Upper Back Pain
There are many fine physical therapy clinics in the Olympia, Tumwater and Lacey area. How do you chose where to go?
You can choose based on location. A friend of mine told me today she chose to go to physical therapy at a clinic close to her house. What would prompt a close choice versus reputation? Maybe she needed to go 2 or 3 times per week. If someone needs to go to PT 2 or 3 times a week for a month or so, then going close to your house would be very convenient, HOWEVER, ask yourself the question: does your condition warrant 2 or 3 times per week?
Recently a former patient returned for a new session of physical therapy. She is a fairly frail 80 something year old, and was sent for BOTH headaches AND shoulder pain by her physician. Her prescription from the physician was directed to be 2 to 3 times per week for 4 to 6 weeks. She may have thought she needed to come that often, but…….when I evaluated her headache AND shoulder pain, I determined that both problems were mainly caused by the same anatomical structure.
I gave her an exercise program based on this one problem, and added customized and specific exercises for the shoulders and neck. As of Friday (January 30) 100% better in the headache and 75% better in the shoulders. She came for 6 visits at 1 x per week.
So the bottom line is, unless you actually NEED to have therapy 2 or 3 times per week consider going somewhere that uses less visits more effectively and you may save yourself some time and money.
The therapists at Comstock Physical Therapy, Joyce Mills, Lori Waterman and Linnea Comstock have extensively studied the body to make our exercise programs very effective and efficient. Give us a call if you would rather go to PT once per week instead of three times a week!
I saw the question in the header on the Magnoliatherapyla.com FAQ website and thought to myself , “that IS a good question.”
Being an independent, strong-minded boot strapper I know I would wonder, “why can’t I just do it myself.” “I can save myself some money.” AND in the short run that may be true, but in the long run, it could be penny wise and pound foolish.
What if I have back pain; can’t I just “strengthen my core” and get better? It is true that much of your back pain will just go away with time…and it will come back unless the deeper core muscles are strengthened, GUARANTEED! How do I know? Our reflexes are meant to protect us, and before we get hurt, our deeper core muscles (defined as transverse abdominis, pelvic floor, multifidus and diaphragm) work together to contract in the just the right way and time to keep us stable BUT…(and this is a big BUT) after a back injury the smaller muscles get screwed up and they begin to misfire, and the larger bigger stronger ones take over…and that….ladies and gentlemen, means that there will be a lot of compression on the back discs and joints and that will lead to arthritis.
It’s a lot like caring for a car or truck…keep up with the 3000 mile oil changes and that baby will hum for a long time but avoid them and they break down a lot sooner!
The video demonstrated below, by an orthopedic surgeon, shows the mechanics of why shoulder impingement happens with the tendons.
See the small space between the ball acromium? That is where the impingement happens. Making sure the supraspinatus tendon, which pushes the ball down as the arm bone is lifted by the deltoid, is working well is a big part of the picture of shoulder healthy function. BUT….if you raise the shoulder blade UP by STRENGTHENING the muscles which lift it up, (such as serratus anterior) and STRETCH muscles which PULL it down (such as latissimus dorsi) you can gain more space, which puts less pressure and pinch on the supraspinatus tendon.
http://comstockpt.com/2011/11/22/neck-pain-stretches-out-olympia-wa/ This link will show you some latissimus stretches, and if you refer to Part 1 in this series of blog posts, with the man leaning against the wall you can see how to strengthen the serratus anterior
Patients never really say it, but I can tell they don’t really want to commit to 2-3 times a week of physical therapy treatment. I’m not sure I would want to commit to that much time, given my busy schedule. So…..I often schedule patients 1-2 times a week unless they hurt really badly or they have an injury, surgery or goal that demands they come in 3 times a week.
If you’ve had a fresh injury like an ankle sprain, knee sprain, etc, PT right away is important to keep you as mobile and strong as you can be without making your injury worse. This idea applies to some surgeries (see the surgeries mentioned in this post http://comstockpt.com/2014/02/01/physical-therapy-hurt/). You may wonder, what happens if I don’t go to PT early on?
Let me tell you, it is BAD news! When you are in a lot of pain from an injury some muscles shorten up and spasm to protect you and other ones get shut down. As a matter of fact recent science has shown that the big muscle on the front of your thigh (the quadriceps) begins to get shut down by your central nervous system 12 hours after pain begins.
When your pain level is lower, and your condition not as fresh you can cut down to 1 to 2 times a week. Chances are you will do well at 1 x per week if you are consistent in doing the exercise program the therapist has given you for homework.
Talk to your PT, she or he will work it out with you.
People often wonder, if I go to physical therapy will it hurt? Sometimes I’ve heard people say “PT” stands for “pain and torture.”
So, does physical therapy hurt? This is the good news: most of the time the answer is NO!
When will physical therapy hurt? Once in a while the answer is yes, BUT that is because of the surgery you have had and the steps that you need to go through to get past the normal side effects of having a surgery. What surgeries will be more painful to rehabilitate from? In my experience as a physical therapist, new knee replacements seem to be the most painful. Second to that is shoulder surgery. The worse pain is usually there for a while only then gets better as you recover and move more, usually within a few weeks to a month.
When should physical therapy be comfortable? Most of the time physical therapy should be comfortable and make you feel better as each treatment progresses. The old adage of “no pain no gain” does NOT apply. When you have an injury, working weak muscles until they are tired will be a good limit of exercise; if you push past the muscle you are working feeling tired (heavy and achey) you might cause more pain because your body is working in its weak zone and that is when more pain happens.
Will there be soreness after my physical therapy session? It is pretty common for patients to feel sore after their PT appointment, especially your first visit because we have to have you move a lot to fully evaluate your problem. Sometimes after introducing a new exercise, or increasing resistance you will be sore too. You should not be in pain, however and if your soreness is there for more than 1-2 days, speak up on your next PT session because that is too long.
Most of the time physical therapy should be comfortable and leave you feeling good!