Healthcare

What High Quality Physio Should Look Like

If you are going to trust a healthcare provider with your recovery, it's important to know what distinguishes high quality from poor quality. After reading this post you should know the difference so you can ask the right questions before getting started. That way you never have to experience poor care!

What Poor Quality of Care Looks Like:

This is my rant for the month.  A good amount of the clients we see, come to us after having failed elsewhere or by another healthcare provider. Some have felt pretty much ready to give up and ‘just live with it, until they were talked into giving us a try by previous clients of ours.

In most cases these folks tell me that they were actually only seen briefly by their healthcare provider.  Maybe some quick hands on treatment, then out the door. Very little or no education/guidance was given on their injury or issue. Those who do have longer treatments tend to be passed off to a lesser qualified personnel or just left to do their exercises on their own most of the time (since the therapist/clinician was busy with other patients).

Needless to say the results were not what these folks were hoping they would be!

      image credit: www.glasbergen.com

     image credit: www.glasbergen.com

Generalized treatment leads to generalized results.

Delegated care leads to less educated professionals providing less skilled treatments.

Ultimately landing you with a watered down treatment approach that results in poorer outcomes and breakdown in communication...... Not to mention that these business usually try to make up for lesser quality of care by having you come in more frequently than necessary in hopes that their outcomes will improve at the expense of your precious time!

At On Track Physio, we guarantee this will not be your experience. We even back it with a money back "Love it or Leave it" guarantee! Something you never see  in healthcare..... If you’re going to spend your hard earned money on our services then it should be focused on YOU and the outcome you are trying to achieve!

Here is what High Quality of Care should feel like:

1) Time is actually taken to listen to and understand YOU, and your story about the path which lead you to your current state or current issue. 

2) Time is actually taken to allow you to ask questions

3) Time is taken to perform multiple assessments each and every visit to best ensure that the intervention given will be most likely to produce the outcome which is desired.

4) Time is taken to demonstrate, teach, and coach the exercise or intervention so it is done properly. But is also repeatable for you to do at home independently of a healthcare provider. This gives you the best possible chance of achieving the desired outcome.

5) Consistent communication throughout the entire plan of care to avoid setbacks.

6) Truly skilled clinical experience and knowledge/understanding of how the entire body works as a unit. Focusing on just the painful area will get results some of the time, but the majority of the time there is multiple contributing factors.

Note: Notice how items 1-4 emphasized time. If your provider is constantly juggling clients or passing you off between provider. Your TIME would be best spent elsewhere!

Obviously we are biased..... At On Track Physio we guarantee that we will show you all 6 of these traits to receive high quality care. If you would like to experience this quality of care, please feel free to reach out to us via phone, email, or schedule a time for a FREE Discovery session. This session is all about giving you the TIME needed to make a good choice in your health.

Greg S.jpg

Ann Arbor, Mi

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Middle Age Woman Pleads Guilty - Part 2

In my last post, you heard about getting called out by a young PT, my epic fail with years of unhealthy living, and how an unforeseen injury prompted my turn around. You can read Part 1 here.

Today I will talk about some of the challenges, and how we need to listen to good advice when it’s given to us!

You can have your cake and eat it too… just not every single day.

Holidays, vacations, and trying to follow a healthy lifestyle in a household where others aren’t exactly on board with what you are doing can be challenging. I was six months in, and still had trouble allowing myself certain foods because I was afraid I would fall off the wagon again. I eventually started letting things back into my diet in small increments. I mean…. come on….you should be able to have birthday cake at a birthday party without completely falling apart! Healthy foods became the majority of my diet, and planning and preparing were a key factor.  I made a lot of modifications, learned new ways to cook, and just bypassed a lot of great looking junk food! I planned my workouts and had to get creative with this when not at home. I had to disregard other people’s opinions, negativity, and unhealthy choices, and just keep doing what was good for me regardless of where I was or whom I was with. I had to stick with this ALL the time……not just SOME of the time.

A rough patch came when I had some unexpected health circumstances that took away my ability to workout at a high intensity for several months. All I would be able to do was walk at a slow pace. I was upset… to say the least. I had done all this work, and now it was all going to go down the drain!  How could I maintain what I had done if I couldn’t run or strength train? Oh……I had quite a pity party for myself, thought about giving up and throwing it all way.  In the past, it would have been easy for me to quit…... “Hello TV and Doritos, here I come”!  I would need to make additional diet modifications, and also adjust my attitude. The last thing I needed was an attitude problem getting in my way…… and boy did I have one…..

However, something was different this time.  Yes, I was mad at the circumstance, but I had busted my butt, reached goals that I never thought possible, and wasn’t about to let all this hard work go to waste. I had changed my mindset so much so, that I didn’t feel like giving in so easily this time. In a sense, I had “retrained my brain”. This turned out to be a very beneficial experience, because it forced me back into working on my mindset and dealing with issues when things don’t go perfectly. I am one of those people that want everything to go as planned, but life doesn’t always work that way. Sometimes you have to “adjust” your path… not just give up. I did what I could, and eventually started working my way back to up to running and lifting weights again.

Funny…. I didn’t gain any weight back during that time.  I really worked myself up into a frenzy worrying about that. Apparently, all the work I had done prior to that had been enough to keep my fitness level stable with just the light walking and diet modifications. If I had a dime for every time I got worked up about something, and then it all worked out…… I’d be a wealthy woman!

