Building Momentum in Rehab

“If I stop pedaling, I’ll crash.” A simple truth from a 7-year-old learning to ride a bike sparked this conversation about one of the biggest mistakes people make in recovery: stopping when the pain stops.In this episode of The Talking Rehab Podcast, Dr. Fred Bagares reframes what true recovery looks like. He shares a patient story, a powerful mindset shift, and a case for why momentum—not pain relief—is the real goal. Whether you're dealing with injury, trying to prevent one, or stuck in a cycle of setbacks, this episode gives you the clarity and tools to move forward—consistently.

[00:00] The Bike Metaphor: Wisdom from a 7-Year-Old
Why pedaling through the wobbles is a perfect analogy for rehab—and what most adults forget about momentum.

[01:20] The Common Mistake: Stop When It Feels Better
Dr. Bagares shares a scenario he sees daily: back pain, ibuprofen, rest… and relapse.

[02:15] The “Stop-and-Go” Epidemic
Why short-term fixes and pain-based decisions lead to long-term frustration.

[02:55] Michelle’s Story: From Chronic Heel Pain to Half Marathon
How one patient broke the loop by committing to rehab after the pain was gone.

[04:00] Pain Is a Lousy GPS
Learn why pain lingers after healing—or disappears too soon—and what metrics are actually useful.

[05:00] The Tennis Example: Two Paths, One Outcome?
Dr. Bagares walks through two ways to return after injury—one quick, one comprehensive—and the hidden risks of the “fast track.”

[06:00] Momentum > Perfection
Why waiting for 100% readiness stalls progress—and what to do instead.

[07:00] Redefining “Better”
It's not about stronger or faster—it's about trust, awareness, and response. Momentum builds that.

[08:00] From Rehab to Resilience: What to Do Now
Dr. Bagares gives a personal challenge: What's one small move you can make this week, even if it’s not perfect?

[09:30] Final Takeaway: Momentum Compounds Like Interest
The earlier you start, the more it builds. The goal isn’t to recover—it’s to come back better.

🎧 Core Message:
Pain relief is not the finish line. Real progress begins after the pain fades. Keep pedaling.

