In my previous post I touched on what physical therapy is in a broad sense. Today I want to bring things closer to home and discuss what it is that I do, that may be the same or different to other physical medicine practitioners.
To put it simply:
I evaluate the human system to determine its strategies for movement, and then optimize those strategies to reduce unnecessary strain and stress on the body.
This method of physical rehab reduces pain in many different ways but the most clear mechanism is redistribution of the loads our bodies (muscles, bones, joints) manage throughout our lives.
The body will develop strategies for managing loads, and these strategies are often not optimal. Usually this is no big deal, we are adaptable, resilient, always changing creatures. However, sometimes it hurts. When it hurts we are limited. When we are limited we are sad. So another answer to the question of “What do you do?” could be, “I make people happy.” Then again, when you love to train and go go go, slowing things down and identifying the little things that are limiting us isn't the most fun. So I'll stick to the first answer.
To simplify this concept let’s discuss when something hurts. When something hurts, without a specific trauma, we have developed a strategy that leverages a muscle over a potential group of muscles. For example: by squatting with a heavy quad dominance people tend to lose depth and either feel anterior hip, knee or low back pain. By identifying this pattern and all the complexities that contribute to it, we can plan a logical progression of movement retraining to balance the load. By biasing the hamstrings, glutes, and abs to do more of the work, the knees hips and back absorb less strain. This will produce a more optimal position for the pelvis and legs when squatting to allow for greater depth, load distribution, and sensation (no pain).
While it’s wonderful when a pattern is simple, often times it is not. In fact, almost any issue that is human related is not simple. Forgive the repetition, but we are adaptable, resilient, always changing creatures. These changes are physical, emotional, and cognitive. If someone believes that an exercise or movement is “bad” for them, then a cognitive and emotional barrier needs to be broken down and resolved before they can access all of their movement strategies and relieve their pain. Some common examples are running on arthritic knees and rounding your spine into flexion. Both movements are most certainly not “bad,” but they are demonized by health care and fitness professionals that choose to share their opinions while not understanding the mechanics of the human body or the power of their words. Research does not equal fact, but the research clearly shows that neither one of these activities is in any way “bad.” As part of a treatment course this patient would need to be gradually exposed to the activity they previously believed was “bad” until they are performing that activity with an optimal physical movement strategy as well as an emotional response of satisfaction rather than anxiety. Think about the first time you saw someone clean a barbell or perform a skaters lunge. It was awkward and probably made you nervous to know that was what was expected of you. It also probably didn't feel great once you did try. Well now your a pro and you clean your groceries just because you can.
How can I help people optimize their movement strategies?
I am able to help my patient's optimize their movement strategies for two main reasons. 1) I have learned how to perform a series of tests that identify preferred movement strategies in a controlled manner. 2) I have learned how to intervene to make a positive change and then reintegrate those changes into the full movement pattern.
Sounds simple right?
Sometimes it is. Most often it is not. I won't repeat it again but you know...people.
It is important to understand that their is never one reason why anything happens. Complex systems require a complex evaluation. That is why I examine the entire human body, head to toe, with any and every injury or dysfunction that walks into my clinic. I require adequate amount of time to do this, so I utilize one hour, one patient and one therapist appointments. This method is the gold standard and the results go far beyond a brief relief of pain. A treatment program at Human Function and Performance will get you the results you desire, give you the knowledge to intervene down the road when your body begins to change again and most importantly restore faith that your body is a beast, and you are in control of your future physical well-being. The arthritis, disc degeneration, and 10 year history be damned. If you can identify what is causing your pain, you can address it.
To summarize, I evaluate the human system to identify movement patterns that can be optimized to reduce stress and strain on the body. I utilize physical interventions like manual therapy, exercise, and modalities, as well as cognitive and emotional support strategies, the therapist in the title ;), to maximize my patient's outcomes. Also, I love to do this. There is nothing I would rather do than figure out how something works, and optimize it. If I hadn't gone PT, I'd probably be a mechanic or an economist. That it is, cars are not as exciting as people and I don't love paperwork.
If I can express one piece of actionable advice via a blog, it's don't worry about it. If your experiencing a mild amount of pain, anxiety will make it a moderate amount. A moderate amount will impact your sleep and ability to recover, making that mild pain a severe amount of pain. If you need assistance, get it.
Send me your questions, I am happy to help in any way possible.