Dear Physio, I Can Take it From Here…

So, when does physical therapy end?

This is just a short piece, a reflective piece, about a value that makes up the very core of what I believe in and what I strive to achieve as a Physiotherapist – empowering my patients with the knowledge and the skills they need to make themselves independent.

These past few weeks have reminded me of a very special part of treating patients – discharging them. For months now I have worked intensely to help the small patient population with whom I have contact. After investing so much time in their development and progress, it is a magical moment when they come to me and say “I am not 100% better but I know what the problem is and I know how to make it better. What I need now is time to follow through on my goals and I can take it from here.”

What a pleasure it is to hear that. I know no one will ever be 100% when it comes to discharge and I am fine with that. First, I don’t set “being 100% pain free” as a goal and secondly, I think we all suffer from pain at some point in time. What I feel is more important is for patients to function normally and in the most ideal way for their lives.

Something patients frequently ask is “How long do I need to keep coming to Physical Therapy?”  Or, “Will I always need to do these exercises?”

The answer to the first – how long does it take you to no longer need Physical Therapy?

The answer to the second – No, you will need them when you need them.

What do I mean by this? Let’s take a look at the ideal stages of recovery involved between initial assessment and discharge.

STEP 1 – LET ME HELP STEER YOU IN THE RIGHT DIRECTION

It all starts at the beginning, when life is altered by pain or injury and when patients seek care because they don’t function in their normal way anymore. Sometimes it can be tough to get the ball rolling, to retrain movement patterns and daily habits, to get pain levels under control, and to motivate patients to begin to drive their own recovery. The first step as Physical Therapist is to understand the problem, the contributing factors, to identify milestones that help patients identify with their own recovery process, and then begin guiding them through rehab until they reach step 2.

STEP 2 – START TO TAKE THE WHEELS

Once pain is no longer driving a willingness to come to therapy, what is?

As I often say to my patients – I will sit beside you on this journey to recovery, but I will not drive you there. So, Step 2 is all about helping patients recognise what other barriers need to be overcome or goals need to be achieved before they can function unrestricted.

STEP 3 –  NOW IT’S YOUR TURN TO DRIVE

Once you are functioning well, do you know how to stay that way?

At this point in time I hope that my patients are developing a sound knowledge about how their bodies present/move/behave when they are both feeling good and feeling not so good. Developing this self awareness is a key step towards understanding their bodies better and identifying how their rehab should progress for them to be 100%.

STEP 4 – I AM NO LONGER A PASSENGER

If you’re staying symptom free and doing what you love – do you still need my help?

It is definitely sad to say goodbye but we have to set our patients free. This past week has been sprinkled with discharge assessments–patients who come in smiling because they only have good news to report. They are playing the sports they love, can use exercises to manage any niggles that may come up, are no longer thinking about their injury or their body part, and can see the end goal in sight. And this is when I ask – do you still need my help to get to the end? And with a smile, they reply, “I can take it from here”.

If you are reading this as a patient I want to to ask yourself:

Are you self-discharging too soon? There is a lot of work that lies between reducing pain and discharge.

Are you holding on too long?

Are you taking the steps along the entire journey to make sure your knowledge is developing and growing to accommodate for the changes in your body at that given time?

At TherapydiaSF we strive to form strong relationships with our patients. Communication is the key to break down what problems exist and create individualised treatments for those problems. We all have our niche areas or injuries we love treating, but at the end of the day, you are the person that will direct the treatment path and we are here to help and facilitate you to reach those goals.

Sian Smale, PT, MPhysio has been part of the TherapydiaSF team since 2016. Originally from Australia, Sian is trained in Musculoskeletal Physiotherapy and Clinical Pilates. When not working as a physiotherapist, you can find Sian cycling the hills of Marin, swimming in the elusive outdoor pools of the Bay Area, and chasing down the best avocado toast.

Movement Matters

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You’ve heard it before, “exercise is good for you.” It probably started with your PE teacher in grade school and now it’s your doctor reminding you at your annual physical exam. It seems that a new study touting the benefits of exercise is reported on the nightly news almost every week. We all know that exercise is good for losing weight and getting stronger, but what you might not realize is that beyond the physical changes you see, by committing to a regular exercise routine, you’ll have a positive impact on your mind, body and soul. So why is it that according to the Centers for Disease Control and Prevention, 25 percent of the U.S. population doesn’t participate in any physical activity?

