[#8] When Rehab Feels Too Slow: What SEO Taught Me About Trusting the Process

I share how an unexpected lesson from working on my business's SEO helped me better understand what many people experience during rehab. 

Whether you're recovering from an injury or coming back from surgery, there comes a point where you've put in a lot of work but still aren't where you want to be yet. That "messy middle" can be one of the hardest parts of the process. 

I'll share stories from a former client, a friend recovering from surgery, and my own experience to talk about why progress often feels slower than it actually is—and how to know whether you're on the right track. 

Main topics covered:

• The similarities between rehab and long-term projects like SEO
• An Achilles tendinopathy case where recovery felt too slow despite clear progress
• Why the "messy middle" is often the most challenging phase of rehab
• A surgery recovery story and the importance of trusting the process
• How to tell the difference between being stuck and simply needing more time
• The role of patience, perspective, and trusting the process during recovery 

Continue the conversation:
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Transcript

SPEAKER_00 0:07

Hello and welcome to Candid Conversations with Dr. Kelsey. I'm your host, Dr. Kelsey, and this is the space where I share my honest thoughts, real experiences, and the no BS conversations I wish more people were having about movement, training, injury recovery, and life as an active human. The goal of this podcast is to help you better understand your body, think more critically about rehab and fitness, and feel more confident making decisions so you can stay active long term. Before we start, a quick reminder. I am a physical therapist, but I am not your physical therapist. Nothing here is medical advice. So if you're dealing with something specific, please reach out to your PT or schedule a session to work with me. Alright, now let's get into today's conversation. About three months ago, I started really focusing on SEO for my business with help from Lex Lancaster. This was after I joined the Lexromine mentorship program that she runs with her partner, Shantae Cofield. So the thing with SEO is that it takes months to see the fruits of your labor. Lex is really upfront about it, and she showed us multiple examples of the quote unquote behind the scenes, um, if you will, of SEO success stories where the results that um these people had came after months of work and just patience, essentially. So I acknowledged this and I acknowledged that it would take time for you know for this to pay off in the long run. Um so fast forward to now, where um a few days ago I was starting to, well actually a a few weeks ago, I started getting really worried about not seeing results. And um I started getting really frustrated that like some of the new service pages that I made for my website were not being were still not being indexed by Google uh Google, uh meaning those pages that I'd spent so much time on like aren't even being shown on search results. And so I started to wonder if there was something else I could be doing or like maybe I was doing something wrong. Um and then I had a meeting with uh Lex the other day and she reminded me that it's literally only been three months. Like um, she had I don't want to say she promised, but I mean she was pretty clear that this stuff, like sometimes it takes like six months um at the minimum to like really see things take off. Um and again, it's only been like halfway to that six-month part. Um and and she reminded me or like she showed me that there is evidence that my website is gaining traction, it's just going to take more time to really see the fruits of my labor that I'm doing like right now. Um, and you know, whatever I'm experiencing or like the stuff that my website is experiencing at this point in my journey is all very, very normal. Like I'm not doing anything wrong. So um, so again, it even because like I live with uh doing the website, like all like my business, like I live with that every single day. And so it had felt like I had been doing this for forever. But when she pointed out that it's only been like three months, I realized that I sounded exactly like what some of my rehab clients sound like to me. So as a physical therapist, I've helped hundreds of people recover from injuries and surgeries, and some cases do take upwards of six months to rehab, um, especially things uh that involve the tendon. I've done a podcast episode on this before. Um, and even though I'm able to see the gradual progress being made, a lot of the clients going through the process might not feel the same way. So today I wanted to talk about the messy middle of rehab, and which is the part where you feel like you've done all this work already, but you still aren't where you want to be yet. So I'll talk about a former client who was in the same place in their rehab that I am now with my SEO, but who decided to quit instead. A friend who couldn't imagine getting back to where they were before, or um, to where they were before uh after getting surgery and doing rehab, but who did eventually make it after trusting the process, and what my experience with working on my SEO has taught me about the uncertainty felt and patience required by you know those going through rehab. So a couple of years ago, I had a client with an Achilles tendon issue. And before coming to me, they dealt with um that issue for about a year, and even before like it flared up the you know that year prior, even before then, like it was something that they had been experiencing on and off for several years. The only difference between like the what they had experienced before and um what they came to me for was that their issue you would go away on its own basically, but now they'd been dealing with this flare-up for like a whole year. So, you know, it didn't just go away on its own. So, like Lex, I was up, I was pretty upfront that tendon issues do take several months to get better. And especially the longer you wait to address them, you know, the longer it's gonna take to rehab. So I gave them an estimate of about six months minimum to be able to return to jogging comfortably again. And you know, they acknowledged it, like, you know, we're I guess relatively excited to start. Um, but just like me with my SEO, at about the two-month mark, they started expressing frustration that they still couldn't run without pain. And so, you know, I reminded them like, you know, yes, I I understand, um, you still can't run, but you know, you but lunges used to bother you before, and now you can do lunges without pain. Um I mean, so that shows progress. It's not like you're stuck to where you were before or like stuck where you were like when you first started, like you're making some progress, but I understand that like you know, it's frustrating you're not able to run yet, but you know, that's usually doesn't come about until the six-month mark. Um