This was the point in which I realized that I was truly ready to keep this up for good. I didn’t let emotions or circumstances run my decisions, kept pressing on…… and everything was fine.

Regardless of what the bad habit is, changing something you have been doing the same way for 25 years is tough, and when you have your heels dug in… it can be hard to pull them out. I just had to find a good balance and stay focused. It has been two years since I started, and the way I live now feels normal to me. My brain and body crave the good foods and exercise now… but I still allow myself some junk food from time to time…. just not “every” time.

If you don’t use it… you lose it! 

Now I don’t know about you, but if I am lucky enough to get those additional 40 years, I plan on feeling the best that I can during them. I want to be able to walk up and down the stairs, travel, play with and lift up grandkids when I get them, and do all the activities I love to do. Cardio, strength training, and a healthy diet boosts your immune system, can help relieve stress and anxiety, improves mood, and gives you the strength and energy that is needed to live life well.

I’m not going to lie… it is hard work getting started. The thing is though…. it’s absolutely, unequivocally, entirely up to YOU to do it. Nobody else…. and I mean nobody else……can do this for you. You have to want it for yourself and do it for yourself.  You are worth it…. and you deserve it.

Think of it this way…. We take our cars in for oil changes, tune-ups, and new tires to keep them running properly. Our body is like our “vehicle for life” and we can’t trade it in for a new one. We need to treat our body well and keep it maintained or it’s not going to run right.……or maybe not at all!

Yup, the physical therapist was right. There is nothing that will stop us from aging, but there are proactive steps we can take to help ourselves. It is inevitable that we are going to sometimes have aches and pains, possibly get an illness, or maybe need a surgical procedure. Who do you think will recover better and more quickly from a knee replacement?  Who do you think has a better chance of fighting off a serious illness or preventing injury?  Well… the polls are in and the individual who has a healthy diet, exercises, and strength trains has a clear advantage. I want to be prepared for battle, not just fall down and surrender to getting old!

No matter your age, ability, or current fitness level, there are always things you can do to improve your overall health. In addition, getting PT first can help address any pain or movement issues that you may feel are preventing you from starting a fitness program, and would definitely be a great first step!  If you want to move more, feel better, and stay active then find a physical therapist, personal trainer, or other trusted healthcare professional to help you get started. I guarantee you won’t be sorry that you did.  The only regret I have about changing my lifestyle, is not doing it sooner.

It may serve us well to listen to the advice of this younger generation of healthcare professionals, as I happen to have met one that just may know what he’s talking about!

 

Middle Aged Woman Pleads Guilty - Part 1

The verdict is in. I am a middle age woman guilty of over 25 years of eating poorly, yo-yo dieting, not exercising, and not treating the ONE body I have the way it deserved to be treated.  The way I felt all those years was definitely “all my fault” and I will be the first one to admit it. I had a mile long list of excuses for the choices that kept me overweight, sluggish, stressed out,  on the couch…... and just feeling overall yucky. Physically I was out of shape, and that transferred into how I felt mentally and emotionally at times…. because one can affect the other. 

Entering your 40’s makes you re-evaluate your life. You never know how much time you really have left, but now at age 45, I am kind of hoping I get another 40 years! When I was younger, I thought I would always be healthy, able to move around, and do anything I wanted for the rest of my life with no problems. It’s hard to imagine being old…… when you are young. It seems like one day you look in the mirror and 25 years have gone by and you’re not sure what happened!

I would love to say I woke up one day and had an “epiphany” to jump on the fitness bandwagon, but I stood on the curb and watched it drive by me several times. Oh, I made “attempts” in the past to lead a healthy lifestyle, but it was short-lived, and I always had a specific reason like losing weight for summer or a special event. Once that was over, I’d get lazy again; go back to being overweight, and always complaining and whining about how I looked and felt. It was only about the number on the scale, not the actual long-term benefits of living healthy. I never truly “committed” to changing. I wanted someone or something else to do it for me. My mindset was clearly the issue…… but I just didn’t realize it.

A few years ago, I was given an unforeseen “opportunity” to think about my mindset and lifestyle.  I was injured unexpectedly, in a lot of pain, couldn’t work, sleep, or do normal daily activities. This scared the daylights out of me because I wasn’t sure if I would get better or how long it would take. For two months, I had time to really think and ask myself “So how is what I’m doing working for me”?  I always had the “choice” of sitting and not moving, or getting up and being active. The injury took away that choice for a while, and forced me to ponder life without the option to choose. That situation prompted me to become “future-oriented” very quickly.

During my recovery, I went to physical therapy and learned quite a bit about how my body is supposed to work.  In addition, I was able to catch a glimpse of what life could be like if I didn’t change my ways. I saw other patients at the PT clinic who were struggling to recover from injuries or illnesses, a lot of times mostly due to the fact that they were so out of shape and unhealthy to begin with. Some of them were not that much older than I was. I did not want that to be me in a few years, and so it was time to get off my butt!

My physical therapist had helped me recover and played a key role in my decision to pursue fitness as part of my lifestyle. I was worried about injuring myself again and concerned about my inexperience, but he reassured me that these would not stop me from reaching my goals. 

