- Dr. Jeffrey T. Stenback, DPT, OCS
It IS More Than Just Exercising…
As much as we all expect that our physical therapy visit will include some type of exercise, it is also important that your ADL’s or “Activities of Daily Living” are addressed. You can be the most consistent and compliant of clients, but if therapy does not also include instruction in relevant ADL’s, your chances of making real progress are limited. What kinds of things am I referring to when I mention your ADL’s? For starters, your therapist will usually ask a lot of questions about the kinds of activities in which you typically participate (your job responsibilities, hobbies, household tasks, sports or recreational activities, etc.) and question you regarding how those activities affect your symptoms (both in positive as well as negative ways). This information gives your therapist a clearer picture of what specific activities or loads you might be exposed to on a regular basis. Your physical therapist will usually ask about anything you might recall doing or happening around the time you first experienced your symptoms, as this information will frequently reveal an activity, position or traumatic event that also helps us figure out how you arrived at this point. From my perspective, I always use this information to try to imagine how an injury or problem started. This helps me understand what tissues might be involved, where I need to focus my examination and to identify those activities I will likely need to address as I treat you. Sometimes you can’t recall a precipitating event and your therapist will ask even more questions about the quality of your symptoms in order to help uncover a potential cause. Since physical therapists are considered the experts in treating the musculoskeletal system, experience tells me that there is usually a causal relationship here. Somewhere there has been a breakdown in your ability to adapt to either sudden or ongoing physical stresses. I expect to uncover some type of movement, activity or position that has led you to us for treatment. Of course, there can be other related factors like underlying arthritic or degenerative changes or a disease process or injury that complicate the picture, but there is usually something in your function that ties into your current symptoms.
So, once your we have taken your history and have a better picture of how you may have begun experiencing your symptoms, we can start to address problem areas. In addition to hands-on treatment to address tender areas, flexibility/strength deficits and functional endurance issues, instruction in learning to move differently and more mindfully is very important right from the start of treatment. Your ADL instruction can include a wide range of things. Sleep posturing and use of proper pillow positioning, guided pacing of activities (so as not to overwhelm healing tissues), correct seating/workplace positioning, self-care activities (like the use of ice or heat, various home use of rollers or self-trigger point work) are all important in getting you to a point where you can manage your symptoms independently,
Our bodies are amazing in their resilience and ability to continue functioning with an injury, a recurrent pain or a disability. The body’s ability to change how it functions or adapts to physical stressors is something that always impresses me. These changes allow us to continue functioning, except that these changes are always at our expense. Your body will reach a point where the adaptations are no longer enough and you will start experiencing the feeling that “something is wrong”. The amount of time you spend exercising is far outweighed by the rest of your ADL’s. This larger portion of your functional day or nighttime activities can either be part of the problem or part of a solution to your symptoms. Regaining a balanced state of functional flexibility, strength and endurance allows you to function from a state of greater stability and assists you in more successfully adapting to the physical world around you. Your ability to become more mindful of what abnormal functional changes have led to your current problems is an important first step in managing your aches and pain. Working together, the patient-physical therapist relationship can help you understand your current condition and aid in creating program that helps you become a less painful, more successful and adaptable version of yourself.
Please call us at 305-595-9425 for all your exercise needs, or to just get moving