Your Body Is Not a Lego Set: Understanding Musculoskeletal Pain

As a physiotherapist, I can clearly see the difference between my understanding of the musculoskeletal system and pain and the way many patients perceive their condition. Sometimes, beliefs and personal interpretations of a pathology can have a considerable impact on how patients manage their symptoms. These misunderstandings often lead to inappropriate self-management strategies that may contribute to persistent pain, long-term dysfunction, and in some cases even disability (1).

Recurrent Shoulder Dislocation Is Not a Simple “Joint Out of Place”

Recently, I discussed this topic with a patient suffering from shoulder instability. Recurrent shoulder dislocation occurs when the head of the humerus moves out of the glenoid cavity of the scapula. This is a true medical condition that requires proper medical management.

Clinical guidelines are very clear on this matter. When a shoulder dislocation occurs, the reduction of the joint should be performed in a medical setting, often in an emergency department. Imaging, usually an X-ray, is required to exclude associated fractures or other structural damage before the joint is reduced (2).

Recurrent dislocations are not trivial injuries. The structures surrounding the shoulder include the brachial plexus, which provides the nerve supply to the arm, as well as important arteries and veins. Improper manipulation of the joint may damage these structures and lead to serious complications.

As a physiotherapist, I do not perform emergency reductions and I follow established clinical guidelines. However, many patients report that their shoulder has been “put back in place” by non-medical practitioners or untrained individuals, as if the shoulder joint were simply a piece that can be snapped back into position like a Lego block.

The human body does not work this way. Beneath the skin lies a complex system of nerves, blood vessels, muscles, and connective tissues. These structures must be respected and managed within the framework of medical knowledge and professional training.

The Limits of Self Rehabilitation

In recent years, it has become increasingly common for patients to attempt to rehabilitate themselves using online videos, fragmented advice, or self-interpreted medical information. While access to information can sometimes be helpful, these approaches are often based on incomplete knowledge or misconceptions about how the musculoskeletal system actually works.

Physiotherapy is sometimes misunderstood because what patients see during a session may appear simple on the surface. A physiotherapist may move a limb, guide a joint, or prescribe specific exercises. However, these interventions are not random movements. They are based on years of university training and on scientific knowledge in anatomy, physiology, biomechanics, and tissue healing.

Rehabilitation is not simply about moving a joint or strengthening a muscle. It involves understanding the stage of tissue recovery, respecting inflammatory processes, identifying contraindicated movements, and adapting the progression of exercises to each individual situation.

Because the visible aspect of physiotherapy can appear simple, some patients underestimate the complexity of rehabilitation and attempt to manage their condition alone. Unfortunately, persistent musculoskeletal conditions rarely improve through improvised strategies or generalized advice found online (1).

Physiotherapists are specialists in rehabilitation. Their role is to guide recovery in a structured and safe manner in order to restore movement, reduce pain, and improve quality of life.

Unrealistic Expectations in Chronic Pain

One issue that frequently challenges therapists is the unrealistic expectations some patients have regarding recovery. It is not uncommon to meet patients who have been living with musculoskeletal pain for one, two, or even five years. Yet some of them expect the problem to be resolved in a single session.

A physiotherapy session typically lasts about one hour. If pain has been present for two years, it is important to consider the imbalance between the duration of the problem and the time devoted to treatment. Two years of pain cannot reasonably be reversed within a single hour of intervention.

Recovery requires time, consistency, and a structured therapeutic process. Manual therapy can help restore mobility and reduce tissue tension, but rehabilitation also involves guiding the patient through specific exercises and progressive loading strategies. These elements must be applied over multiple sessions in order to produce meaningful and lasting results (3).

For this reason, patients need to approach rehabilitation with realistic expectations. Returning to normal function often requires commitment, regular attendance, and active participation in the rehabilitation process.

The Myth of “Grandmother’s Remedies”

When musculoskeletal pain appears, many patients rely on what could be called “grandmother’s remedies.” The reasoning is often simple: if something hurts, massage it and it will pass.

For minor discomfort in small joints and outside a traumatic context, people may apply ointments such as Tiger Balm, massage the painful area, or simply keep moving. When the pain decreases afterwards, they often attribute the improvement to the massage or the product that was applied.

However, musculoskeletal pain frequently evolves over time. Symptoms may naturally decrease as the acute phase settles. When someone massages the area or applies a topical product during this period, it can create the impression that the intervention solved the problem, when in reality the pain was already decreasing as part of its natural course.

For minor and short-lived symptoms this misunderstanding is usually harmless. The situation becomes more problematic when a true pathology is present. Applying improvised solutions without understanding inflammatory phases, tissue healing processes, or the nature of the injury can delay appropriate care.

In some cases, relying exclusively on these informal remedies may lead to worsening of the condition during the acute phase or to a lack of appropriate management that allows the problem to progress toward chronic pain (1).

Conclusion

Despite the familiar appearance of the human body, many people believe they possess medical knowledge without having the scientific background required to understand it. From the outside, the body may appear simple and intuitive. In reality, it is a highly complex biological system.

Medicine relies on the understanding of anatomy and physiology, disciplines that bring together principles from physics, chemistry, and biology. This scientific foundation is also reflected in the name of the profession itself. Physiotherapy refers to the understanding and application of human physiology, particularly the physiology of movement and exercise.

Understanding that the human body is not a simple mechanical structure, but a complex living system, is an essential step toward better health decisions and more effective care.

I provide structured and evidence based online physiotherapy for patients worldwide, offering clinical assessment, diagnosis, and personalised rehabilitation.

I also receive patients in person at my physiotherapy clinic in Phnom Penh.

You can begin your online physiotherapy session through the dedicated platform:

https://www.studiohealthon.com/online-physiotherapy

More information on clinical standards and supporting evidence is available here:

https://www.studiohealthon.com/online-physiotherapy-clinical-evidence

Yannick Sarton, MSc Physiotherapist

International Online Physiotherapy and In Clinic Care, Phnom Penh

References

(1) Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. The Lancet. 2018;391(10137):2356-2367.

(2) Zacchilli MA, Owens BD. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. Journal of Bone and Joint Surgery. 2010;92(3):542-549.

(3) Hayden JA, Van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. Annals of Internal Medicine. 2005;142(9):765-775.