At this point, I felt like I was given a “get out of jail free card” and I wasn’t about to blow that opportunity doing my own thing.  Low and behold…. this PT was also certified in strength and conditioning, and so I enlisted him to help me get started. It was perfect, because he knew the in’s and out’s of my injury, ability, and goals.   I really wanted to do this at home, as I did have some exercise equipment. He said it was doable and recommended I also purchase a 20# and 30# kettlebell, and I’d be all set. I thought to myself “Um… he’s crazy if he thinks I will ever be able to lift that”. (I had only ever lifted up to 8#). He seemed pretty confident, but I assumed he was trying to kill me! I purchased those kettlebells that I KNEW I would NEVER use……but kept the receipt for the time being.

 You don't have to be like Arnold to be strong

You don't have to be like Arnold to be strong

Strength training was a big part of the program he designed for me, and for good reason.  I met with him numerous times for instruction, and remember joking about how easy some of the strength training exercises seemed. However, I wasn’t laughing so much a few weeks later when trying to walk up and down the stairs after a few days of squats! I kept at it, changed my eating habits, and also began training for a 5k, which gave me a good goal to reach three months down the road.  Weight lifting was making me stronger both physically and mentally. Running was a great stress reliever, endurance builder, and really kept me feeling motivated. I now looked at food more as fuel for my body instead of just a pleasure activity.

Fast forward six months later……I had lost 50 pounds, had significantly increased strength and energy, and felt amazing. I was running 3 miles at a stretch and was now lifting those 20# and 30# kettlebells…….and I had to suck it up and tell the PT he was right! I was able to do more now than even in my 20’s.  My goal was much less about the number on the scale, and more about changing my behaviors, mindset, and attitude for the long-term. The benefits of this lifestyle change were starting to sink in…..

The question now was “Could I really keep this up for good”? I certainly didn’t trust myself yet.  I was feeling great and had developed a lot of confidence, but was still very nervous about going back to my old habits. It’s really easy to keep doing something when you don’t have any roadblocks, but what about when you are presented with challenges or triggers?  That’s when the real work starts, when you have to toughen up that mindset even when the chips are down, and push on through regardless of the circumstances. 

Stay tuned for Part 2!

How To Avoid Physical Therapy – Old Geezer Medication

This really does not have to be complicated. Most injuries are from a sudden increase in activity that your body was not prepared to handle or a repetitive physical stress without ample rest. The way you avoid Physical Therapy or Injury is become resilient to stress. 

News flash! You don’t build resiliency to stress by standing on a BOSU ball and thinking you are working on balance. 

In order to become resistant to injury your body has to be able to withstand stress. If you have ever seen someone who was bed ridden for any period of time, you can almost see the person becoming more fragile right before your eyes.

Strength training is on the opposite end of the spectrum because it signals for survival and GROWTH. This forces the body to grow stronger muscles, tendon, ligaments, and bones. It also impacts the endocrine and central nervous system as well!  All these qualities you would think that strength training would be more mainstream in the public health sector. Essentially it could be considered the anti-old geezer medication or maybe the fountain of youth.....

Working as a physical therapist (and being young, will be 27 next month) I hear patients tell me every day that "getting old sucks!" or "whatever you do, don't get old!".  Does it really take an almost 27 year old health professional to tell you point blank that aging is normal? It’s going to happen folks! Cardiovascular disease, muscle atrophy, hypertension, Type II diabetes, shortness of breath, chronic fatigue, obesity are all preventable. Yet they are the majority contributors to death and healthcare dollars. So what are you going to do about it?

The McDondalds drive through, watching your favorite tv season on Netflix for the 3rd time, and going to your Doctor so they can prescribe you some meds isn’t exactly a recipe to age well.

Side note: If you are still reading this, I think you may realize how much the title of this article actually pains me. Did I really have to catch your attention by saying how to avoid physical activity (physical therapy) by taking a medication?

Enough ranting, let’s go back to the topic at hand which is strength training. I fully realize that everybody’s goals are different. For the athlete, strength is important for performance and resisting injury. To be clear, you do not have to be big/bulky to be strong (so lady’s, that’s a poor excuse). The average Joe or the aging population, strength training has a multitude of benefits that keeps your mood and body strong and resistant to injury. A study in 2008 by Ruiz and colleagues titled “Association between muscular strength and mortality in men” found that of the 9000 men followed over 20 years, muscular strength was inversely related to death from any cause. This still held true when the stats were adjusted to take into consideration fitness and cardiovascular health.

Boom! Strength wins!

Now for the elephant in the room. Guess what? Strength training is going to take some work. It’s not easy. However, a 2016 study by Giessing and colleges showed that training just 2x per week, 8 exercises, just 1 set to failure actually increased strength. If you are still in the boat of not having enough time. Then I really don’t have the sympathy when you say “getting old sucks.”

If you have never strength trained before, and are intimidated, then it would be a great time to find a trusted trainer or healthcare practitioner who believes in these same concepts which are backed by science and research. Being intimidated is perfectly fine and normal. Most anything of value is going to be intimidating the first time you do it. That’s why when you were a kid, your parents forced you to do things you didn’t necessarily want to do. Find a trainer or healthcare provider that knows what he/she is doing and will take things in stride because you’re going to be in this for the long haul. It’s an investment in your health that can benefit you both mentally and physically, but also financially by avoiding frequent doctor visits and medication bottle refills.

