Feeling Burned Out in Physical Therapy? Treat Your Career Like an Overuse Injury

What if I told you that the way you treat yourself when it comes to your relationship with your work, your career, or your business is the exact opposite of how you would treat a patient with an overuse injury?

What would you say?

If you’re new here, I’m Julie. I’ve been a physical therapist for 17 years, and my particular specialty was working with female athletes, especially those with overuse injuries

This also applies to other rehabilitation settings — spinal cord injuries, strokes, brain injuries — and honestly, you don’t even have to be a physical therapist for this to apply to you.

Because if you’re a woman in healthcare -- like most of the physical therapists I work with as a coach -- who feels like something about your work is wearing you down-

I would argue that the way you’re treating yourself around your career is probably the exact opposite of what you would tell a patient with an acute or catastrophic injury, an illness, or an overuse injury.

Let’s use the overuse injury because it keeps this simple.

Say a runner comes to you and says, “God, my knee has been hurting for six months. Every time I run, I just don’t feel like myself. It hurts. It’s getting worse. And by the way, I’ve tried effing EVERYTHING to feel better.”

She’s been in Facebook groups getting free advice from the internet. She’s watching TikTok videos for exercise ideas. She’s foam rolling. She’s taking anti-inflammatories. She’s kinesiotaping based on something she saw online.

She did go see a physical therapist for approximately three minutes. It didn’t help, so she decided physical therapy doesn’t work.

She’s stretching. She’s strengthening. For all intents and purposes, she’s doing everything the internet tells her she should be doing.

And she tells you she can’t stop running.

She already tried that. It wasn’t good for her mental health, it wasn’t good for her identity, and as a skilled provider who works with athletes, you know that unless there is actually a contraindication to running, your job is probably to find a way to keep her running — even if you need to modify it for a while.

So you tell her, okay. We’re gonna keep you running. And we’re gonna figure out how to make this work for you.

You might analyze her running form and see whether something about the way she’s moving is working against her. You’ll look at the environment where she’s running and whether the surface is a great choice for her right now. You’ll check her shoes.

Maybe she’s on a training plan that has her doing way too many long-distance days and not enough intervals, periodization, or cross-training.

You’re going to look at all the inputs she’s getting, along with her lifestyle, nutrition, sleep, work schedule, and everything else that might matter.

Then you’re going to start figuring out what the actual problem is and why this injury might be there.

And here’s what you’re probably NOT going to do.

You’re probably not going to take her completely out of her sport.

Once you’ve figured out what seems to be driving the problem, you’re going to find the minimum effective dose of what will actually help her.

And more than likely, you’re going to simplify the three million things she has been trying so she can focus on the things most likely to make a difference.

Maybe that’s a couple of exercises. Maybe it’s changing something about her gait, modifying her training plan, addressing nutrition, whatever.

But you and I both know that if you pile 17 more things onto this athlete on the first visit, you’re going to lose her.

You want her to buy in. You want her to be able to follow through. You want to set her up for success.

You’re also not going to recommend that she just keep doing everything exactly the way she’s been doing it.

You’re not going to tell her to keep listening to people who make her feel like garbage or give her terrible advice, and you’re certainly not going to recommend something that makes her mental or physical health worse.

Now let’s translate this to you and the way you’re treating yourself in your sport — aka your career.

At this point in your career, you’re really good at what you do. You’re skilled, accomplished, have credentials out the wazoo, people refer you patients...and you’re tired of it.

Or something is off.

It doesn’t feel quite right anymore.

You can’t motivate yourself to do good work the way you used to be able to, so you start trying all the things that used to work.

You take another course hoping it’ll give you some inspiration. You go into Facebook groups and read the threads and comments looking for ideas, which mostly makes you feel like garbage because everyone is fighting in the comments section.

You get another certification because maybe if you have something new and different to offer, you’ll get different clients, or you can start doing more coaching or more holistic care.

You pile on more things.

