When Past Injuries Cause Current Problems w/ Rick Olderman

The Story That Changes Everything

Picture this: A man breaks his ankle at 20. Gets it fixed, moves on with life. No pain. Thirty years later, he's dealing with chronic back pain, sciatica, and now a hamstring tear. Three separate problems, right?

Not likely.

This was one of the patient stories that physical therapist Rick Olderman shared in our interview on The Chronic Illness Therapists Podcast, and it perfectly illustrates why we've been thinking about chronic pain all wrong. That ankle injury from decades ago just might have been the first domino in a chain reaction that led to every single one of his current pain issues.

This isn't some mystical mind-body woo. This is biomechanics. This is systems thinking. And it might just change how you understand your own pain.

The Medical System's Blind Spot

Here's what I've learned from working with people in chronic pain for years: if you've been dealing with pain for more than three months, you've probably been told one of two things.

Either: "Nothing's wrong with you. Your scans are clean. Maybe try therapy for the psychological component."

Or: "Here's another structural issue we found. Let's treat this specific thing."

Both approaches miss the bigger picture. As Rick explained, our medical system excels at component thinking - breaking the body down into individual tissues and treating what's broken. This works beautifully for acute injuries. You break your arm, we fix your arm. Done.

But chronic pain doesn't work that way. Chronic pain is a systems problem, not a component problem.

The Ankle-to-Back Pain Highway

Let me walk you through how that 20-year-old ankle injury created 30 years of compensation patterns.

When the ankle healed, it lost 50% of its range of motion. The man didn't notice because he wasn't in pain. But here's what his body was doing every single day:

When he walked, his ankle couldn't bend properly. So the force that should have been absorbed by the ankle joint had to go somewhere. It traveled up the chain to his knee, causing it to lock. When the knee locks, it turns off the glute muscle. When the glute turns off, a deeper muscle called the piriformis takes over - and that's what was pinching his sciatic nerve.

His brain started shifting his weight off that leg to compensate for the pain that would’ve occurred had he been bearing weight on it. This created an elevated pelvis on one side, which pulled down his ribcage, increasing compression on his spine right where the sciatic nerve roots exit.

One ankle injury. Multiple compensation patterns. Years of accumulated dysfunction. And not a single healthcare provider connected the dots because they were all looking at individual components instead of the whole system.

The Physical Reality of Emotional Pain

But here's where it gets really interesting - and where the mind-body connection becomes more than just a buzzword.

In the episode, Rick introduced us to something called myofibroblasts. These are specialized connective tissue cells that get laid down in areas of mechanical stress. Unlike regular muscle tissue that responds to nerve signals from your brain, myofibroblasts respond to chemical signals in your bloodstream.

And what triggers those chemical signals? Stress. Anxiety. Emotional trauma.

When you're under chronic stress, your body releases cytokines (specifically something called transforming growth factor beta one) that circulate through your bloodstream and cause myofibroblasts to contract. These tissues have a longer lead time to contract and a longer tail to release than regular muscle.

This means your body can literally hold tension patterns from emotional states, and it takes time and conscious awareness to release them.

In my opinion this means that chronic pain MUST have a physical and a cognitive component to treatment. This is a real, physical mechanism by which emotional states create physical tension patterns in your body. Your lower back, where these myofibroblasts are most concentrated due to natural mechanical stress points, becomes a storage site for both physical and emotional tension.

Why You're Not Broken

If you're someone who's been told "nothing's wrong" while living with very real pain, what I’m about to say should be validating: Your pain isn't imaginary. It's just that the traditional medical model isn't designed to see systems problems.

Think about it this way: you can have bulging discs and no pain (this happens to 90% of people over 70). You can also have massive systems dysfunction causing significant pain with completely normal imaging. Neither scenario means you're broken - it just means we need to look at how your body is functioning as a whole.

As Rick put it, some people can compensate around structural issues for decades without feeling it.

The Chess Master Approach

Rick described his approach to treatment like a chess master seeing the entire board. Instead of looking at individual pieces (your shoulder, your hip, your neck), he sees the patterns, the connections, the flow from past moves to future possibilities.

This is what's missing in most chronic pain treatment. We need practitioners who can step back and see the whole picture - how that old ankle injury connects to your current back pain, how your stress patterns are literally wired into your fascia, how your walking pattern is setting up tomorrow's problems.

Moving Forward with Systems Thinking

The beauty of understanding pain as a systems problem is that it gives you agency. Instead of being told "nothing's wrong" or "learn to live with it," you can start asking different questions:

  • What compensation patterns might I have developed over the years?

  • How is my body moving as a whole system?

  • Where are my areas of mechanical stress, and how might my emotional state be affecting them?

  • What tests can help me understand my specific deficits?

This doesn't mean every chronic pain problem has a simple fix. But it does mean there are often concrete, addressable reasons for your pain - even when traditional tests come back normal.

The Path Forward

If this resonates with you, Rick's YouTube channel offers free videos that walk you through the tests from his book "Pain Patterns." You can start understanding your own body's systems and compensation patterns.

But more importantly, you can start looking for practitioners who think this way. Who see the connections. Who understand that your decade-old car accident might be related to your current neck pain, even if your neck "looks fine" on imaging.

Your pain is real. Your body is giving you information. And there are people out there who know how to listen to what it's trying to tell you.

The conversation around chronic pain is shifting from "it's all physical" or "it's all mental" to "it's all connected." And that connection isn't mystical - it's mechanical, chemical, and completely addressable when we finally start looking at the whole picture.

Disclaimer: Everything we discuss here is just meant to be general education and information. It's not intended as personal mental health or medical advice. If you have any questions related to your unique circumstances, please contact a licensed therapist or medical professional in your state of residence.

Destiny Davis, LPC CRC, is solely responsible for the content of this article. The views expressed herein may or may not necessarily reflect the opinions of the guest.

The content in this blog post comes directly from a real, human interview between Destiny and her guest on The Chronic Illness Therapist Podcast. This written version was formatted using AI. Listen to the full episode to hear the actual conversation.

Listen to Rick’s interview with me, Destiny Davis, on Ep 101:When Past Injuries Cause Current Problems

Listen on Apple

Listen on Spotify

 
Podcast cover art for "The Chronic Illness Therapist Podcast" with Destiny Davis, LPC CRC

Listen to Rick’s interview with me, Destiny Davis, on Ep 101: When Past Injuries Cause Current Problems

Listen on Apple

Listen on Spotify

Rick Olderman, physical therapist, smiling wearing a light blue button-down shirt while holding a small anatomical model of a human skeleton

Rick Olderman, MSPT, is a leading physical therapist with over 25 years of expertise in chronic musculoskeletal pain and the creator of the Fixing You Method, a revolutionary system for solving pain at its root. A best-selling author of the Fixing You series and Solving the Pain Puzzle, Rick has helped thousands regain their lives through his innovative home programs and holistic approach to healing.


Destiny Davis, LPC CRC, smiling in a pink sweater standing outdoors with crossed arms

Meet Destiny - The host of The Chronic Illness Therapist Podcast and a licensed mental health therapist in the states of Georgia and Florida. Destiny offers traditional 50-minute therapy sessions as well as therapy intensives and monthly online workshops for the chronic illness community.

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When Trying Harder Makes It Worse: A Different Approach to Chronic Illness Recovery