Listen, I get it. I was a collegiate athlete just 5 short years ago. I can’t do some of the things now that I could then. Life happens. Priorities shift. Time doesn’t stop. But how to stay strong doesn’t change!

(Part 4) The Setback, The Comeback, and Staying On Track!

Learning The Value Of Physical Therapy – A Patient’s Perspective

Let’s Recap:  Last week you heard about my successful experience with physical therapy, and how I was ready to ride off into the sunset. You can read Part 3 HERE (or maybe you missed Part 2 and Part 1).

This week I talk about how I thought I was good to go, acted like I was invincible, needed a reality check, and finally put an end to all the madness!

Prior to what I refer to as “The Setback”, I had taken big steps to improve my overall health. The PT I worked with was also a fitness trainer, and I didn’t’ hesitate to hire him for this venture. He understood my ability and history of injury, and took this into consideration when developing a fitness regimen. Everything was going great for about six months. I had lost 50 pounds, gained a lot of strength, and was feeling awesome! This was the best shape I had ever been in, and I was starting to feel “invincible”.  I started doing too much, too often, and taking things too far………

The Setback

After a few weeks of being “invincible”, I woke up one morning feeling a very familiar pain.  My right arm was aching and I felt some pain in my back and neck area. I didn’t panic right away….. but then three days passed and the pain was still there. Now I started to panic. The thought of re-living that pain was terrifying to me. My anxiety went from 0-100 in a matter of days, and the pain started to increase. I saw the physical therapist, and he did a brief evaluation. He didn’t seem overly concerned, and thought I had just overdone it with exercise. He encouraged me to do the PT exercises and stretches again for a few weeks.  This calmed me down, but that would be short-lived. I did what he told me to do, but I was full-on freaking out and things started to get worse. The pain was similar to before…….but different…… not as consistent in level or location, and I didn’t have any weakness……. but range of motion in my neck was decreased (the pain I had before was constant and unrelenting). My fear and anxiety about the pain returning took over, and I threw myself back in the ditch!

I went back to the physical therapist and insisted I had another herniated disc. I had been in pain for over two weeks, and was starting to feel like I was in a vicious circle. He agreed that my range of motion was decreased and something was going on, but not for the reason I thought. I argued with him about my previous MRI, cervical disc problem, and my pain. He had me sit down to try to explain something to me……. but I didn’t get what he was saying.  All I heard was “Your body has an alarm …. blah blah blah…. brain thinks there is a problem……blah blah blah……not a herniated disc.”  It sort of sounded like he was saying the pain was all in my head. I was certain it was caused from the disc issue, and I didn’t have a clue why he would be thinking anything else. Did he not believe me?

I got home and started thinking about what he said, and of course went on the internet. I found myself on websites that talked about something called “pain science”. I didn’t grasp this concept, but I was intrigued.  I saw him again for another appointment, and we talked more about pain science. He explained that he DID believe that I was having pain, but my clinical symptoms weren’t consistent with a herniated disc. He used some different analogies that made more sense to me, and went into more detail about this “alarm” going off. I still was having a hard time with the concept that this pain wasn’t necessarily coming from the area I was feeling it, but I was determined to find a way to understand this.

The Comeback

It was time to move on to getting me out of trouble yet again. This PT was standing there by the ditch, but he wasn’t going to pull me out this time. He was going to throw me a rope, and make ME pull MYSELF out! He gave me a “reality check” and said I needed to get my fear and anxiety under control if I wanted to change what was happening. He gave me more information on pain science, as well as reputable websites and professionals who had written about it. I read some very good books on the subject, and realized that I was the person in the books……..and the light bulb turned on!

My pain was definitely real, but was being magnified by my brain “thinking” I was in danger, and not from an acute injury. My prior injury had “sensitized” my neurological system, and pushing myself too far with exercise alerted my brain that I may be in danger, thus setting off this alarm. This was why my pain was so inconsistent and would wax and wane depending on what I was doing, or my emotions (and also why no weakness was present).  Sometimes the brain can be a little too protective and respond with pain even if there is not an actual injury, this is because it remembers the previous injury. (Pain science is a whole other blog post!)

Grasping the pain science concept and knowing that I didn’t have an acute injury reduced my symptoms significantly, but there was still work to do. My neurological system had gone haywire, and it would take some trial and error to reset it. I did the exercises and stretches, got my anxiety under control, and the PT did some manual therapy.  Before I knew it, I had pulled myself out of the ditch and turned the alarm off.  It would still take a little time until I got the hang of this “alarm” in my brain. My neurological system was really sensitive now, and I had to be careful not to flip the switch.  I tried going back to my fitness routine, but every time I did, it would trip the alarm and the symptoms would return.  I finally realized I needed start over and do what the PT said and what I had read in the pain science books…….“graded exposure”. I needed to start out very slow, take small steps, and work my way back up. This drove me crazy, because I had no patience and wanted to be back to the level of fitness I was at prior to the setback.  It took an entire year, and there were bumps along the way, but I finally got there!

Staying On Track

It took me almost two years to fully appreciate the value of physical therapy and how it improved the quality of my life. There are so many lessons learned, that I have lost count! This experience forced me to develop patience, which I definitely needed. I learned to understand my body, how it works, and that I need to listen to it when it is trying to tell me something.  I learned that doing things the right way might take longer, but I will get a better end result. I learned that anxiety and emotions can have a big impact on me physically. I learned that I need to participate in my own healthcare, and what I want in a healthcare provider. I learned that physical therapy is an excellent choice as a first-line treatment for pain and movement problems, and it will ALWAYS be the first place I go before considering other interventions.

