Why does one thing finally start to feel better… and then something else decides to hurt?
It can feel like you’re chasing injuries. Like you calm one fire down and another pops up.
Is that bad rehab? Or is that actually how complex systems work?
In this episode of Past Your Prime, Craig introduces the concept of Layered Pathology, the idea that injuries build in layers, and when one layer improves, the next one becomes visible.
Injury Whack-A-Mole Is Usually Not a Mistake
When symptoms shift, most people assume either the plan failed, the provider missed something or the treatment caused damage.
But often what’s happening is more complex and often expected. You reduce stress on one tissue. Force moves elsewhere. The next weak link becomes loud enough to notice.
Compensation Is a Feature, Not a Bug
Your body compensates to keep you moving.
If the big toe can’t absorb load, the forefoot adapts. If the knee can’t tolerate force, the hip or back steps in.
Compensation protects you short term. Over time, it can create a secondary overload and then you develop another compensation. It is not that the first compensation is now gone. It is still there, but it is lurking behind another compensation and injury.
Fixing One Layer Reveals the Next
Craig walks through real examples of a foot injury:
- Big toe irritation
- Forefoot overload
- Stress reactions in the metatarsals
- Movement pattern changes
- Calf, knee, or back symptoms
When you treat the most painful structure, the deeper movement or capacity issue may finally show up.
That doesn’t mean rehab is wrong. It means the system is reorganizing. As you pull on the string, it can uncover symptoms that are actually worse than the original problem that brought you in.
It’s Not Just Mechanical
Layered pathology isn’t only about joints and tendons.
It includes:
- Tissue capacity
- Movement sequencing
- Neural sensitivity
- Energy capacity
- Nutrition and recovery
- Life stress
Sometimes what feels like a “new injury” is actually systemic fatigue finally reaching its limit.
This is why symptoms like fatigue should not be ingnored. It can be a sign of underfueling that makes you start catching injuries. Read more about this in our article “Fatigue in Active Adults.“
The Real Trap Is Chasing Pain
When symptoms move, people panic.
They:
- Switch exercises too early
- Abandon structured progression
- Provider-hop
- Look for a magical cure
Instead of asking:
What layer are we working on right now? What triggers did I reintroduce? Is this new or do I have a game plan (think about the body inventory)?
The difference is one will build tissue capacity while the other will keep you permanently doing treatments that help for a moment but never breakthrough your problem.
6. How to Stop Chasing Injuries
Breaking the cycle requires:
- A clear diagnostic process
- Inventorying triggers and treatment responses
- Stabilizing tissue capacity before progressing
- Looking for issues with energy capacity leading to low energy availability
- Objective benchmarks
- Follow-up, even when things feel better, worse or the same
Progress in complex systems is rarely linear. But it can be structured.
The Takeaway
If rehab feels like you’re chasing injuries, it doesn’t mean you’re broken.
It may mean you’re finally uncovering the next layer.
And that’s not a setback.
That’s how real healing works.
🎙️ About Past Your Prime Podcast
Past Your Prime is the podcast for active adults balancing training, rehab, family, and real life.
Hosted by Craig Smith (PT & SPC Founder) and Alex Keicher (professional athlete and working dad) and presented by Smith Performance Center.
