If you’re unsure whether an assessment would be appropriate for you, I’m always happy to advise.