Mind:
When faced with a busy schedule and too many meetings on your calendar, exercise often takes a backseat. If you’re not sleeping well and wake up exhausted, the last thing you want to do is lace up your running shoes and head out for a sweat session. However, the next time you’re fading midday, consider skipping your visit to the local coffee truck and hit the gym instead.

According to a 2011 study of more that 3000 people, those who get at least 150 minutes of exercise a week sleep significantly better and feel more alert during the day than those who do not.1

In that same year, a study of older adults revealed that regular aerobic exercise increases the volume of the hippocampus, the area of the brain related to memory, and can help improve memory function. While its effect on the mind is continually being studied, findings strongly suggest that exercise promotes improved brain function.2

Body:
You’ve probably known that aerobic exercise is essential for heart health as long as you can remember. Starting an exercise program is often the first piece of advice given to individuals at risk of developing cardiac disease. People who exercise regularly tend to develop less heart disease their sedentary colleagues. If they do develop a form of heart disease, it happens later in life and is generally not as severe.3

Exercise also promotes bone health, an important consideration as we age. While studies are ongoing, one released earlier this year showed moderate intensity aerobic exercise may have a protective effect on bone and cartilage by regulating elements in the body involved in increasing our bone mass density.4

A strong heart and strong bones are important, but exercise can help the body in other ways. Emerging research suggests that moderate amounts of exercise may have a positive effect on chronic pain by changing an individual’s perception of and response to their pain.5 Movement continues to be the most conservative, most inexpensive, and likely the most effective treatment for lower back pain, a condition that affects 80% of us during our lives.

Soul:
Have you ever started a workout in a bad mood and ended it feeling even worse? Not likely. Do you alleviate stress with a tough session? You might be on to something. There is a strong link between between exercise and mood. In general, active people are less depressed than sedentary people. A 2007 study concluded that exercise was generally comparable to antidepressants for patients with major depressive disorder.6 A hot topic of research in the mental health field, scientists are extremely interested in learning how to prescribe exercise as treatment for a variety of conditions including stress, anxiety, and depression.

The more digitally connected we are, the less real contact we tend to have with friends and family. There’s an app for everything, but not one that promotes in-person interaction with our true social circles. Exercise has a positive effect on our relationships and can even lead to developing new friendships. Finding a common exercise interest increases motivation, fosters healthy competition and can create strong social bonds with friends and family.

The benefits of exercise are vast and the scientific support of movement continues to grow. Who wouldn’t want to look better, feel better and be better? If you’re a regular exerciser, keep it up! The changes you’re making are huge. If exercise hasn’t been your thing, find something you enjoy, commit to your health and get moving. Your mind, body and soul will thank you.

  1. Loprinzi, Paul and Bradley Cardinal. “Association between objectively-measured physical activity and sleep, NHANES 2005–2006.” Mental Health and Physical Activity2, (2011) 65–69.
  2. Ericksona, KI, et al. “Exercise training increases size of hippocampus and improves memory.” PNAS 108.7, (2011) 3017-3022.
  3. Myers, J. “Exercise and Cardiovascular Health.” Circulation.107(2003) e2-e5
  4. Alghadir, JH, et al. “Correlation between bone mineral density and serum trace elements in response to supervised aerobic training in older adults.” Clin Interv Aging.11 (2016) 265-73.
  5. Jones, MD, et al. “Aerobic training increases pain tolerance in healthy individuals.” Med Sci Sports Exerc8(2014) 1640-7.
  6. Blumenthal, JA, et al. “Exercise and pharmacotherapy in the treatment of major depressive disorder.” Psychosom Med. 7 (2007) 587-96.

 

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Physical Therapy: What to Expect

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Marathon training has picked up and your Achilles tendon has been bothering you on your long runs. Or maybe you played golf this weekend and your back has been sore ever since. Perhaps work has gotten busy and your neck has been sore for a week. Whether it’s a friend or your doctor, chances are, if you ask around, someone will suggest you see a physical therapist.

