Who Should See a Physical Therapist?

Short answer- if you’re reading this, probably you.

 

Most people, including those in the fitness community, don’t really know what it is that we as Doctors of Physical Therapy, actually do.  Until recently, I think most people thought it was something their grandmother did, or only if you had surgery.

If you get injured and don’t see a physical therapist first, typically the first thing people do is go to their primary care doc or other medical doc.  Usually they end up seeing an orthopedic surgeon who suggests expensive imaging that can elevate fear but also can lead to unnecessary procedures. While that is an unlikely outcome for most people, it does happen.

Many times, people will wait a few weeks (or months!) to get their injury checked out.  For most injuries or pains, physical therapy sooner rather than later will decrease the time it takes to get you back in the game and decrease your cost.  A 2012 study showed that people who started PT within 14 days after injuring their lower back were able to save $2700!

But what about those that have had pain for 6 months… or 6 YEARS!?

Physical Therapists are movement specialists.  That means whether its walking down the street, picking your kids up, or being able to perform your fitness routine, we can help you!  The best results you’ll see is from working with us on how you move by correcting any dysfunctions and gradually reintroducing non-painful movements and load!

Case Example: A middle aged, male patient who does CrossFit with chronic shoulder pain for over 5 years!  Imaging showed a massive rotator cuff tear and labral tear.  His orthopedic surgeon was ready for surgery ASAP; just to be clear, this is a pretty severe injury so surgery is often first thing on the table.  However, this patient did not want to stop working out and wanted to try anything BUT surgery.  After 12 weeks of commitment to rehab homework, coming in weekly for hands-on work and a slow return to CrossFit, he was pain-free and beginning to have full range in his shoulder.  Now a year later, he has no shoulder pain and a new PR in his shoulder press. We focused on decreasing pain and improving function rather than harping on “fixing” the tear. It takes patience, dedication and active involvement from the patient—but it is possible!

Physical Therapy at Big League is different from your usual PT clinic:

– One on one with a Doctor of Physical Therapy
– One hour visits
– Skilled hands-on techniques
– Personalized homework- not just therabands and hamstring stretches!
– No referral needed

Bottom line- If you’re having pain with sitting, while you’re working out, or walking down the street, don’t wait for it to go away, and don’t let it take you away from the things you love to do!  Get assessed and the earlier to can address it, the sooner you can get back in the game!  Less time and money spent than the other options!

Your rehab shouldn’t just be about therabands and pelvic tilts- it should be focused on YOU and your goals! If you live in the Washington DC area, give us a call and let’s see what we can do for you! Click Here to book your initial evaluation!

4 Keys to Picking the Right Physical Therapist

Being a Physical Therapist in a CrossFit gym has given me a great opportunity to talk to many athletes about the sport as well as current issues they may be having.  It’s always surprising to hear how grateful they are when you spend a couple minutes listening to their situation.  It makes me think what are we, in the medical community, actually doing that no one has been able to answer these questions.

Unfortunately, in the state that Physical Therapy is right now, seeing patients in a one on one environment is very rare.  It’s just too hard to maintain a profitable business with this type of strategy due to insurance reimbursements.  What happens instead, is we move from a patient centered model of care to a therapist centered model of care, where the Physical Therapist  is seeing anywhere from 3-5 patients an hour.  What happens then is the PT will get to spend about 10 minutes per patient before having to move on to the next one, while you get handed off to an assistant, aide, or volunteer.  The PT ends up just running around putting fires out all day, instead of actually getting to listen and talk with you about what’s going on.

As we’re learning more and more about pain.  We’re learning it’s a very complex, multifactorial thing that isn’t always connected to biomechanical factors, other variables such as sleep, diet, and stress also play a role.  These are things your Physical Therapist should be talking about with you and how to manage them.  In the therapist centered model of care, it’s easy for a PT to get caught up in the injury and forget about the whole person.  The focus should always be on you, not just your injured body part!

With that said, these are the 4 things I recommend checking out before you commit to a Physical Therapist:

 

  1. Pick a Physical therapist who will work with you 1 on 1 for an hour.

    • Physical Therapy isn’t unlike any other business. The saying “you get what you pay for”, definitely applies.  It’s very unlikely, you’ll see a business  advertising that they treat 4 people/hour.  Would you go to an accountant that set up 4 different meetings at the same time?  I hope not, because why would it be ok for people to treat your most important asset, your body with less respect than your accountant gives to your tax return.
    • Due to poor Insurance re-imbursements, many clinicians will practice in fee for service type model or accept limited insurances. The reason they do this is out of necessity.  They refuse to sacrifice quality for quantity.
      • Not just Physical Therapists but many physicians, dentists, and chiropractors have also begun to shift to this model of care. This allows them to treat patients, the way they deserve.  Some lady in Iowa who works for Blue Cross, should not be determining how many visits of PT you get!
    • Medical Providers with a true passion for helping other are shifting to this model every day. It’s good for them, and even better for the patient.  You should work with someone that treats you the way they would treat a family member.
    • Understand that you have a choice in the matter, do your own research and choose a PT that you feel comfortable working with.

 

  1. Pick some who performs hands on treatment

    • The act of putting your hands on someone can be very powerful. Sometimes to get the nervous to relax, the best way is just putting your hands on someone.  Think about when you go to the doctor, you wouldn’t like it if they just stood there and said what’s the matter.
    • From my experiences, putting my hands on people has definitely helped them get better quicker. Your PT sessions shouldn’t consist of getting a hot pack, some ultrasound, e-stim, and some dumb leg raises that don’t even make you feel tired.  These are the kind of places that give physical therapy a bad name.  Leave and don’t ever go back!
    • When looking for a PT, a safe bet is someone who performs manual therapy. Other key words are mobilizations, manipulations, as well as soft tissue or fascia techniques such as Active Release Technique.