Just like the athlete who is piling on all the things she thinks she needs to be doing.

And maybe you’re trying really hard to take care of yourself, too.

You’re meditating more. Working on your nutrition and sleep. Optimizing your wellness. Maybe you’re thinking, I’m just getting older and I’m tired and it’s probably my hormones.

You’re doing all of it, and you’re doing it so well.

But you’re still piling on more things without ever getting particularly clear about the actual problem.

You probably have some intuition about it. You think -

Maybe I need to cut back my hours.

Maybe I need to shift into something else.

Maybe I actually want to stay here, but I need to fire someone or hire someone.

Instead of getting clear on that, though, you keep trying different treatment ideas on yourself without ever getting particularly clear on the diagnosis or the minimum effective dose of what you actually need to do about it.

And my favorite part of this whole analogy is that, just like we wouldn’t tell a runner she needs to quit her sport, nobody is telling you that you need to quit your job, burn the whole thing down, and never do it again.

Nobody is telling you that you have to leave healthcare and move into non-clinical work.

That might be the answer for you. It’s a perfectly fine answer if that’s where you determine you want to go.

But nobody is telling you that you need to make some enormous, radical change.

And just to the nervous system reading this and already panicking a little bit:

You probably don’t.

Even if you eventually decide you DO want a major change, you’re probably going to ease your way into it bit by bit, just like you would with a runner who tells you she wants to run a marathon when right now she’s running 5Ks.

You wouldn’t say, “Great, we’re gonna do that tomorrow.”

Absolutely not. That’s ludicrous.

You do not need to turn the tables of your entire life and career upside down simply because something about your career is unsatisfying.

But when you’re trying to solve this entirely on your own, it’s really easy to keep piling on the same things that aren’t working and aren’t making you feel any better.

And it comes from such a good place.

You’re trying to problem-solve, be responsible, and figure it out.

I love this about you. It's what makes you such a great clinician AND great human who cares about herself and her own wellbeing.

But at some point, all of that problem-solving becomes a whole bunch of Band-Aids that still aren’t getting you where you want to go.

And it’s exhausting.

You’re already carrying the weight of your patients and a healthcare system that was not exactly designed to accommodate your needs, your body, your desires, or your personality.

You do not also have to carry the weight of your entire career and life trajectory by yourself.

Maybe the problem has changed because you have changed

There are so many reasons something about your work might not fit the way it once did.

Maybe you’re stretched so thin that continuing to work the way you have been conflicts with your own ethics or values.

Maybe your body has changed and you simply don’t have the same capacity you once did.

Maybe your interests have changed and the things that used to light you up don’t anymore.

Maybe you’ve gone through pregnancy, postpartum, perimenopause, an injury, autoimmune disease, surgery, or the loss of someone you love.

You are not supposed to be doing exactly the same thing for the rest of your life.

That narrative may have made sense when you were in school working your ass off for the credential.

Maybe you applied for a job that genuinely felt like your dream job when you got it, and you thought you’d stay forever.

Maybe you started a business that you were absolutely certain was your forever thing and now you’re going...

Hmm. Maybe not.

You are going to grow and evolve as a human being throughout your life. Of course your relationship with your career and your work can grow and evolve, too.

One of the things that brings me so much joy in my work is when a woman in healthcare is willing to say:

You know what? This isn’t working for me anymore.

That is an incredibly brave thing to say inside a system that very much benefits from you staying put and continuing to give more of yourself to it.

It also gives me so much joy when someone has the courage to say:

I actually don’t know what the answer is, and I don’t want to figure it out by myself because that sounds exhausting. I’m already tired. Why would I make my life harder?

That can feel incredibly vulnerable when you’re used to being the giver, you’re not particularly practiced at receiving, and you have spent most of your life being the person who figures out the answer.

Especially when you’ve also learned that the answer usually comes through more learning, more expertise, or more fixing of yourself.