So what should you expect?

During your first visit your PT will work to understand your injury and develop a treatment plan. We will ask you questions about your pain or discomfort—when did it start, what makes it better, what makes it worse? We will ask you about your work and the things that you do for fun. Sure, we want to get to know you, but, more importantly, that info also helps us understand how to best help you and keep you as active as possible while you’re recovering.

We will watch you do certain movements and collect some information by taking measurements and conducting particular tests. Often we will even look at different areas of your body that may not seem to be related to your injury.

Once we feel like we have enough information to create your treatment plan, we will likely get started that first day by teaching you an exercise or two to work on until your next appointment.

You should expect to work with the same PT at each session. Occasionally, two PT’s will work together as a team during your course of treatment, but our goal is to maintain consistency from visit to visit, and we find this harder to accomplish when more than two PT’s are involved.

When you return for your first follow up visit, expect to get to work! Your PT will have developed a plan that may include a variety of manual therapy techniques (‘hands-on’ work) and will definitely include exercise. We might ask you to do some things that seem silly—feel free to ask us why. It is not uncommon to see our patients blowing up balloons during their appointments, or crawling across the gym mat. It’s actually fun and we laugh a lot! At each session we will check and recheck some of the same tests we performed on day one, to understand the effect of the treatments we have been providing.

When you leave our studio, you will be expected to do your homework. We will provide resources to help you remember your exercises and yes, we will know if you’re doing them. Patients who are active participants outside of the PT clinic almost always heal faster than those who aren’t. A physical therapist can’t make you better alone. Physical therapy is a team approach and we need your help!

How often you come to PT is part of the treatment plan that you and your therapist develop together. Among our patients, there is a wide range of plans that change over time (i.e. once per week, once every other week, twice per week, etc). There are several factors we consider when planning your PT schedule. From the rate of healing and the body’s adaptation to new activities, to being swamped at work or due to financial constraints, treatment schedules will be specifically recommended to fit your needs. However, you should expect to attend at least 3-5 sessions in order to get the full benefit of working with your PT.

Once you are back to your marathon training, out on the golf course, or are able to sit at your computer without neck pain, it’s probably time to graduate from physical therapy! Some of our patients choose to continue to work with their PT for exercise as part of one of our wellness programs while others reach out the next time they need us.

Let us know how we can help you stay as active as possible!

The Top Five Reasons Why You Should Get To Know Your PT

A few years ago I hosted a get together with a bunch of friends. At some point in the evening, after everyone had figured out how we were connected, someone remarked, “It’s a good thing you’re a PT. You wouldn’t have any friends otherwise.” As I looked around the room at my guests, two were physical therapy colleagues, while the rest were former patients turned friends. While I understand that some PT’s prefer not to develop personal relationships with current patients, I truly believe in the importance of developing a long-term professional relationship with one.

If it’s not a good fit, find one you trust and with whom you can connect. If they turn into a good friend, even better!

Here are The Top Five Reasons Why You Should Get To Know Your PT:

We’ll be spending quality time together.
During the course of your treatment, you’ll be seeing us regularly. I am fortunate to spend 45 minutes with patients, often once, maybe twice a week. Compare that to the amount of time you spend with your doctor during a scheduled appointment, or even how often you see your best friend in any given week. Several years ago, I attended the wedding of a patient-turned-friend after knowing her only a few weeks because, as she told me, “The only person I spend more time with during the week is my fiancé.”

You can confide in us.
Because we will be spending time together working on improving your health, there may be certain things that come up during our time together. Human are complex creatures. There are many factors that can contribute to health, some of which may not be that easy to bring up. As healthcare providers, we are bound by law and ethics to maintain your privacy, and need to know about factors that may be affecting your healing. During any given week I talk to people about such potentially uncomfortable topics as depression, intimacy, problems in relationships, and other sensitive things. We talk about frustrations with treatment and health concerns seemingly unrelated to their physical therapy treatments. Often, the things we discuss are vital to my success as a PT though occasionally I need to refer out to someone better equipped to handle the issue. You need to feel comfortable enough with your PT to be able to discuss the uncomfortable.

