Why Your Physio Exercises Aren’t Working (And What to Do Instead)
If you're reading this, you’re probably frustrated. Maybe you’ve seen one—or several—physiotherapists in Edinburgh. You’ve done the exercises, trusted the process, showed up to your appointments… and yet your pain remains the same. Or has even gotten worse.
You’re not imagining it.
You’re not “non-compliant.”
You’re not “too sensitive,” “too tense,” or “not trying hard enough.”
For thousands of people living with chronic pain, especially in Edinburgh’s busy city environment, the traditional physiotherapy model often falls short. And it usually has nothing to do with the therapist’s skill or your motivation. The real issue is that the model of care itself isn’t designed for complex, long-standing pain.
Typical physio appointments are short, symptom-focused, and built for acute injuries—sprained ankles, pulled muscles, post-operative rehab. But chronic pain is a completely different condition, requiring longer assessment times, deeper investigation, behavioral insight, and a highly tailored plan that actually addresses your movement patterns.
If your physio is not working in Edinburgh, the reasons are often predictable—and absolutely fixable. Once you understand what’s been missed in your care so far, you’ll finally know what to do next.
In this article, we’ll break down:
why traditional physiotherapy often fails people with chronic pain
the five most common reasons your exercises aren’t working
how clinical exercise physiology takes a different (and far more thorough) approach
when it’s appropriate to seek a second opinion
what you can do today to finally move toward real, lasting relief
Let’s lift the lid on it.
5 Reasons Standard Physio Might Not Work for Chronic Pain
1. The Assessment Was Too Short to Understand the Real Problem (30 minutes vs. 90 minutes)
A standard physiotherapy session is usually 20–30 minutes, sometimes even shorter. That’s just not enough time to assess the complexity of chronic pain, which often involves:
long-standing movement compensation
fascial restrictions
nervous system hypersensitivity
muscular imbalance
old injuries that were never fully resolved
workplace and lifestyle stressors
psychosocial factors
breathing mechanics
motor control deficits
Most people with chronic pain need at least 60–90 minutes for a full-body biomechanical, postural, and functional assessment. Anything shorter forces your clinician to focus only on the pain site—not the deeper causes behind it.
As a result, you walk away with exercises targeting the symptom, not the system.
2. Generic Exercise Protocols Don’t Address YOUR Unique Movement Patterns
Even highly skilled physiotherapists often rely on standardised exercise sheets or protocols. These can work beautifully for:
acute muscle strains
sports injuries
simple mechanical issues
But chronic pain is never “standard.”
It’s highly individual.
For example, two people with low back pain can have entirely different root causes:
one has hip immobility
one has thoracic stiffness
one has poor load transfer
one has deep core inhibition
one has compensatory bracing patterns
And yet both may receive the same exercises—bird dogs, clams, dead bugs, bridges.
If you’ve ever thought “These exercises don’t feel right for my body” or “I’m doing everything and nothing changes”, it’s likely because the exercise plan wasn’t matched to your actual neuromuscular presentation.
Chronic pain requires precision programming, not guesswork.
3. Exercise-Only Rehab Misses Deep Fascial Restrictions
This is one of the biggest problems with the “just do your exercises” model.
If your fascia (the connective tissue surrounding muscles) is restricted, stuck, or dehydrated, your muscles cannot activate properly. You can strengthen all you like, but the movement remains dysfunctional.
Common fascial problems include:
thoracolumbar fascia tension
anterior fascial line tightness from prolonged sitting
superficial back line restrictions
pectoral and latissimus dominance pulling the shoulders forward
fascial densification from old injuries
lateral line tightness affecting gait and lower back loading
Exercises alone cannot fix these restrictions.
They must be released, retrained, and reintegrated with movement.
If you feel like:
you always “tighten up”
stretching never lasts
you exercise but remain stiff
one area keeps overworking
…you’re likely dealing with an untreated fascial issue.
4. Your Compensation Patterns Were Never Identified (Or Corrected)
When one area hurts, the body finds a workaround. That workaround becomes a pattern. And over time, that pattern becomes your new “normal.”
Compensation patterns can be subtle and incredibly powerful. Examples include:
using your low back instead of your glutes
shrugging with upper traps instead of using mid-scapular muscles
bracing the abdomen instead of engaging deep core
rotating from lumbar spine instead of thoracic
relying on quads because your hamstrings can’t fire
pulling from lats instead of serratus anterior
Most physio exercises strengthen the pattern you already have—even if it’s dysfunctional.
This is why many people say:
“The exercises made me stronger but didn’t fix the pain.”
Without identifying the compensation, strengthening only reinforces the dysfunction.
Correcting compensation requires:
slow, controlled movement
external feedback
targeted inhibition work
neuromuscular retraining
postural re-education
breath mechanics optimisation
This is specialised work most standard physio appointments don’t have time to address.
5. You’re Discharged Before the Root Cause Is Fully Resolved
Standard physiotherapy is often designed around short treatment blocks—often 4–6 sessions.
But chronic pain rarely resolves in that timeframe.
Most people need:
full movement retraining
progressive loading
habit and lifestyle modification
fascial release
posture correction
nervous system regulation
long-term strength programming
Instead, many are discharged when the pain slightly improves—not when full function is restored. Then the pain returns, and the cycle starts again.
If you’ve ever felt abandoned mid-journey, it’s not your fault. The system simply isn’t set up for long-term, holistic, high-touch rehabilitation.
What’s Different About Clinical Exercise Physiology?
Clinical exercise physiology offers a radically different approach—one specifically suited for complex, long-standing, and recurring pain.
Here’s how:
1. Longer, more detailed assessments (60–90 minutes)
This allows your clinician to explore your:
movement patterns
joint restrictions
breathing mechanics
fascial tension
gait
strength balance
nervous system involvement
pain triggers
lifestyle stressors
Nothing is rushed. Nothing is guessed.
2. Treatment focuses on the whole kinetic chain
We don’t treat the symptom—we treat the system.
A knee issue is rarely just a knee issue.
A shoulder issue is rarely just a shoulder issue.
Everything is connected.
3. Deep fascial assessment and mobility retraining
This includes:
myofascial release
mobility sequencing
dynamic mobility drills
fascial line integration
This creates lasting change—not temporary relief.
4. Individualised programming that adapts weekly
Every session builds on the last.
Your exercises evolve as your body evolves.
This is not a “sheet of exercises” approach.
It’s a progressive, supervised strengthening and retraining plan.
5. Emphasis on long-term change, not short-term pain relief
The goal is:
restore natural movement
unwind compensation
retrain deep stabilisers
build capacity
prevent recurrence
return to meaningful function
Sustainable, not superficial.
When to Seek a Second Opinion
If any of the following sound familiar, it’s time to get a second opinion:
You’ve done your exercises consistently for 4+ weeks and nothing has changed
Your pain returns immediately after stopping physio
You feel your body is “working around” something
You don’t feel seen, assessed, or understood
You’ve been told “everything is normal” despite persistent symptoms
You feel your treatment was rushed
You keep receiving the same exercises no matter what you say
Your progress has plateaued
Chronic pain deserves more than a generic approach.
You deserve an assessment and plan that actually explains your symptoms—and solves them.
Ready for an Approach That Finally Makes Sense?
If you’ve been thinking:
“My physio isn’t working—now what?”
You’re not stuck.
You’re just one proper assessment away from clarity.
💬 Book your free 15-minute consultation
Let’s talk through your symptoms, history, and goals—and map a path toward lasting recovery.
