I have been mulling over this post for a while now. For some reason I felt some resistance to actually writing it. I’m also sure I could even write more than 10 reasons, and please feel free to add your own in the comments sections.
10. Conditions in which you cannot reverse, but only acutely improve quality of life – MS, Parkinson’s, ALS, etc
9. Overbooked PTs
8. Friends, family, and WebMD – Not literally WebMD, but patients coming in and saying that they read “yadda yadda yadda” on some site, or that their neighbor or sister did “x” when they had pain.
7. In reference to exercise programs; Doing as much as possible, not as much as necessary.
6. Patient’s actually don’t want to get better – To some of you this may sound crazy, but there are patient’s out there who gain something from being “injured” ie, attention, worker’s comp, etc.
5. Inconsistent performance of home exercise programs – This really means people not doing their home exercise programs. When a PT says “can you show me how you’ve been doing [exercise A] at home” and it is followed by a blank stare, do people think we don’t know what’s going on?
4. Continuing to do what caused the injury/pain/condition – Me: So your shins only hurt when you run? Patient: YesMe: Okay, so for the next couple of weeks I don’t want you to run Patient: Why? And for PT’s continuing to do what is not working.
3. ONLY treating the site of pain
1b. Lazy patients – For some reason when people are told they should go to PT, they hear “Go to physical therapy. These people will massage you and do tons of work which requires you to do absolutely nothing. Oh yeah, also, if they make you exercise you should definitely complain.”
1a. Lazy PTs – PTs who just diagnose and treat based on what they have done in the past or what they learned in school. See my hummer’s post. Also, not enforcing good form at all time.
Always Evolve,
Mike
Mike Scott, DPT 
I’d like to add – inconsistently getting treatment. I may or may not know this from personal experience.
Great List Mike.
I’d add …
1. When rest is required and exercise is the patient’s drug activating the same hormonal pathways as cocaine, alcohol, television, or food, she won’t stop exercising because it’s the only thing that activates those pathways.
2. When the patient suppresses mental stress, emotional pain and baggage, and manifests it physically. If the patient is observant enough, she might even notice when she thinks of a certain person or thing, the pain worsens.
Chris, I think that your #2 is much over-looked within the scope of rehab. I think that when we all talk about how connected the parts of the body are, we cannot forget that the brain/mind/emotions are part of the body too and will affect everything else it is connected to. Thanks for reading!
Mike