How many visits?

Why tissue type sets the floor

Different tissues change on different timescales, and no amount of treatment frequency compresses that biology.

Joint restriction and muscular guarding can change quickly — sometimes within a visit, often within a few. That is why some people feel dramatically better early, and it is genuine rather than placebo.

Tendon is slow. It remodels over weeks to months, which is why plantar fasciitis, tennis elbow and gluteal tendinopathy have longer timelines regardless of what is applied to them. Disc changes are similarly measured in weeks.

Strength and capacity are slower still. Meaningful adaptation takes months of progressive loading. This is why the honest answer to how long depends heavily on whether the goal is to stop hurting or to stop recurring — those are different endpoints with different timelines.

The first few weeks, and why your feedback matters

Early care is front-loaded on purpose. Recent and acute problems generally need closer spacing while tissue is still irritable, so you will see us more often in the first few weeks than at any later point in the plan.

That stretch is also the most informative. We are watching how you respond between visits — what eased, what came back, what you were able to do that you could not do the week before — and using it to adjust technique, frequency and the home programme as we go.

Which means the single most useful thing you can do is tell us. What changed, what did not, what made it worse, what you noticed at work or overnight. Small details you might assume are irrelevant frequently redirect the plan. Care built on continuous feedback gets to a result faster than care that waits for a scheduled review to discover something was not working.

Then, at roughly the 30-day mark, we step back and reassess formally: measure against what we expected, and change the plan if the results are not there. Constant feedback in between, a hard checkpoint every month.

The maintenance care question

Some practices recommend indefinite periodic visits for people who no longer have symptoms. We want to be straightforward about where we stand.

The evidence for preventive adjustment in asymptomatic people is limited. There is more support for continued care in specific circumstances — some people with recurrent chronic conditions do appear to benefit from periodic treatment — but that is a narrower claim than lifelong maintenance for everyone.

Plenty of people choose periodic visits because they find them useful and they value how they feel afterwards. That is a perfectly reasonable thing to choose. Our objection is not to the choice but to presenting it as clinically necessary when the evidence does not carry that weight.

Why pain stopping is not the finish line

Pain typically resolves before capacity is restored. Someone whose back has stopped hurting may still have the strength and endurance deficits that made it vulnerable in the first place.

This is the mechanism behind the pattern people describe of getting better and then flaring again a few months later. The treatment worked on the symptom, the underlying capacity never changed, and the next demanding week reproduced the problem.

It is also why the home programme matters more than the final few appointments. If you want to stop early, the useful conversation is not about booking more visits — it is about what you should be doing yourself to hold what you have gained.

When more visits is the wrong answer

If you have had appropriate treatment for several weeks and nothing has changed at all, the answer is rarely more of the same.

The possibilities worth considering are that the diagnosis is wrong, that a driver has not been identified, that something is maintaining the problem outside the clinic, or that this needs a different profession or investigation entirely.

Any of those is a better response than extending the schedule. If a course of care is not working and the proposal is simply to continue, that is a reasonable thing to challenge — here or anywhere else.