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3 Critical Questions To Ask Your Physical Therapist on the First Visit

Physical therapy (both in person and virtual physical therapy) is most effective when you are actively involved. While the physical therapist is responsible for identifying issues and developing a plan, the patient should be actively involved by asking questions and providing necessary background information. Here are three important questions to ask your physical therapist to get the most out of your session in Chevy Chase or Bethesda.

1. Why did this happen, and how can we ensure it doesn’t happen again?

Solving the underlying issue and resolving any pain or discomfort is essential when working with a physical therapist. But beyond that, you also want to ensure that the problems don’t resurface. By asking about the root cause of the injury or pain, you’re able to better prevent the problem from becoming a long-term issue.

2. What do I need to be doing at home?

Unfortunately, time with a physical therapist is limited. Outside of a few hours a week, most time is spent away from your PT. When meeting with a physical therapist, it’s vital to clarify any exercises you should or shouldn’t be doing at home. A great physical therapist will make sure you have the tools and exercises needed to take control of your health, both inside and outside of the session.

3. How can you be sure I’ll make progress?

If you decide to work with a physical therapist, the intention should be to progress towards your goal. Oftentimes the  healthcare system will establish general objectives, such as reaching a “baseline” or returning to ADLs (active daily activities). Although these standard guidelines are a good starting point, the purpose of physical therapy is to reach your goals, not the goals of the insurance companies! By asking this question directly, you set a clear intention for the results you desire.

Physical therapy works best when there’s an active partnership between you and the PT. The more engaged you are in your health, the more progress you will make. By asking these three essential questions, you’ll set clear intentions for your physical therapy and build a better working relationship as a result.

Fact or Fiction: Do our bodies actually fall out of alignment?

We are excited to begin a series of posts discussing common myths in the realm of athletic physical therapy. Today’s myth commonly applies to back pain physical therapy as well.

Many of our patients have been told that their body may be “out of alignment”, or that their joints need to be “re-aligned.” Unfortunately, this is not the greatest advice.

Human beings are never in a static position. Even at rest, the simple act of breathing creates movement. By definition, being in alignment means that our bodies are in a straight line, or that all parts of our body are consistently in the appropriate relative positions to one another.

We cannot consistently be in alignment because we are always moving. If our body was constantly aligned, we would be unable to move anywhere.

Your body can feel as if it is out of alignment when you overuse or rely upon specific movement strategies or body positions. This can happen for a myriad of reasons and results in feelings of stiffness and discomfort that often temporarily feel better with an adjustment.

An adjustment can be helpful if the causes of stiffness or discomfort are also addressed. The root causes of stiffness or discomfort are typically addressed by focusing on movement limitations that are present.

Any relief provided by an adjustment will be temporary when the root cause of the discomfort or stiffness is left unaddressed. Check out the article below for some activities that may help!

3 Home Exercises to Help Your Back Pain

We hope that this provided some insight into a common rehab myth. Stay tuned for more to come!

Do your running shoes pass the test?

You don’t need performance physical therapists like us to tell you that footwear makes a large impact on running performance. The correct running shoe can reduce your race times and lower your injury risk.

When walking into any running store in Bethesda or Chevy Chase, you will find many different shoe brands and several different models of shoes within each brand. Among this wide array of shoes, how do we determine which is best for you?

The answer is different for each person and is dependent on a multitude of different factors. However, any running shoe must meet a few requirements to be considered and these are the first things we look for when assessing any running shoe in physical therapy for runners.

The first is that it must have a firm and snug heel cup. Your heel sits at the base of the shoe, in a place called the heel cup. The heels cup should fit snugly around your heel and should not be much wider than your heel itself. This prevents your heel from sliding around within the shoe, which would negatively impact foot mechanics.

Next, the shoe must have a toe break that folds where your toes bend.  Place your shoe on the ground and hold it there. Pull the front of your shoe upwards from underneath. The folding point of the shoe should be located where your toes bend. If your shoe prefers to fold at another location, your foot is being encouraged to bend somewhere else. This alters foot mechanics and can lead to breakdown within the structure of the foot itself.

Finally, you should be able to feel the entirety of both feet on the ground as you are standing still in your shoes. People are often unable to feel their arches, which results in more stress on the areas that are receiving better ground contact.

There are 26 bones and 30 joints within the human foot. This results in a large number of ways that our foot can compensate, and therefore, a large number of factors that we need to be mindful of when choosing the correct running shoe.

The 3 factors outlined above are a good place to start when choosing the right shoe, however there are many other factors that may also need to be considered.

Please contact us for help assessing your foot and determining the best running shoe for you!

 

3 Home Exercises to Help with Your Back Pain

Did you know that according to research, over 70% of Americans will experience back pain during their lives?

Surprisingly, this statistic remains high among active people. Sometimes their training even contributes to it!

One of the things you can do to help reverse this trend is to implement Pilates into your training. Dr. Ciara is a physical therapist and certified Pilates instructor. She has taught us how to incorporate Pilates into the treatment of physical therapy patients right here in Bethesda and Chevy Chase. These principles can also be used in performance training.

The good news is that Pilates doesn’t require you to go to a Pilates studio. Many Pilates exercises can be done from home and performed within your training regimen.

Begin with the 3 exercises below.

  1. Roll like a ball into Zen Teaser (C-Curve)
  2. Single Leg Stretch
  3. Curtsy Reach

The goal of these activities are to teach you how to control your body using your deep abdominals and glutes. Therefore, it is essential to focus on quality of movement, rather than the quantity performed. There are no heros with these exercises!

To learn more about Pilates, check out last weeks article below!

What Actually is Pilates?

Training with back pain may only require a simple modification

Back pain remains as one of the leading causes of disability worldwide and according to research, over 70% of people will experience back pain at some point in their lives.

When back pain is measured among such a large number of people, it is impossible for each person to specify the different ways in which their back pain presents.

When treating physical therapy patients with back pain, we see this pain present in many different ways. Since we treat such active people, our patients are very aware of the different movements that elicit their symptoms.

Many times, picking objects off the floor, aka deadlifts, produce their back pain. During these movements, the body bends over by folding at the hips. This moves the spine into a position that is horizontal relative to the ground, resulting in more shearing forces within the spine. Shearing force is the force of one vertebra wanting to move forward or backward relative to the one above or below it.

For many others, squatting movements are problematic, specifically when squatting with resistance (such as when lifting weights). When squatting the spine is vertically oriented (compared to a deadlift) resulting in more vertical compression against gravity.

Do you have back pain? If so, is it worse when picking things up off the ground or when squatting with resistance?

If it is worse when picking things up off the floor, aka deadlifting, you may want to consider replacing deadlift exercises with squatting variations within your training program. While this should not be a permanent solution, it can help you get out of pain while addressing the root causes of the issue.

If your pain worsens when squatting with resistance, you may want to consider switching to more single leg squatting variations in place of double leg squats. Once again, this should not be a permanent solution (although single leg exercises are awesome!), however it can help you get out of pain while addressing the root cause of your pain.

For help addressing the root cause of your pain, simply contact us!