I could waste time thinking about what I should have, could have, or would have done differently, but I’m not going to do that. The fact of the matter is, there are a lot of times that “You don’t know.....what you don’t know”.   You find out things along the way that help you make better choices. You can’t go back, only forward, and use what you have learned in the future. I wouldn’t go back and change any of the events that happened, because then I wouldn’t know what know now.

I ended up meeting that physical therapist by happenstance, and I feel like I dodged a bullet because of it. There are several different unpleasant scenarios that could have played out here. I could have had an unnecessary surgery gone wrong.  I could have ended up dependent on prescription pain medications or injections. If I hadn’t learned about pain science, I may have ended up as a chronic pain patient, living in a terrible vicious cycle. Instead, I went to physical therapy and met a smart PT who helped me learn how to help myself. I am very grateful for that, and now I have a healthcare professional I trust who I can use as a resource.

If I have to be totally honest here, I’m pretty sure I initially went to physical therapy out of pure spite towards that neurosurgeon, because he said it wouldn’t work. This will probably be the only time in my life where being spiteful actually worked in my favor! Regardless of how I got there, I made it to that first appointment, continued going, and learned the value of what physical therapy can do for a person.  I may have shown up on that PT’s doorstep looking like a “train wreck”, but I left that experience with the information, education, and tools that are going to help me stay “on track”……..and the rest is history!

(Part 3) - PT Tow Truck "Versus" Skeptical Train Wreck Patient

Learning The Value Of Physical Therapy – A Patient’s Perspective (PART 3)

Let’s Recap:   Last week I talked about my interactions with all the healthcare providers who rode with me on that awful merry-go-round, and why I eventually decided to jump off of it(Read Part 1 and Part 2).

I am now sitting in this ditch holding the “Referral” for Physical Therapy. I stopped popping the pills prescribed at the ER because they didn’t really help, and turned me into a zombie. I was back to using Motrin and frozen bags of vegetables to help control my pain.  I have now had enough healthcare experiences to know what I DON’T value, and am ready to find out what I DO value!

It was time to get this show on the road and call the physical therapy clinic. I explained the situation, and the receptionist said they treat patients with my type of problem all the time. Wait……what? This seemed WAY too easy, but I liked what she said. This literally was like the feeling you get when your car is broken down, and the tow truck finally shows up to help get you out of trouble.  My “PT Tow Truck” was on the way, but would it really be able to pull me out of that ditch?

The day of my first appointment, I showed up on the PT clinic doorstep looking like a “train wreck”.  I was in pain, hadn’t slept in weeks, anxiety ridden, and probably hadn’t showered that morning because squeezing a shampoo bottle proved to be too exhausting due to weakness. I’m a skeptical person by nature, had now developed some trust issues, and didn’t have the best attitude walking into this PT clinic. You can imagine my dismay when an extremely “youthful-looking” young man approached me, stating he would be my physical therapist.  I was thinking “Great…. I got the new guy…. it figures!”  I remember quickly scanning the walls for a diploma or license with his name on it. Sure enough, it was hanging right near the clinic entrance.  Nobody my age or older had been able to help me yet, so I decided to let him take a crack at it.  I’m sure he had an opinion about me as well, and probably thought “Great….. I have to deal with this anxious, possibly un-showered, skeptical, train wreck patient today…. perfect!”  This physical therapist would have his work cut out for him………

At the first visit, he spent over an hour actually listening to me, asking questions, evaluating me, and performing different tests and therapy techniques. He didn’t seem alarmed with my diagnosis, and that worried me. I pressured him about the MRI results and what the other specialists said, but he still remained calm. He explained that “WE” were going to work on getting the pain under control, addressing the weakness and movement limitations, and see how things go. I was anxious and skeptical, and questioned everything he said and did. He performed something called “cervical traction” on my neck that day, and this helped my pain. He said this “pull” on my neck was creating some space between the cervical vertebrae. He also had me do some weird-looking exercises and stretches that I was to start doing at home. I wasn’t a fan, and didn’t want to look dumb doing these. He ignored my unwillingness, and encouraged me anyway. I reluctantly complied and did these stretches, chin-tucks, sliders, and side-bends. I have to give him credit, because he held up pretty well considering my behavior.  I felt better after that first appointment, but the pain would start to return that night, and my next appointment was two days away.  He had a plan though, I was included in it, and this was a nice change.

At the next few visits, we did a lot of the same things, and it was the hands-on therapy and cervical traction that helped my pain the most. He was able to help my “new” primary doctor get a home traction unit for me to use in between visits, and this provided a lot of relief. It was now about a week and a half into treatment and I was starting to feel better and was making progress. My pain was reduced, I could sleep again, and I was starting to “buy in” to physical therapy.

We talked at each visit, and I would ask A LOT of questions. He did his best to explain the in’s and out’s of my condition and the therapies he used. I took the knowledge he shared, and researched the internet for more information. I was starting to understand my condition, what caused it, how to treat it, and how to prevent the symptoms.  Years of improper movements, incorrect posture and body mechanics, mismanaged stress, and a bit of genetics all piled on top of each other to help create this problem. I was learning that these physical therapy techniques were the key to recovering, and that I would have to be an active participant in the process if wanted it to work.

