Getting Performance Anxiety in Front of the Physio

Ever had that moment where you walk into a doctor’s or physiotherapist’s office, all set to explain how your knee has been staging a rebellion for weeks, only for it to suddenly decide it’s auditioning for the role of "perfectly functioning joint"? If you’ve ever felt like you’re starring in a live-action version of “The Boy Who Cried Wolf,” welcome to the world of the observer effect—a strange phenomenon where your body’s symptoms seem to evaporate the moment someone in a white coat enters the room.

The observer effect is a well-known concept in physics—where the mere act of observing something can change its behavior. But it turns out your body’s been taking notes. When you’re alone, that shoulder ache feels like you’ve been hit by a freight train, but when the physio starts poking and prodding, it suddenly seems to say, “Pain? What pain? I’ve never heard of her.”

If the phrase "Observer's Effect" sounds a little too sciencey for you, here's a more relatable title "Performance anxiety". It's hard to rise to the occasion when someone is watching.

This is not just your imagination. The observer effect in healthcare is a real thing. It’s why some symptoms mysteriously disappear when you’re being examined and why you might feel like you’re gaslighting yourself. Trust me, as a young physiotherapist, I’ve seen it all—from patients swearing their back was practically disintegrating that morning to suddenly being able to touch their toes when I ask them to bend over.

One time I had a patient (let’s call him Tony) who came in, limping, only to walk perfectly fine the minute I asked him to demonstrate the problem. Tony's knee was like a shy kid at a friend's house being offered jollof rice—nervous under pressure, but with plenty to show when no one’s watching.

But don’t worry, Tony. You’re not alone in this. We’ve had my own share of performance issues too. Take the time I was trying to demonstrate a simple stretch to a student. My hamstring decided it had other plans and staged a mini-rebellion halfway through the stretch. There I was, supposed to be the flexible physio, yet my body had clearly missed the memo.

Why Does This Happen?

There’s a fascinating psychology behind why your symptoms might disappear during an exam. Some experts believe it’s because your body is wired to perform when under scrutiny—like how you suddenly remember all the right answers during an oral exam after blanking out while studying alone.

Others think it might be due to the adrenaline rush that comes with the anxiety of being examined, which can temporarily mask pain or discomfort. (Which might also be the blame factor for the other type of performance issues).

In some cases, it’s just plain old muscle memory. Your body’s so used to doing certain movements that when asked to do them on cue, it performs flawlessly, even if you swear it was malfunctioning a few hours ago.

What to Do When Your Symptoms Ghost You

First, don’t panic. Your body’s not lying to you, and you’re not making things up and your physio isn't judging you. Symptoms ebb and flow, and their temporary disappearance doesn’t mean they’re gone for good—or that they were never there. The best thing you can do is keep track of your symptoms outside the clinic. Take notes, make videos, and even draw diagrams if that helps. The more information you can provide, the better your physio can understand what’s going on when your symptoms aren’t playing nice.

And hey, next time your symptoms decide to play hide and seek with your physio, just remember—you’re not alone. We’ve all been there, whether we’re the ones being examined or the ones doing the examining. It’s just one of the quirks of being human—and honestly, where would the fun be without a little unpredictability?

So the next time your knee starts acting up at home but turns into a perfect joint in the clinic, don’t worry. It’s just your body’s way of keeping things interesting.