We can help ease your fears.
Perhaps you’ve just received a new diagnosis that is troubling, even scary. Sometimes the medical jargon associated with an MRI report or after a doctor visit can be overwhelming. Chances are, we’ve worked with other patients with similar problems and can help explain things in ways you’ll understand. It is not a normal week if I don’t have a friend or family member reach out with questions about a particular diagnosis. The discussion this weekend was about Jason Day at The US Open, his struggles with vertigo, and how PT can help…did you know that?

We can let you know when it’s time to get serious about your health.
There is a reason your back hurts. Ignoring it isn’t the answer and it is likely a symptom of a larger problem. The good news is, you’re willing to invest a little time and energy, and maybe a few little changes to your daily routine, we can make a huge impact. Sometimes a friend or PT who knows you well is the best person to impress upon you the importance of taking your health seriously. You only get one body in this life, treat it well.

We can help you navigate the confusing world of medicine AND fitness.
There is so much misinformation and conflicting advice floating around out there. Who can help you differentiate fact from fiction? A PT with a good clinical experience who has continued to grow professionally and is able to critically evaluate research is good person to have on your team. Well-meaning but incorrect advice is commonly dispensed from people who don’t have the same training and expertise as PT’s who work in musculoskeletal medicine every single day.

We really do care.
My colleagues and I talk about this all of the time. It is not uncommon for us to say to a patient, “I was thinking about you on my walk to work.” I often develop new treatment plans in the most unlikely of places. This is why my showers are sometimes a little longer than necessary. We PT’s are generally so invested in our patients that we take it to heart when someone doesn’t seem to value or appreciate our care. This is also the reason we are exhausted at the end of the week. Don’t expect your PT/friend to want to get together for Happy Hour on a Friday evening!

Top 5 reasons we are out-of-network with your insurance…and what that means for you

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I sat down earlier this week to write a piece with the title above, but very quickly realized there really aren’t that many reasons. The only reason we are out-of-network with most insurance plans comes down to one simple fact:

We want to offer physical therapy treatment on our own terms, the way physical therapy was intended to be provided.

Most plans have out-of-network reimbursement. Many people think that if a practice is not in-network with their insurance, they can’t seek services at that clinic. The truth is, in most cases, you can work with a PT who is out-of-network. All it means to be in-network is that a physical therapy provider has signed a contract with a health insurance company that allows the insurance company to decide on the value of the physical therapy provided. Sadly, the current climate of physical therapy insurance reimbursement often has providers being paid less than the cost of a personal training or Pilates session, haircut, or full tank of gas.

A few things you need to understand about physical therapy:

  • We have extensive education, training, and are licensed by the state in which we practice (see The Educated Therapist).
  • All physical therapy is not created equal. PT’s do not receive a handbook on graduation day that tells us how to treat a specific diagnosis. Treatment should be customized, taking into consideration an individual’s activities, lifestyle, home and work demands, and even emotions related to the injury or pain.
  • All physical therapists are not created equal. Some PT’s further their education by taking classes and additional training beyond what is required by our governing board. Some PT’s look for every opportunity to expand their knowledge and stay current with studies and treatments. Good PT’s know that there is not one treatment to help everyone and, while we may not be able to cure all, we have a network of additional resources who might.
  • All components of physical therapy, from hands-on treatment to exercise, should be delivered by physical therapists.

We have chosen to stay true to our ideas of how physical therapy should be delivered. We find that our 45-minute treatment sessions, spent entirely with a physical therapist, help us form relationships with our patients, allow us to address multiple components of pain and injury, and often expedite treatment.

While out-of-network benefits vary, we have discovered that out-of-network reimbursement is often comparable to in-network coverage.


 

What does this mean for you?

We will:

  • provide excellent customer service from the first call.
  • check your benefits and discuss these with you before your first visit so that you have an understanding of the payment and reimbursement process.
  • help you find the best PT fit.
  • follow up with your insurance company on outstanding reimbursements.
  • reimburse you as soon as we receive payment from your insurance company.

What’s different?