Now that the pain was better controlled, it was time to work on the weakness in my right arm caused by nerve compression in my neck, and also treat the underlying cause of my movement limitations. He added strengthening exercises to my regimen, and still made me do those weird exercises at EVERY appointment AND at home.  He explained that the exercises were re-training my brain to know that it was okay for me to move my neck and head in certain directions, but I still looked ridiculous doing them! He would assess my progress at each visit, try new therapies and exercises, and see which ones were working the best. I was always expected to hold up my end of the bargain, and do a home program in between visits.

He then started a new hands-on therapy, which had me thinking he might be off his rocker…… It was a soft tissue therapy called “IASTM”.  He used an odd-looking metal tool with lotion to sort of “brush” in different patterns along my back, neck, shoulders, and arms. He explained this would “Increase blood flow and reduce my sensitivity to stretch” allowing me to move better in these areas.  I couldn’t see how this would work, but I skeptically let him proceed with this therapy at my visits.  As it turned out…. this actually worked quite well.  I never realized how “restricted” my range of motion had been, until I was backing out of a parking spot one day, and it dawned on me that I could turn my head all the way to the right to look behind me. I hadn’t turned my head this far in probably 10 years!  It was now becoming very apparent that this PT knew what he was doing. My skepticism and anxiety diminished, and he gained my trust as he was pulling me out of that ditch. 

Guess what?  Six weeks of physical therapy went by, andI consistently got better without prescribed medications, injections, or surgery………. The hands-on manual therapy, cervical traction, weird exercises, and stretches worked. The pain was gone, strength was returning, and range of motion had greatly improved. This therapist not only addressed my acute situation, but also the underlying soft tissue problems that had built up over the years, and I now felt better than I did even before my initial symptoms started!  I was quite puzzled as to WHY physical therapy was only mentioned to me as a last resort, and was told it probably wouldn’t work?  PT should have been my first stop……… not the last.

I was thankful I gave this physical therapist a chance to help me, and also restore some of my faith in the healthcare system. I had just experienced first-hand, the value of physical therapy.

I was now ready to put this all behind me and ride off into the sunset, but my neurological system had OTHER plans, and this would not be the end of my story just yet. I would throw myself back into that ditch for a moment, get a BIG reality check, and then hopefully put an end to all the madness! There was another lesson to learn before I would completely grasp how valuable physical therapy really was………

Fun Term Of The Week - Train Wreck:  A chaotic or disastrous situation that holds a peculiar fascination for observers.

UP NEXT WEEKThe Setback, The Comeback, and Staying On Track

Stay Tuned for the Final Conclusion of this 4 Part Series!

Learning The Value Of Physical Therapy – A Patient’s Perspective (Part 2)

To Recap: Last week I covered why I wanted to write about the value of physical therapy, and how my flawed mentality got me into hot water. You can read part 1 HERE. This week, I get down and dirty about my ride on the “healthcare merry-go-round”, the people who joined me, and the making of my mess.  Again, I want to reiterate that these were just interactions I had with healthcare professionals along the way. I’m sure their intentions probably were to help me, even though it may not have seemed that way at the time. Their specialties all have a place in healthcare, but they aren’t going to be the first place I stop at in the future!

merry_go_round.jpg

Just a little snippet on my HMO insurance…..I’m not going to say much on this subject, as HMO pretty much speaks for itself. It’s a revolving door of referrals, authorizations, and denials. It’s like walking around with a pebble in your shoe or a thorn in your side, making everything just a little more difficult than it really needs to be. Everyone should try an HMO once in their life…. just for the experience! Moving on to the Primary Care Doctor.…

Two years prior to my injury, I had started having consistent pain in my neck, head, and back area. I was on a steady diet of Motrin for this. I work a desk job, and eventually it was just too hard to sit and work.  My “quick fix” medication wasn’t cutting it. Over the next year, I went to my primary care doctor three times. She diagnosed me with head, neck, and back pain…. and for some reason a urinary tract infection?  I got antibiotics, muscle relaxers, and was told to keep taking Motrin. No mention of what might be causing the issue, or any other possible solutions. Why she ever thought I had a urinary tract infection, I will never know ha ha. This interaction wasn’t really good or bad. It just wasn’t “anything”, and produced no results. She was satisfied with the status quo. The only thing I got out of this was a “referral” to the chiropractor, which was my idea. I’m on the merry-go-round now, but really bored because it’s going slow and nobody is on it with me.  Moving on to the Chiropractor….

One year prior to my injury, and after obtaining the coveted “referral” required by my HMO, I started seeing a chiropractor. I got x-rays and was told I was in “bad shape”. I was subluxed and degenerated, and needed to start treatment ASAP. I jumped on board with this, went three times a week over the next year, and it did provide some relief! This treatment still kept me in that “quick fix” mindset. Each visit was only a few minutes, got adjusted, and back to my day.  I was now dependent on this for relief, just as I had been on Motrin. Hey, at least I had someone on the merry-go-round with me now, and we were having a pretty good time….. at least for a while!

The day of my acute injury, I had gone in for a regular adjustment, but this time I didn’t get relief and it caused me pain. It was a severe “pinched nerve” feeling in my neck and back. I was told not to worry, and that they could fix this.  I was still “all in” at that point, and wanted to see if they could help me, but this would be the beginning of my mess.

