Monthly Archives: November 2011

Physical Therapy – Traverse City

So what should Physical Therapy in Traverse City look like?

There are many things to consider when choosing which physical therapy clinic is right for you.  Over the next few weeks I’m going to offer a few suggestions for things to think about, or even ask other therapists about, prior to beginning a course of physical therapy.

Some things should be fairly obvious such as how many different therapists will you see, time spent with your therapist, number of visits per week, and so forth.  What I want to discuss are the things most people would not normally consider (in fact, most therapists and physicians aren’t thinking this way either!)

1) A Movement Based Approach:  my previous blog entries  Don’t Put Fitness on Dysfunction and Movement Proficiency and the Ankle describe how looking at patterns of movement are critical to narrowing down where the cause of the pain is coming from.  Just because your back hurts doesn’t mean it’s the back’s fault.  Your back may just be the victim of poor hip mobility below and poor shoulder mobility above just to name a couple.

A simple model I discuss in those previous posts is the Joint-by-Joint model of alternating mobility and stability requirements.

Following the traditional physical therapy model, you’re probably not going to find the connection.  Instead the pain in the low back is the focus.  Not that the low back does not deserve to be treated to reduce pain and inflammation.  That absolutely must be done, but if that is all then chances are your low back symptoms will be back sooner than later.

 

The Selective Functional Movement Assessment is a quick and effective way to determine the person’s most dysfunctional movement pattern.

The object is to determine which pattern is the most dysfunction, and then break that pattern down into it’s component parts to find the impairment.  So for example, if someone cannot touch their toes, it could be a lack of mobility in the spine or hips, a lack of hamstring flexibility, or even a lack of core stability.  Your therapist must have a way to find that answer!

If you’ve ever been to physical therapy for your back, I can almost guarantee you were told you must stretch your hamstrings.  Well if you can’t touch your toes of course your hamstrings will feel tight.  Lacking mobility in your spine or hips will limit your toe touch and make it seem like your hamstrings are tight.  It’s probably only the hamstrings 25% of the time at the most.

Unfortunately many people are spinning their wheels in physical therapy because they are not working in the right place at the right time.  Could be why I’ve become the ‘physical therapist of last resort’.  I can’t tell you how many people have been referred to me over the past few years after that have failed a trial or two of traditional PT, injections, massage, etc.

2)  A Soft Tissue System:  at Elite Physical Therapy and Sports Performance I prefer the Graston Technique because of the great results I’ve had treating all types of soft tissue injuries from tendinopathies, to plantarfasciitis, to contusions, scar management, and more.  This is my tried and proven method and there are other systems out there that do work, but you really should be looking for someone with a system in place.

The majority of the time exercise alone will not fix the problem.  Some sort of soft tissue release is typically needed in and around the site of pain.  Very often even above and below the site of pain there will be significant soft tissue restrictions that should be addressed.  As I mentioned in #1, only by using a movement based approach will a physical therapist be able to detect these other restrictions.

For example, we know from the literature that very often trigger points in the gastroc/soleus complex (calf) will contribute to plantarfasciitis and even radiate pain to the bottom of the foot.  Limitations in hip extension and glute strength will also contribute to the condition.  Is your therapist looking that far up the chain?

So what difference does all this make?  Ultimately it can be the difference between actually ‘fixing’ the problem or just addressing symptoms.  When we can ‘fix’ the problem (the ultimate cause of your pain), we may never see you again and that’s a good thing.  When only the site of pain is addressed, very often you will find yourself back in the Dr. office and back for another bout of physical therapy a few months down the road.

At Elite Physical Therapy and Sports Performance, our goal is to ‘fix’ the problem, and to give the patient the tools necessary to prevent a recurrence.  Call us anytime with questions about our methods, and how we can help you if you’ve been unsuccessful with other methods of treatment in the past.