  • Your PT may structure a different plan of care than used in traditional PT.  Do you really need 2 times per week for 8 weeks? Maybe not. Your PT will work with you to develop a plan that will help you recover effectively, while keeping in mind schedule and financial concerns.
  • We expect you to be actively involved in your own recovery.  We can’t make you better by ourselves.
  • You will have homework. We may ask you to modify some of your activities (Thought you knew how to sit?? Think again). We make these recommendations not to put a wrench in your lifestyle, but because we know they will help expedite the healing process.
  • We will be available to encourage and support you along the way.
  • You can access your PT via email in between appointments if you have questions or concerns.

Please let us know if we can help you learn more about your physical therapy benefits.  We will gladly call your insurance to verify your coverage and provide you with the information we receive.  We look forward to helping you on your path to recovery!

 

The Educated Therapist

Let’s face it. Most physical therapists aren’t winning any sales and marketing awards. Most of us have don’t have a business background and typically enter this profession based on a love of health, exercise and helping others. In school, we don’t really have time to cover anything beyond examination and treatment of our soon-to-be patients. We graduate, enter the world of health and wellness as practitioners of physical therapy, and soon realize the competition is fierce. In San Francisco, a city with something for everyone, there are individuals providing health and wellness services that seem in direct competition with everything we offer. There are personal trainers, massage therapists, Muscle Activation Therapists, Sports Therapists, Neurokinetic Therapists, Core Activation Therapists, and more. Have you ever stopped to consider who is best trained to help you heal? While these practitioners may indeed be skilled at the services they offer, based on our level of education and training, physical therapists are in a league of our own.

The other day, I had a pleasant conversation with a gentleman who was interested in learning more about the field of physical therapy. A seemingly intelligent man, he’d also had personal experience as a recent physical therapy patient. At some point in our conversation, he stopped me and asked, “Do you have to have some sort of certificate to be a physical therapist?” My jaw dropped.  It was then and there I realized how physical therapists have done such a terrible job of informing the public of what we do, what we can offer, and why we should be considered the practitioners of choice for musculoskeletal health.

So here’s what you should know: physical therapists go to school for 7-8 years. This includes 4 years of undergraduate education, heavily based in science (physics, chemistry, microbiology, exercise physiology, etc.), and 3-4 years of graduate-level education. Students graduating from physical therapy programs in the United States today earn a Doctor of Physical Therapy. The first Doctorate program in Physical Therapy was started in 1993 at Creighton University in Nebraska and, as of 2015, all accredited and developing physical therapist programs are DPT programs. Often part of a medical school, PT programs teach physical therapy examination and treatment, as well as courses in Anatomy, Neuroanatomy, Pathology, Pharmacology, Radiology and Differential Diagnosis (how I determine if a symptom may be something more serious—and outside of my scope of practice—than run-of-the-mill back pain). In fact, when I attended UCSF in the early 2000’s, the physical therapy students were the only students who performed full cadaveric dissections. Other programs used the cadavers we spent our first foggy summer in San Francisco dissecting. It was also the start of our collaboration with the first year medical students, where we 2nd year PT students helped teach the medical students musculoskeletal anatomy. Most recently, residencies and fellowships after graduation have grown in popularity to provide advanced training for physical therapy school graduates.

Beyond our formal education, physical therapists are licensed by the state in which we practice and are held to a high level of professional conduct that includes requirements for continuing education every year. Most courses are held on the weekends and many physical therapists travel great distances to take courses of interest. This year alone, PT’s from TherapydiaSF will take courses in San Francisco, San Diego, Montana, and Las Vegas. Some physical therapists also opt to enhance their degree and training by completing board certification in different areas of practice, including Orthopaedics, Pediatrics, Women’s Health, Neurology and 4 other areas of specialty practice.

The next time someone suggests physical therapy, please consider our extensive training and education and know that we have the education, expertise and dedication to help you work, play and move without pain.

 

 

Fit as a…fiddle?

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Body image has been a hot topic over the past several years. Recently, many companies have run advertising campaigns to promote healthy body types in reaction to the extremely thin models who have been so prevalent in the media.

The recent video of dancer Misty Copeland has had a huge impact on the dance world and has made us think about the concept of an ideal dancer’s body.  I remember not too long ago, when “athletic body type” was considered a euphemism for “thick” or “heavyset.”  I hope you agree that while Misty is certainly athletic, she is neither thick nor heavyset.