One week into my mess, I had went every single day for adjustments, but the pain was getting much worse. I couldn’t sit, couldn’t sleep, couldn’t work, and was losing strength in my right hand. Taking 800 mg of Motrin barely made a dent.  He took another set of x-rays, and seemed very concerned. He stated my x-rays looked much worse than at my initial evaluation one year prior. My heart dropped into my stomach, he got nervous, and I got scared. Was it the adjustments that caused the problem or was it a coincidence? I didn’t really know, it didn’t really matter, and I just needed help. I told him I thought I should seek other medical care since things were getting worse. He then became somewhat defensive. Maybe he was offended that I wanted to get another opinion, or thought I was accusing him of something.  I expected him to offer some suggestions, but that didn’t happen. This interaction became all about him, and not about helping the patient anymore, so that relationship was over! I was on the ride alone again, and it was spinning faster.  Moving on to the ONLY place that my HMO doesn’t require a “referral”…. the Emergency Room…

Two weeks into my mess, I still have severe pain in my neck/back/arm, numbness and tingling, and the right hand was much weaker…. off to the ER! This ER doctor examined me, and sent me for an MRI. A few hours later, he briskly informed me I had a herniated disc in my cervical spine (neck) that was pressing on some nerves, which was the reason for my intense pain and weakness. He gave me a script for pain medications and steroids. He also handed me a card for a neurosurgeon, and stated I needed to see him ASAP. I spent the next week popping pills, flipping out, and of course searching on Google for all the horrible things that could happen. This interaction provided me six things… a diagnosis, three medications, a business card, and a lot of anxiety!  That doctor could work on his “diagnosis delivery” skills, but he did his job that day, and I can’t fault him for that. I’m freaking out now, and my ride has really picked up speed!

Moving on to the Neurosurgeon and the PM&R doctor…..

Three weeks into my mess, I have worked myself into an anxious frenzy, have my “referral”, and now I’m seeing the neurosurgeon. This was my least favorite interaction. He examined me and reviewed the MRI. After just a few minutes, he very bluntly said he could “fix” all my problems by drilling a hole through the front of my throat and shaving off the disc that was pressing on the nerve. I almost passed out, and then started to cry. I told him I didn’t want this and asked what else could be done. His demeanor quickly changed to irritated and angry. He spent the next 10 minutes reprimanding me and talking down to me like I was an idiot for asking questions. He said he was busy, had other patients to see, and flippantly commented, “You can TRY physical therapy, but it probably won’t work,and might make it worse.”  He then said he would have his PM&R doctor see me. I didn’t know what a “PM&R” doctor was, or why I needed to see one. I’m still crying, had failed to wear my waterproof mascara, and now looked like a complete disaster!

This new doctor walked in with a consent form for an epidural injection in my neck, and a “referral” for physical therapy.  Nobody asked me if I wanted an injection, or told me what it was really for, and I was having NONE of it that day! They spent about 15 minutes with me, treated me like an idiot, and then expected me to just blindly agree to their interventions. My thinking was this….

If you can’t treat me with common respect, then why would in the world would I trust you to cut into me with a sharp instrument or stick a large needle into my neck?

I left that appointment upset, exasperated, still in pain, confused.... and crying all the way home ha ha ha. If I wouldn’t have been in so much pain, I would have tried throwing both of them off the merry-go-round! This interaction, while extremely negative, was probably the best thing that could have happened to me at this point, but I wouldn’t realize this just quite yet……..

Wait… hang on a second……Everyone was offering me “quick fix” solutions for my problem, so why am I so upset!  Adjustments, surgery, injections, medications…… so what’s the problem here?  The problem was that nobody was really explaining my condition to me, what was causing it, what the interventions were all about, and what the consequences may be. They didn’t spend enough time with me or give me enough information. This was my spine, there were nerves involved, and I couldn’t afford to make a wrong decision based on limited information.  Was there something else I could be doing to help myself?  Were these my only options?  I had lasted three weeks with this pain, and figured I could go a little longer if it meant finding answers to my questions. I needed to stop just going along for the ride, and take some control of my own situation. I closed my eyes and jumped off that spinning merry-go-round. I ended up landing in a ditch, but made sure to keep a tight grip on that interesting piece of paper the doctor had given me that day……… the “referral” to PHYSICAL THERAPY.

Fun Term Of The Week - Merry-Go-Round: A continuous cycle of activities or events, especially when perceived as having no purpose or producing no result.

UP NEXT WEEK:   PT Tow Truck, Skeptical Train Wreck Patient, and the Weirdest Exercises I Have Ever Seen…….Stay Tuned for Part 3!

Learning The Value Of Physical Therapy - A Patient’s Perspective (Part 1)

Who, What, and Why?