Sometimes your relationship to the work and the container you’re doing it inside need to change.

And there is SO much nuance here because your career isn’t some random thing you can swap out without consequence.

Your identity is wrapped up in it.

It’s a huge part of your financial safety.

Your patients love you and depend on you. Your referral sources might, too.

There can be a lot at stake.

Which is exactly why it takes courage to say any of this out loud and ask for help with it.

Because my guess is that once you admit something to yourself — once you see what you want to do differently or where you might want to go — you’re not particularly good at unseeing it.

You’re driven. You’re achievement-oriented. Once you see the thing, you want to PURSUE THE THING.

Which means sometimes the brave choice is also saying:

I don’t have to turn the tables today.

I don’t have to pursue this entire thing in three days, three weeks, or even three months.

I can take one bite at a time, with help, and use as much intervention as necessary but as little as possible.

Minimum effective dose.

And I can have another set of eyes on this who isn’t trying to pressure me into somebody else’s preconceived notion of what a “good” healthcare career is supposed to look like.

Because I genuinely do not care what you ultimately decide to do.

I care very much about you.

And I believe that what is good for you — in your heart, your body, your soul — is ultimately good for the people you serve, your family, your career, and even the healthcare system you’re part of.

There’s a trickle-down effect.

You get to pick what that looks like.

And you get to change your mind again.

Think about your runner.

If she wants to run a 5K, a marathon, an ultramarathon, or one mile, you probably don't have your own identity wrapped up in which distance she chooses.

You want her to feel good in her body, make a choice that belongs to her, and move toward it in a way that supports her health, her identity, and the rest of her life.

You’re invested in her being empowered enough to make choices that work for her.

And you’re also pretty damn clear that she’s not getting there overnight.

Why would your career be different?

Before you throw another treatment at yourself

I want you to notice where your next career decision is coming from.

Are you buying the next thing, staying put, pivoting, or blowing the whole thing up because it’s actually what you want?

Or are you reacting?

Maybe your fight response looks like doubling down — buying all the things within the system, learning more, getting another credential, and looking toward the same people who have always told you what “good” looks like.

Maybe flight looks like wanting to burn the whole thing down and leave.

Maybe freeze looks like staying exactly where you are while doing a LOT of things that feel like progress without actually moving you forward.

Maybe fawn looks like cozying up to the gurus who make you feel like you’re never quite good enough — not a good enough provider, not a good enough business owner — and looking to them for more advice about how to self-improve in place.

And this is one of the things I find so interesting about healthcare.

For our clinical development, professional development, personal health and wellness, and sometimes even our personal development, we tend to get a LOT of our input from people we see as mentors inside the health and wellness world.

That’s not inherently a bad thing.

But when you’re deeply caught in that web, you can end up looking to the same system you’re increasingly unsatisfied inside for all of your answers about how to feel better inside of it.

Sometimes you need to step outside the current for a minute.

You don’t necessarily need to swim against it.

Maybe you find a different current within the same system that works better for you.

Maybe you eventually decide you do want to get out of the water entirely.

But I am begging you to stop piling on things that keep you stuck exactly where you are and make you even more exhausted when some part of you already knows that, sooner or later, something needs to give.

There’s no rush. There is absolutely no glory in forcing yourself into something before you’re ready.

But if you’ve been thinking:

God, is it just me?

Maybe I’m crazy.

Maybe I’m ungrateful.

Maybe I’m being dramatic.

Maybe it’s just perimenopause.

Consider for a second that you might be looking for the answer in the same water you’re trying to get some perspective on.

Sometimes you have to step out of it for a minute.

Just for a minute.

Look at it from the outside, with somebody in your corner who can help you see what’s actually happening before you prescribe yourself seventeen more things to do about it.

And then?

Give yourself the minimum effective dose.

Take it one bite at a time.

You can decide where you want to go from there.

Would love to hear your thoughts on this!

As always - reach out!

Big hugs!