Beyond the notion of an ideal body type, I’ve recently been thinking about the concept of fitness. I blame this partly on recently reading The Sports Gene by David Epstein, and also having just returned from a continuing education class filled with practitioners who each work with a different clientele, including college athletes, golfers, yoga practitioners, and the general population, some more active than others.   As I thought about the baseball pitchers, cyclists, runners, and CrossFit participants with whom we each work, I could easily identify ways they are fit, but I also thought of areas where they may be deficient.  I began to wonder about fitness.

When someone is decribed as “fit”, what does that really mean?  Does it mean the same thing to everyone?  There are different dictionary definitions of fitness, some of which brought a smile to my face:

1. The condition of being physically fit and healthy (I’m going to need a little more here…).

2.  Good health or physical condition, especially as the result of exercise and proper nutrition (ok, we may be getting somewhere…).

3.  The capacity of an organism to survive and transmit its genotype to reproductive offspring as compared to competing organisms (well….I bet you know plenty of people who have the capacity to transmit their genotype to reproductive offspring who you would not call fit).

So, we’re back to the drawing board with defining fitness.

Is a body builder with bulging biceps and massive quads more fit than a marathon runner?

Is Tiger Woods more fit than Serena Williams or Michael Phelps?

What does it mean to be fit?  Ah…what I would do to take a camera out onto the streets of San Francisco and ask people this question (stay tuned…).

As we think about each of the athletes and their respective sports, it quickly becomes clear that fitness is hard to define and describe.  While the bodybuilder might have larger muscles that allow him to lift heavy weights, the marathon runner would certainly show greater cardiovascular endurance across those 26.2 miles.  Tiger Woods and Serena Williams both demonstrate amazing muscular development and precise hand-eye coordination, but if he had to run around the golf course like she does the tennis court, could Tiger keep up with Serena?  Michael loves the game of golf and, like Tiger, has an amazingly strong core, yet I wouldn’t want either one of them representing the other’s sport in competition.

This is an important topic to me both personally and in my work with athletes of all ages, skill levels, shapes and sizes.  To me, there is no one definition of fitness.  I believe that fitness is a balanced combination of strength, stability, balance, flexibility, and endurance…and maybe even mindfulness.  What the general population thinks of as an ideal of fitness may actually be a person who excels in the sport in which they train, but has severe and potentially harmful imbalances in some of the categories mentioned above.  The fittest people with whom I work are those who enjoy a variety of exercise and sporting activities.  These are the folks who are rarely in our studio for treatment, except for the occasional tune up after having changed their routine. Often, the people who appear most physically fit are those who are plagued with injuries related to imbalances in overall fitness.

I’ve learned that there is no one ideal body type just as there may be different ideas of fitness.  I encourage my clients to be successful in their rehab and develop and improve their fitness by recommending a three key steps:

1. Move well and move often.

2. Find something you enjoy doing.

3. Mix up your routine—your body will thank you for it.

So, what does fitness mean to you?

And, in case you were wondering where “Fit as a fiddle” came from…

When should I see a physical therapist?

Many of the patients I treat are extremely active, though few make their living playing sports professionally. They are passionate about their lifestyle and sport of choice, and take their health very seriously.  With many sports and hobbies, aches and pains are likely to occur.  Athletes quickly get used to sore muscles and minor injuries, often considephysical-therapy-san-francisco1ring these a normal part of an active lifestyle.

But should these be treated more seriously?

Many of the patients with whom I work initially ignored what seemed to them to be minor injuries, yet have since become more frequent or more intense.

At what point should you visit a physical therapist?

Read more for quick tips to decide if what you’re feeling needs a closer look.

1. Immediately after a specific injury.

A number of recent studies have shown support for early physical therapy for lower back pain.  The studies show that physical therapy within 2-4 weeks of a lower back injury leads to a decreased risk of surgery and injections, fewer doctor visits, faster recovery, and fewer incidents of chronic pain.