A 43-year-old female who was in her usual state of health until……

When I sat down to write my personal healthcare story and how I came to really understand theimportance and value of physical therapy, I got my notes out and read through them and was like “This story is like some sort of bad reality show or TV mini series, did all this stuff seriously happen?”   Yes……Yes it did… and you can bet that I am glad it is over. It has been a few years now, so I can laugh about it and roll my eyes, but when it was happening it wasn’t so funny. I am writing this series of blog posts for several reasons.  First off, I want to help people understand the value of physical therapy and why it should be considered as a first choice treatment for pain and movement problems, and I also want to encourage others to be their own advocate when dealing with their health. Our body is like our “vehicle” for life, and we can’t trade it in for a new one. We need to be aware, educated, and informed about our body, how it works, and our healthcare options. If I can help even one person avoid a bad ride on the “healthcare merry-go-round” like the one I was on, then it was worth my time to write this.   The other reason I am writing this is to help physical therapists understand how a patient may have ended up on their respective doorstep looking like a “train wreck”, and the patient’s frame of mind that got them there.  Trust me….I’m pretty sure they didn’t get that way on their own!

Getting started on writing this was harder than I thought.   When this injury happened, I didn’t go straight from Injury to Physical Therapy.  Instead, I took a not so enjoyable trip down Pain Boulevard, Frustration Street, and then had an unfortunate ride on the Healthcare Merry-Go-Round.  PT will always be my first stop in the future, before other interventions, but I will get into that a little later. There were a lot events and interactions that influenced how I feel now. Learning the value of something is a process and not instantaneous. There is trial and error, screwing up, asking questions, falling down again, and then getting back up and brushing ourselves off.  Sometimes we need to learn what we DON’T value first, before we can really understand what we DO value. Because of this experience, I have completely changed my entire outlook on the healthcare system, the role of providers, and where my responsibility lies in this as a patient. Now that I have my groove back and I’m in the swing of things, I can honestly look back and really see what happened, how it happened, and why.  It’s a good thing I have a great sense of humor, because I wouldn’t be able to write about this without that, so here we go!

My First Problem.... A Flawed Thought Process…. What Was I Thinking!

I’m in my middle 40’s now and looking back, I realize that the root cause of my problem started way before my acute neck injury. It started a long time ago with a flawed thought process ingrained in not just me, but in society as a whole.  We seem to always want a “quick fix” for everything so we can get on with our life, but we shouldn’t be approaching our health like a “Quick Lube Oil Change”. This flawed thought process carried over into how I viewed my health and how I thought about doctors. When I went to the doctor, I expected them to fix my problem on the spot so I could get on with my day. Usually within 5 or 10 minutes, I had a diagnosis and prescription. I also took to popping Motrin and Tylenol on a regular basis as a quick fix for pain or discomfort. I never really had any big problems, so normally this worked pretty well…….until it didn’t. I also didn’t really know anything about my doctor other than she only spent about 10 minutes with me, handed me a prescription, and I paid my co-pay and left.  Hmmm… I’m pretty sure I have spent more time picking out paint colors for my walls, than I ever did thinking about my own healthcare. Is it possible that this was a dumb thing to do on my part?  The polls are in, and yes, it was definitely dumb!

Patients (me included) have come to expect quick fixes for all our ailments. We have so much available to us, and we have become accustomed to expect a medication, injection, or surgery to be the first thing that we, and many healthcare providers, go to in order to solve all our problems.  It’s just become the normal way of thinking and the normal thing to do. Until you actually have an injury and are in pain, you may not think much about these options. Being in pain affects your emotions, which then can affect your decision making skills. When my injury occurred, I immediately wanted an instant fix. I was in a lot of pain and wanted it to stop. It wasn’t until later, through physical therapy, that I started to realize I had some control over my situation and could play a big role in my own recovery, as well as prevention of future problems. (More to come on this).

Obviously you can’t just do a “quick fix” all the time, and you need to find out what the underlying problem is so it doesn’t keep happening, causing a more serious issue. Think of it like if the pipes in your house kept leaking and you never looked at why. For years and years you just keep plugging up the different leaks, but then one day all the pipes burst and you are standing there wondering what the heck happened!  On the flip side of this… you also don’t want to rush and replace all the pipes in your house immediately, just because you found one leak. What you need to do is find someone who is knowledgeable, honest, has common sense, and will be willing to refer you to a better plumber if he is not sure how to fix the problem. What you don’t want is someone fixing something that isn’t broke, creating more problems, or making absolute claims on how to fix things after being in your house for two minutes without even doing an inspection of the pipes.

There are plenty of wonderful healthcare providers out there, but there are also plenty of mediocre and not so good one’s as well.  The problem is that healthcare is sometimes like trying to navigate a maze with a blindfold on, and finding those great providers or treatment options isn’t always easy. Let’s be honest here, healthcare is a “business” driven by “numbers”, with the patient sometimes left holding an empty bag. Don’t even get me started on insurance companies!   Yes…. I am somewhat to blame here for being a clueless patient and thinking anyone with a credential after their name was an expert.My flawed mentality eventually got me into hot water, but I’m not taking all the blame on this one! I had plenty of people with this same flawed thought process keeping me on sort of a “healthcare merry-go-round.  They kept depositing quarters for my ride until I eventually had enough sense to throw myself off it, landed in a ditch, and had to call the PT tow truck to help me get out of trouble.

With all that being said, I want to make it clear that next week when I tell you about the ridiculous details of my healthcare story, I am not trying to throw anyone under a bus. Whenever you learn a life-lesson, there is ALWAYS a back story… and a back story you will get. Sometimes you just have to say how it all went down!

Fun Term Of The Week – Quick Fix: An easy remedy or solution, especially a temporary one which fails to address underlying problems.

UP NEXT WEEK…… The Merry-Go-Round and The Making of a Mess…. Stay Tuned!