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!

High Intensity Interval Training- HIIT or MISS

High Intensity Interval Training, also known as HIIT took the number ONE spot on the list of major workout trends for 2018. This probably isn’t news to many, especially here in the Washington DC.
Benefits of HIIT classes include:

  • Burning TONS of calories
  • Boosting metabolism
  • Time efficient workouts
  • Make quicker cardiovascular gains than with longer, less intense workouts
  • Can slow down aging at the cellular level by increasing mitochondrial levels
  • Creating a judgement-free community where everyone is excited to workout

Now as exercise trends grow, HIIT has made its way to the mainstream, as this happens more and more people end up trying it.

The biggest problem I have is when new or “untrained” individuals jump into these classes without any prior experience. There should be some understanding of fundamental exercise techniques such as the ability to perform a squat, hip hinge, overhead press, etc before jumping into a class.


4 Key factors to watch out for when doing a HIIT class:

  1. Inadequate warm up or preparation- everyone of us has different needs whether it’s mobility or stability, and jumping right into a program without addressing those needs can have negative effects.
  2. Bad programming/instruction- Unfortunately not all coaches/trainers are created equal. This can lead to programming mistakes such as working the same body part or motion repeatedly over back to back classes and not giving enough rest time either in or between workouts. An example of this is that CrossFit HQ recommends that workouts consist of 1 strength/skill exercise OR a metabolic conditioning workout with a 2 days on, 1 day off or 5 days on, 2 days off schedule. However most boxes will schedule a strength AND a conditioning work out 6 days per week.
  3. Improper Form- This is the biggest risk, especially for newer exercisers. The intensity and speed of the class will not allow you to focus on proper form and this is where injuries can happen. That’s why I stated before, that individuals beginning HIIT class should have solid understanding of fundamental movements patterns beforehand.
  4. Not enough recovery- While you might think you need to work out every day, the risk of overtraining can increase. Many people who utilize this type of training will work out above their maximal recoverable volume, which is “the highest volume of training an athlete can do in a particular situation and still recover.” While they may progress for a while and hold up for a period, eventually it catches up to them in the form of an overtraining injury. It’s recommended to attend these classes 3-4/week MAX? There should be time spent working on imbalances and restorative activities such as yoga, foam rolling, and strength training.



With all that said, here are some ways to stay safe when trying out HIIT training:

At Home:

  • One of the best things about HIIT is that you don’t need to be in a gym to do it. However if there is a move that you haven’t done before or don’t feel comfortable with, it’s definitely best to go over with a trainer or your instructor first. Even simple moves like push ups and squats are commonly done wrong, so there’s nothing the matter with a form check beforehand. The last thing you want to do is be in the middle of class and have no idea how to do a certain move when you’re already tired from everything else in the class. Also maintaining form is even harder when you begin to add weight to that exercise.  So that means if you’re incorporating dumbbells, barbells, kettlebells, or any other type of weights into your at-home workouts, it’s a good idea to check your form with an expert first.

In Class:

  • Being in a class gives you the advantage of having a teacher or trainer who ideally will be watching you. Its definitely a plus having a trainer or instructor who is experienced and can make sure you’re doing everything correctly. And if you’re new to HIIT, definitely let your instructor know so that they can keep an eye on you!
  • Remember to listen to your own body and go at whatever speed/intensity is comfortable, It’s definitely easy to get caught up in the excitement and competitive nature of these types of classes, but there’s no need to be a hero. No rep/time/PR is worth getting injured.


At the end of the day, there are some risks associated with this type of training, however, there are a LARGE number of benefits in taking these classes! Research has also shown that exercise if more fun when its more challenging!


If you’re in the Washington DC area and trying to stay healthy/fit but can’t because of pain stopping you from exercising, or if you’re worried an injury will prevent you from doing activities you love like CrossFit, Bootcamp, or Spin Class, Send me an email- Mike@bigleagueperformanceandrehab.com and let’s talk about what’s the right plan of attack for you!