so I did my best to reassure them, but um at the three-month check-in, they ultimately decided not to continue with rehab. Um, and so getting through the messy middle, so they were in the messy middle, and getting through that is probably the most difficult part of rehab because you're past that initial stage of excitement of starting something new and like, you know, doing something to progress towards your goals. Um, but you still have quite a bit to go, uh still have quite a bit to go to get to where you want to be. Um, like, you know, you've essentially built the foundation of your rehab and are now giving it time to pay off. And for someone living through it, you know, they see themselves, they're with themselves all the time, obviously. And so it can seem like nothing's happening because they're still dealing dealing with the pain or they still like can't do certain things, they still have to modify things. Um, but from the outside, so like from my perspective, um, small changes and steps towards progress are a lot more obvious. So, like with my previous client, they were super fixated on the fact that they still couldn't run versus on the outside, um I could see their progress because I was like, okay, before you couldn't do this without pain, but now you can do this pain-free. Um, before you couldn't do this exercise, but now we've progressed to a more difficult exercise. And obviously looking back, like the miss the messy middle is often where the most important work happens. So it's like once you get over that hump, like everything after that is a lot easier. But when you're when you're in the middle of it, when you're in the thick of it, like you just feel like you're stuck, like you you don't really see, you can't see over the crest, I guess is the best way to describe it. And a friend of mine uh recently experienced this. So they just recovered after an injury that led to a surgery. Um, but again, after the first few weeks of their rehab journey, they genuinely couldn't picture themselves getting back to where they were before. So that was their goal. Um but like to them, it seemed like every single milestone they achieved like um would turn up new challenges. So for example, they were fine when they were finally clear to walk without um without a boot, they realized, oh, like I can't walk normally. So they had to relearn how to walk normally again. So it's like every time they reached a goal or a milestone, like something else would come up. So then it just seemed like their progress was going in a straight line instead of you know like up at it on a diagonal um towards their goals. And they they stuck with it though, so they just kept at it. I mean, it I mean, they it's not like they were like super excited about it, but you know, they they kept with it. And eventually, just one day, they just kind of had an aha moment where all the rehab work that they'd done like kind of finally clicked. And then they they were able to see like the finish line. They were able to like see like, oh, like I'm able to do all this stuff now, and then like my goals are over here, like there's not much left to be able to reach my goals. And so now they're back at they're back at uh the gym kicking everyone's butt, um, even though they're not quite at the level they were before, but they're definitely close enough that it seems a lot more doable. And so when it comes to rehab, it's really important to remember to look at how far you've come versus how far you still have to go. Because I feel like people get really, really fixated on the end goal. And I mean, it's you know, it's important to keep sight of your goals, but then then it becomes frustrating because every step closer you get, like it still seems so far away, versus just you know, looking back, turning around and seeing, hey, I used to be all the way over here, and now I'm at this point. Um and also a reminder that highlight reels on social media don't really don't usually tell the full story. And even if they do talk about like the messy middle a little bit, um, I feel like it's only touched on a little, or maybe the people seeing it what it including myself, like the people watching it don't realize fully or don't appreciate fully like how difficult and how long the messy middle is because it's boring. The like such a huge part of the process is so boring and repetitive. And so, like, you know, who wants to watch that on social media? So a lot of times those highlight reels will will show the beginning, obviously. They're gonna show like the where they started and maybe like some of the initial excitement or whatever, kind of you know, briefly show the middle part, like gloss over it, and then show the end, like, yay, we did it. Um, and so I think that kind of turns into an expectation for us that like, hey, yeah, it's you know, we're gonna do this thing, it's gonna take probably not that long, or even if like I like for me with the SEO, even if we acknowledge, like, yeah, it's gonna take a few months, like a few months feels like forever. And then um, and yeah, so then we just kind of get stuck in this little trap, so to speak. Um so with rehab and with other things, so like in my case SEO, um, it's important to not only to like remember to look at where you've come from, but also to zoom out and look at the big picture. Um, because we again we get stuck at looking all the at the little details because we we live with it every single day. And so if you're able to kind of take a step back and try to look at things from a different perspective, you might find that you're actually making a lot more progress than you thought you were. And but one thing I want to be careful about is that you know I don't want people to think that they need to keep doing the same thing indefinitely because there, I mean, there are times when like you're doing you might be doing something that's not helping you. Um an example of this are two other previous clients I've had. Um they actually came independently, so um, but they came from the same clinic where they realized they were doing the same thing over and over again, and there was no end in sight. Literally, like there was no like, you know, time they were not given a timeline, so they didn't really know where the end would be. Um, and so they came to me and then you know they were they were able to get better after like four weeks. But um so there is a difference between being stuck in the messy middle of a successful successful plan or just being stuck in the messy middle of like some sort of plan and just being stuck. And so, you know, how obviously how do you tell the difference? Like it's kind of 2020 hindsight is 2020, but if you're in the thick of it, it's really hard to tell the difference. Um, but there are some subtle things that you can look for to help you. So when it comes to rehab, rehab has a fairly predictable timeline. So most things are gonna take about three months, like six weeks to three months to get better. Um, and again, like I