 

  1. Pick someone who has experience in working with people who are similar to you

    • Pretty easy, if you’re a crossfitter, make sure they’ve worked with crossfitters before. If you’re a runner, make sure they’ve worked with runners before.  If you’re a baseball player, make sure they’ve worked with baseball players before.
    • You don’t want to get attached to a PT that doesn’t understand A) your goals and B) the demands of your goal.
    • If you do CrossFit or Olympic lifting, your PT clinic should have a squat rack and barbells to help prepare you for a return to your sport. Just as if you want to be able to walk up the stairs pain free, they should be able to help you accomplish that as well.
    • Even though, we all have that same sheet of paper from an accredited university, there can be a massive difference in physical therapists. Pick one that understands your sport and your goals.  You should feel comfortable with them and if they tell you to stop doing CrossFit or to stop running, tell them no thank you and kindly get up and leave.

 

  1. Ask your prospective physical therapist, how much they dead lift.

    • This is a recommendation from Kelly Starrett at MobilityWOD. Danny Mattas of Athletes Potential in Atlanta, GA think you should ask them how much they snatch.
    • Realistically, if you’re a crossfitter, your therapist should have knowledge of both. As well as squatting, thrusters, pullups, double unders, etc.  You get the idea, they should be well versed in what you’re trying to do.  If they don’t know what a snatch or a clean is, you’ve definitely gone to the wrong place.
    • Many physical therapists will tell you to stop doing CrossFit. This is like telling a runner to stop running, it just isn’t going to happen.  If you look at injury rates from CrossFit, they’re no different than the rates for running, soccer, and hockey to name a few sports.  No one is trying to end those sports!  Make sure they understand that return to your sport is vital.
    • I’m not saying that they need to be able to deadlift twice their body weight, but they need to be well versed in what you’re trying to achieve.

 

If you’re injured and seeking out a physical therapist, I hope this post helps you.  No matter where you are in the country, you have the right to take these principles and apply them to your search.  Don’t let anyone tell you, you’re resigned to only 1 place whether or not their interests align with yours.

If you’re in the Washington D.C. area and have been struggling with an injury, we can help.  You don’t have to live with pain, no matter how severe or nagging, you deserve to do the activities you enjoy.  We help people just like you get back to the CrossFit gym, back to playing with their kids, and back to waking up pain free every morning!

Learning to Squat- 6 Variation to Help You Perfect Your Form

The squat is a pretty important movement. Sitting/standing, bending over to pick stuff off the ground, the squat definitely has its place in just about all training programs.

Due to its functionality, the squat should be an integral part of any exercise program. That being said, it can be a tough move to learn. To avoid putting extra stress on other parts of the body, you shouldn’t just throw 225 on the bar and go at it.

If you’ve never squatted before, or don’t do it well, that’s ok, here are a few variations to help get you started!!

1. Wall squat- intro to squat, working on building quad and glute strength.

2. Squat isometrics- starting to find the balance point at the bottom of the squat with good trunk position.

3. Squat RNT- the band will pull the trunk forward forcing his trunk extensors to fire, helping keep me upright.

4. Bottoms squat iso- looking to control trunk position at the bottom of the squat.

5.Goblet squat to bench- keeps trunk upright and prevents hips from rising faster than the trunk.

6. Air squat- TADAAAAAAA

Try these out and let me know how you do!!

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LEARN HOW TO SQUAT‼️ . ⚡️The squat 🏋️‍♀️is a pretty important movement. Sitting/standing, bending over to pick stuff off the ground, the squat definitely has its place in just about all training programs. Anddddddd, after all @syattfitness says it makes you gooder at sex, so there’s that too👍. . 👉If you’ve never squatted before, or don’t do it well, that’s ok, here are a few variations to help get you started‼️ . 🎥☝️- wall squat- intro to squat, working on building quad and glute strength. 🎥✌️- Squat isometrics- starting to find the balance point at the bottom of the squat with good trunk position. 🎥👌- squat RNT- the band will pull the trunk forward forcing his trunk extensors to fire, helping keep me upright . Try these out and let me know how you do‼️ . TAG, COMMENT, SHARE with a friend who needs to squat‼️ . 🎶- The Middle- Zedd ft. Maren Morris . #Physicaltherapy #physio #dptstudent #dptschool #crossfit #crossfitopen #workout #legworkout #squat #squats #lifting #quads #glutes #buttworkout #strength #strengthtraining #strengthcoach #performbetter #washingtondc #dcfitness #dcfit #fitdc #thefitdistrict #districtcrossfit #dcphysicaltherapy #igdc #mydccool #capitolriverfront #navyyard #docmike

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LEARN HOW TO SQUAT Pt 2️⃣‼️🏋️‍♀️ . ⚡️As discussed yesterday, the squat should be an integral part of any exercise program due to its functionality. That being said, it can be a tough move to learn. To avoid putting extra stress on other parts of the body, you shouldn’t just throw 225 on the bar and go at it. . 👉Here are some more progressions from my post from yesterday. . 🎥1️⃣- bottoms squat iso- looking to control trunk position at the bottom of the squat. 🎥2️⃣-goblet squat to bench- keeps trunk upright and prevents hips from rising faster than the trunk 🎥3️⃣-air squat- TADAAAAAAA . Try these out and let me know how you do‼️ . TAG, COMMENT, SHARE with a friend who needs to work on their squat‼️ . #physicaltherapy #physio #dpt #doctorofphysicaltherapy #crossfit #squat #squats #legworkout #lowerbodyworkout #lifting #mobility #quads #glutes #hamstrings #gluteworkout #deadlift #performbetter #washingtondc #dcfitness #dcfit #thefitdistrict #districtcrossfit #igdc #bythings #docmike

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