When I was in high school, I read the book A Tale of Two Cities by Charles Dickens. I can’t help but compare that story to my journey as a physical therapist. When I looked over my old cliff notes in preparation for writing today’s blog, Dickens came right out the gate in his first paragraph with the theme of duality. He compares contrasting concepts like hope and despair, light and darkness, and even best and worst. But maybe a good old-fashioned definition of duality may help you understand my point.
The interweb defines duality as an instance of opposition or contrast between two concepts or two aspects of something. As a physical therapist I battle with dualism all of the time. After all, there are two sides to every coin. Most therapists would rather treat someone who presents with a low level of pain versus someone with a high level of pain. They would prefer to work on someone with one injury versus someone with multiple injuries. For this blog, I’m going to focus on how I used to treat patients dealing with high levels of pain and multiple injuries when I first started out in my career, compared to how I think about and treat these patient populations today.
When I became a physical therapist over 20 years ago, I would go as far as sometimes not even doing a movement screen on my patients in fear of aggravating their symptoms. I would start them off with a hot pack and electrical stimulation for 15-20 minutes with hopes of reducing the intensity of their pain before attempting any exercises. FYI, there’s very little evidence that heat and stim actually help with pain, but I did it anyway. Then I would give them pelvic tilts, isometrics and some basic mobility and lumbar stabilization exercises. I would tell them to do these exercises several times per day and that eventually their pain would go away in a few months.
In reality many of those patients barely got any better. To be totally honest, I think the ones that did get better had symptoms that were going to resolve on their own over time. Or they just felt better from taking the medication prescribed by their physician which probably helped more than what I was doing for them.
Keep in mind that I was working in a standard “factory-style” clinic. I had to treat 3-4 people every hour. So there was minimal time for me to assess, treat and educate each person individually. This is actually why so many PTs still use hot packs and other traditional modalities. They’re simply trying to buy themselves time so they can help other patients.
Fast forward to 2009. I joined a cash-based practice called Activcore. Time was now on my side. I could finally give my undivided one-on-one attention to each person individually for 55 minutes at every session. I could also refine my skills as one of the first physical therapists to use the Redcord suspension system. In fact, I began teaching other physical therapists and athletic trainers around the United States how to use this system of ropes, slings and bungees to help them assess and treat their own patients.
Redcord became my secret weapon. The science behind it is called NEURAC (NEURomuscular ACtivation). It applies repetitive “zero-gravity” movements that essentially wake up deactivated stabilizer muscles in order to restore pain-free joint mobility and function. Simply put, it’s like turning on a light switch to the body’s deep stabilizing system that went dim from trauma and pain.
Today, with decades of professional experience and all that I have to offer as the nation’s leading authority in suspension based physical therapy, I can actually make a difference in people’s lives. So now, when those same clients come in with high levels of pain and multiple injuries, my chest instinctively sticks out a bit with confidence that I’m ready and fully equipped to help them. I have ample time to listen attentively to their story. I get to talk about pain science and explain what is happening to their body in the presence of pain. I do a proper examination which includes a total body functional movement screen. Plus I take them through a series of neuromuscular testing in the ropes.
The point of this story is, I never settled for the status quo. I took it upon myself to transform from one type of PT into a totally different one. Hopefully my tale will inspire other physical therapists out there to do the same.
In my next blog article, I will discuss how pain interferes with the healing process and how I apply suspension based physical therapy to overcome this.
Disclaimer: The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.