Clinically, I have seen even earlier physical therapy provide excellent results. I am a strong advocate of patients developing a relationship with a physical therapist as a practitioner on their medical team (see post).  I also believe that patients should have email access to their physical therapists in order to communicate updates and ask general questions.  Often, a patient will email or call our office within the first few days of an injury and we will schedule them that day.  Earlier this year, I worked with a triathlete who developed intense back pain after a weekend race.  We saw her the next day and within a week she reported an 80% decrease in her symptoms. The following week she reported a 95% improvement and was able to race again exactly one month later. The sooner we can see a patient post-injury, the faster their recovery from the painful, acute stage.  This allows us to move to more advanced stages of physical therapy earlier, in order to address the root cause of their injury.

2. If an old injury has reappeared or never disappeared!

As I was getting ready to graduate one of my runners from physical therapy the other day, she asked, “but…how will I know if I need to come back?”  It was a great question, yet one without a definitive answer.  Runners, especially, are subject to occasional minor aches and pains.  At what point should they take these more seriously and seek help?

In general, you should reconnect with your physical therapist when:

You feel pain during an activity that gets worse as you continue the activity.  This is a sign that something is not right.

Your pain changes the way you perform the activity.  If you are running down the street with foot pain and you have to limp so it doesn’t hurt as much, go home and call your PT.  Remember, the faster the painful symptoms are addressed, the more likely the root cause will be identified and other related injuries are less likely to occur.

You feel pain during three consecutive workouts or activities Often pain will be present at the start of an activity, but will disappear within a few minutes.  Does that mean it should be ignored?  No.  If you are consistently feeling the same or similar symptoms, even if they go away during the activity, schedule an appointment.  Pain is a sign of tissue fatigue or too much stress on a particular part of the body, likely related to an underlying movement dysfunction.  In English?  You’re likely not moving as well as you could, an area of your body is doing more than its fair share of the work, and it needs some help.

3. For an annual check up.

Physical therapists can be, and should be, the medical practitioners of choice for a musculoskeletal wellness/fitness screen, an assessment with a physical therapist to identify risk factors for developing a particular injury.  Much like we visit the dentist on a regular basis, we believe that everyone should schedule an annual preventative visit to their physical therapist to identify and address areas of dysfunction (that tight neck you’ve been complaining about, poor posture, or the shoulder that occasionally hurts in your bootcamp class).  Left undetected, these will likely get worse over time.  We would much rather see you once a year to revise your exercise program and keep you healthy, than have you wind up in our office as our newest patient!

Remember, you shouldn’t try to tough it out or wait until an injury becomes more severe before visiting your physical therapist.  You will wind up suffering needlessly and make our jobs even harder!

If you’re still not sure you should come in for an assessment, feel free to email us:  hello@therapydiasf.com.

In your email, please provide the following:

-where is the location of pain?

-how did the injury occur?

-how long have you had the pain?

-what makes it hurt?

-what makes it feel better?

We will review the information and advise you on the best option for your injury.  This may include advice for self-management, the need to schedule a physical therapy assessment, or a physician contact, if necessary.

Physical Therapists and Exercise

Why work with a physical therapist for fitness? 

PT’s are trained in movement:

We are healthcare professionals trained in optimal patterns of movement, posture, and form and will provide a safe and effective workout.

PT’s are experts in anatomy:

We will design a full body program to address strength, flexibility, cardiovascular health, and balance.

PT’s understand injury:

We will design a program that takes into consideration current and previous injuries, muscle imbalances, and current goals.

At TherapydiaSF, we offer a full selection of wellness services including:

  • Pilates
  • yoga
  • TRX training
  • general fitness training
  • small group classes
  • Fitness Screen: complete assessment of strength, flexibility, balance and independent program design.
  • RunRx: complete assessment of strength, flexibility, and video of running mechanics

Pain IS the perfect excuse…

…to call your physical therapist.  I get it.  I’m the one who cleans the apartment BEFORE the housekeeper comes. But waiting to schedule because you’re in too much pain is like telling your dentist, “my teeth are too dirty”, your personal trainer, “I need to lose weight before I start ” or your therapist, “I’m too down in the dumps to see you today.”  I can understand the fear that a PT may make you move, but being in pain is exactly why you should see a PT who will assess your movement and choose a treatment to alleviate your symptoms.