mentioned for tendon things, tendonopathies, um that that time frame is usually like six months, more like six months. And it's the same thing with surgery. So after you get surgery, like most things are gonna take like 12 weeks um to be able to go back to like normal day-to-day stuff. Like, so if you have a desk job, like that would be for you. If someone is more active, um, so like most of my clients, they want to get back to a sport, they want to get back to like CrossFit or you know, um triathlon, HIROX. That's gonna take a little bit longer, just depending on the surgery, you know, six months or longer, just to get back to like that same level that they were before. Um yeah, that's after surgeries. But it's you know, it's pretty predictable the timeline. And of course, there are gonna be some deviations and exceptions. Like some people are gonna recover a little bit faster, some people are gonna have some setbacks, and so but even with those deviations, it either shortens or prolongs the timeline in a predictable manner. And so that's why like I'm able to still give like some sort of timeline. Like I'm even even though I'm not I might not be a hundred percent sure if like going back to my client, I wasn't a hundred percent sure he'd be able to get back to running at six months versus five months or even seven months, but I was you know 90% sure that it would be around the six-month mark where he would at least be able to do some jogging with way less pain than he was experiencing right now uh at the beginning. Um and so with that, like if someone is going to give um if someone's going to promise anything or guarantee that I never like to give 100% guarantees because I don't think anything is a hundred percent guaranteed in life. Um that's why like I'm usually like 95% sure or whatever. So if someone is going to tell you how long something is going to take, there should they should be able to estimate based on like their past experiences or even on like the experiences of other people. So for me, like my rehab timeline, like or my um prognosis, my ability to you know estimate prognoses came from obviously my experience, but then also just from the literature and from other people's experiences, like and reading protocols and things like that. So it's like a culmination of all this information. Um so yeah, so firstly, there should be some sort of timeline and it shouldn't be based like for physical therapy, it shouldn't just be based on like your referral. Because I know a lot of doc like a lot of people will have referrals from a physician that says, like, oh, like, you know, this referral says two to three weeks for six weeks. Or sorry, two to three times a week for six weeks. And so in their brains, they think that they'll be better in six weeks, which to be fair, like the six-week mark is usually kind of like that mark um that's actually like right past the messy middle, so it's right after that hump where you're like, oh, I made progress and like I'm almost back to normal. Um, but some people might need long more time, some people don't need six weeks. Um but I've known several physical therapists and I've heard from client like clients um from when they went to other physical therapists that they've been told like, oh yeah, just do this thing for six weeks. And so they think that automatic like six weeks is like the automatic cutoff or something. Um so the timeline shouldn't just uh depend on the referral. Um it should re it should depend on like the assessment, basically, and the um and the physical therapist's like um prognosis, which is based on the assessment. Um so yeah, so that's the first thing. Um another thing to think about um when trying to decide if like, oh, I'm just in the messy middle versus being stuck, is looking at if they're asking yourself if there has been progress. And again, it's really, really difficult to sometimes it's really difficult to notice if there's been any progress, especially if you're like look just looking at the end goal and realizing that you're not there yet. But you know, remember that sometimes you need to zoom out, sometimes you need to turn around and see where you were before, and also asking the physical therapist and saying, hey, do you see progress? Like, like what are the things that you're measuring that you see progress on? Like, you know, do I have more range of motion? Um, am I able to do things like uh am I able to do more things before the pain flares up or whatever? Um, so you know, making sure that there is progress, because if absolutely zero progress is happening, then you might need want to consider, like, hey, maybe I should, you know, should I be doing something else? Um and then lastly is whether the plan is progressing appropriately. Because if the plan's not progressing, if you're not being appropriately challenged, of course there's not going to be progress because there's nothing challenging you to initiate that progress. Um though there is a very there is an exception, but there are very, very few like for certain exercises that seem easy but are actually doing something. And uh in my experience, it's going to be something like a joint mobilization. So I had another client that I was seeing for their toe, and I had them doing like um a joint mobilization of their big toe, and they I mean we were doing some other stuff too, but she uh they told me like, you know, it feels like I'm not doing anything. I'm like, I'm like, I promise, I know you I know I told you like if something feels like it's not doing anything, like I'll change it, I'll progress it. But for this one exercise though, just this singular exercise, I promise, um like stick with it for at least a couple more days, like a couple more weeks, and then from there we'll see if it didn't do anything. And then yeah, after after like another week, just like, oh yeah, like my toe feels better. So so that's like something like a joint mobilization thing, like that's the only exception um that I've seen. Um, but in terms of like exercise, like normal exercises, like yeah, they should be challenging. Um, because if it feels like you if it feels like nothing's happening, even for stretches, if it feels like nothing's happening, they're likely it's not really doing anything and you're kind of wasting your time doing that exercise. Um so yeah, so even though so if you're stuck in the messy middle and you're trying to decide if, you know, you're in the messy middle versus just being stuck and needing to needing to do something else, like looking at, you know, do you have like a time frame and you know, is the time frame based on your assessment versus just based on like some arbitrary six weeks? Um has there been progress and is your plan progressing appropriately? Or is is there a plan? Like, is there an explanation for where you are besides just, oh yeah, just trust the process? Because yeah, you do need the trust to trust the process, but there has to be a reason to trust, if that makes sense. Hopefully that makes sense.