Transcript

0:01

I was at the park the other day watching a young girl ride her bike. she seemed to be maybe about seven years old. Looked like they had just learned how to start riding without their training wheels, and I could tell she was. she was wobbling all over the place. But what fascinated me was that every time that she started to fall, she would instinctively just pedal harder, not slower, but actually start to pedal harder. And she kept saying, dad, if I stop pedaling I'll crash. And. I thought, yeah, that's a pretty smart kid. And that kind of sparked, today's topic. this young girl intuitively understood something that most adults forget, which is momentum is what keeps us upright. I'm Dr. Fred b Garris, and this is the Talking Rehab podcast where we challenge the conventional wisdom about recovery and healing. Today we're talking about why stopping your rehab when you feel better is like stopping pedaling when you're still learning how to ride. Quick favor, before we dive in. If this podcast has changed how you think about your body or your recovery, hit that subscribe button. It's free. It takes two seconds, and it's how we keep bringing you these conversations every week. No fluff. Just real talk about what actually works. Thanks for being here. Now let's get into it. Picture this scenario. It happens in my clinic. Constantly. you hurt your back lifting something heavy. You rest for a few days. Maybe take some ibuprofen when it still hurts, you finally see somebody, maybe me, maybe a family doctor, maybe the emergency room. We work on it, the pain gets better and you feel relief. So you stop treatment and go back to your normal routine. Three months later you're back. Same pain, or maybe it's your shoulder. This time it just came out of nowhere. You tell me. But did it really? This is the stop and go cycle, and it's an epidemic. We treat our bodies like broken appliances, fix the immediate problem, then expect everything to run perfectly forever. But here's the reality. Your body isn't a machine with broken parts. It's an intricate system with patterns, compensations, and learned behaviors. When you stop rehab at pain relief, you're stopping right before the real work actually begins. Let me tell you about Michelle, a 42-year-old accountant and weekend warrior who came to see me with chronic he pain. I'm so tired of this cycle. She said, every time I get back to running, it comes right back. I rest, it gets better. I start running again, and then boom, back to square one. Michelle had been through this loop four times in two years. Each time she'd rest until the pain disappeared, then jump right back into her old routine. What if I asked her instead of stopping when the pain goes away, we kept building even when you felt good. And that was a light bulb moment for her. We didn't just treat her plantar fasciitis. We addressed the weak LUTs that were overloading her legs. We worked on the ankle mobility she had lost from years of sitting at a desk. We gradually built her running volume using a progression that challenged her tissues without overwhelming them. Most importantly, we kept the momentum going even when she felt good. Eight months later, Michelle ran her first half marathon, not because the pain magically disappeared, but because she stopped using pain as her only metric for progress. Here's something that might surprise you. Pain, is terrible at telling you what's actually going on. Sometimes pain lingers weeks after tissues have healed. That's your nervous system being overprotective. Sometimes pain disappears Even when you're not fully ready to return back to your previous activity, that's your body temporarily adapting to lower demands. If you use pain as your only guide, you'll end up lost. instead, I teach patients to track different markers, functional improvements. Can you put your socks on without holding your breath? Can you get out of bed without that first step? Stiffness. Looking at your confidence. Do you trust your knee going down the stairs? Do you feel secure reaching over head? How about the tissue capacity? Can you walk further than you did last week? Can you lift your kids without bracing yourself? These changes often happen before pain disappears, and they're much better predictors of long-term success. What's interesting is you can often reach the same short-term goal using two completely different approaches. Let's say you want to get back to playing tennis after a shoulder injury path. Number one, the quick fix. Rest until pain subsides. Maybe get an injection. Return to tennis. When it feels okay. Cross your fingers and hope for the best Path Number two, building a good foundation. Address the movement patterns that led to the injury. Strengthen the entire kinetic chain. Gradually progress loading. Build your confidence through controlled challenges. Both paths might get you back on the court, but only one builds resilience for the long haul. Path number one is like putting a bandaid on a crack in your foundation. It might hold for a while, but the next storm will reveal the weaknesses. Path number two is like reinforcing the entire structure. It takes longer, but it is built to last. Asked what I've learned over treating. Patience for the past 10 plus years is that momentum trumps perfection every time. Perfect is waiting until you feel 100% before starting activity. Momentum is starting at 70% and building from there perfect is having no pain. Before you start trusting your body, momentum is learning to distinguish between discomfort and danger. Perfect is following the textbook timeline. Momentum is adjusting the plan based on what your body's telling you. When you build momentum, you're not just recovering, you're building a new relationship with your body. You're learning to listen to signals beyond pain, and you're also building confidence through these small wins. I tell my patients the goal isn't to get you back to where you were. It's to get you back better than where you left off. Better doesn't necessarily mean that you're stronger or faster. It means that you understand your body signals and respond appropriately. You become more resilient by handling stress without breaking down You build confidence in trusting your body and its ability to adapt and recover. You become more aware of your body and you catch problems early before they become injuries. This is what momentum gives us, that the quick fix doesn't. Not just temporary relief, but long-term transformation. So how do you apply this in your own life? If you're currently in pain, don't just focus on making it stop. Ask yourself what led to this problem and how you can build a better foundation. If you're recovering from injury, don't stop treatment. When you feel good, that's when the real work begins. If you're trying to prevent problems, don't wait for pain to start moving better. Build momentum through consistent progressive challenges. if you're stuck in the stop and go cycle, consider that Maybe the problem isn't the treatment, The thing about momentum is that it compounds. every session you continue past pain relief builds on the last. every movement you master makes the next one easier. It's like investing the earlier you start building momentum, the more it pays off over time. I've seen patients who embrace this approach become more active in their fifties than when they were in their thirties. Not because they got lucky, but because they understood that consistency beats intensity and momentum beats perfection. So here's your challenge. Forget about the finish line for a moment. What's one small thing you could do this week that builds momentum? Even if you're not feeling perfect? Maybe it's taking a 10 minute walk, even though your knee isn't feeling that great. Doing your exercises, even though you don't feel like it. Scheduling that follow up appointment, even though you're feeling better, adding one more set to your routine, trying that movement you've been avoiding. It doesn't have to be big, it just has to be forward. Recovery isn't a sprint to the finish line. It's not even a marathon with a clear endpoint. When you build momentum instead of chasing perfection, you're not just treating an injury, you're developing a skill that will serve you for decades. Let me leave you with this. The moment you start building momentum, you stop being a victim of your circumstances and start becoming the architect of your recovery. don't wait for perfect. Start with possible. Don't wait for pain free. Start with progress. Don't wait for someday. Start today because Real sustainable momentum is the closest thing to magic we have in rehabilitation. that's it for today. Thanks again for listening. Thank you for listening to The Talking Rehab podcast. I hope that this podcast stimulates you to question your own practice and how you approach rehabilitation. I truly appreciate your time and attention. If you enjoyed listening, make sure to like and subscribe to the podcast. I wish you a movement filled day. Take care.