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Um

SPEAKER_00 22:00

Um, but yeah, like you know, remember that real progress is rarely as dramatic as social media makes it out to be. And my experience being in the messy middle of improving my SEO makes me appreciate what my clients and others are going through during physical therapy so much more. I mean, I've gone through physical therapy before as well, but I feel like this is I think those processes were like three months or less. So I that's why like I feel like I've never experienced something this long before where I'm like, I don't know if I'm going in the right direction. Um But yeah, so if you're going through physical therapy right now and are stuck in the messy middle, you know, remember to zoom out so that you can so that you can see the progress that you've made so far and you know, trust the process. Like I gave you the exceptions, uh, the framework. Um, but you know, if you're making some progress, you've been given a timeline, and um things are like your exercises, your plan is like progressing, then unfortunately you you might just need to hunker down, trust the process, you know, keep grinding, and then you'll also feel that aha moment where like everything clicks. Um because you never know how close you might be to reaching your goal. So you don't want to um give up, so to speak, too early after doing all of this work. So I know it's like it's a fine line, but um, but yeah. So thank you for listening. If you liked this episode and know someone in the messy middle of their own rehab journey, send them this episode for hopefully for motivation to be able to trust the process so that they can get to so that they can reach their goals um in a more timely manner. Otherwise, I will see you in the next conversation.