THE GREAT DECEPTION
A really friendly, energetic middle aged lady recently was at Peak Performance PT for her Low Back Pain and Radiating Leg Pain. We’ll call her Suzanna for the sake of our story. This is kind of like the old Mission Impossible where the recording would self destruct seconds after playing. Our HIPPA laws require confidentiality so rather than inventing a space age Memory Zapper that would pop out of this email to erase her actual name from your memory, it’s easier to just go the fictitious route.
I wanted to share Suzanna’s story with you because it’s a really common mindset out there that I think I can help you better understand. Suzanna had been going to the Health Club for years, doing classes along with weight machines and cardio machines. She felt pretty fit and really didn’t have any complaints.
But then her bubble burst and about two months ago she developed not only Low Back Pain but she was also getting radiating symptoms into both hips and thighs. That really stinks. The back pain is something many of us are familiar with. In fact, studies suggest that humans are 80% likely to have at least one episode of significant Low Back Pain in their life – to such an extent that it limits function.
Suzanna’s pains into the hips and thighs were a different thing though. That was a bit of a wake up call to know this wasn’t just some tiny little back pain episode that could be ignored. It’s especially hard for someone like her who enjoyed going to the club and being active so much. It was really cramping her style.
Recently during a treatment when I was sharing with her some of the shortcomings I’d found on testing, she said something to the effect of “But I was just healthy a month ago….I was fine. I was working out three days a week. How could I have all these issues when I exercised so much?”
BINGO! That was the Million Dollar Question.
She was flabbergasted. Maybe she was thinking that she put in all that time yet was being told her body wasn’t quite the Picture of Health ….that it wasn’t that idealistic example of what dedication and consistent hard work could result in. Maybe even in the back of her mind imagining her Health Club grown fitness served as a shining example to her peers of how good middle aged bodies could look and feel with a little work. Nope! Reality had set in and she was not a happy camper. She was frustrated, disappointed and then throw in a little confusion!
I can shed a little light on this for you and that day I explained the same thing to Suzanna. You see, when you do rhythmic activities like running or the elliptical machine, complex activities such as actual sports that require timing and reaction and especially contain significant components out of your control, or when you’re using both limbs (ie. both hands or both legs) simultaneously your body will do whatever it can to accomplish the end goal.
Whatever you “bring to the table” you will use. If you’ve got a little left sided hamstring tightness you’ll still run on that treadmill. Your body just adapts and cheats – or a nicer word to use is “compensates” around that tight hamstring. It doesn’t usually stop you from actually running, but it also isn’t the case that the exercise – the running in this case – will actually stretch out that tight left hamstring.
The same is true for an Aerobics or Boot Camp class, playing soccer or baseball or golf, being active in the yard at home, or having a physically demanding job. All those things are great activities to challenge your body and contribute to overall fitness. Your body will do whatever it takes to do what you tell it to do.
So Suzanna, all the while she was enjoying and relatively succeeding in all of her fitness endeavors, nevertheless, had a number of important limitations that little by little were adding up to eventually overstress her tissues….and, in the end, result in pain and inflammation that led her to seek out help.
I’m glad she came in for Physical Therapy. The Evaluation picked up some areas she needed to work on and she’s improving now that she’s doing exercises CUSTOMIZED for her own unique needs. I reminded her that it was critical that she specifically addressed the areas I found deficient because the generic exercises she’d been performing at the Health Club, things that were total body in nature and often rhythmic or alternating in nature, were just never going to help undo the asymmetries and imbalances she had.
Suzanna asked “Well how is anyone ever supposed to know these things are wrong with them? Who is going to find and fix these issues?” That’s where we step in as Physical Therapists. PT’s are uniquely trained in musculoskeletal evaluation and the non-operative management of those things that ail you. The Functional Biomechanics training that Mike Golisano, Karen Napierala, and myself have gone through helps us even more to be prepared to evaluate your Function and figure out the best ways to quickly get your body working the way you hope it can.
So remember – you can’t fix asymmetric physical deficiencies with bilateral or generic exercises!
Peak Performance Physical Therapy first opened its doors on January 17, 2005 and since that time we have helped over 3200 local patients with their Physical Therapy needs!
We would like to thank each and every one of you for placing your trust in us with not only your own rehabilitation but for having the faith and confidence in our work to refer your friends and family to Peak Performance as well.
It has been a blessing to help so many people in the Rochester area recover from simple overuse injuries to post-operative care and everything in between.
We look forward to many more years of helping you, your friends, your family and our community members get back to their Peak Performance!
Just a few days ago I was working with a patient, we’ll call her Pam, and spent some time talking about the pain she’d been having in her hip – especially about the flare up she’d had the prior weekend.
I asked her lots of probing questions, trying to piece together the details of how she’d gotten herself into trouble. Pam ended up being really insightful as she reflected on her answers.
I figured Pam’s introspective discovery would ring true and be helpful to many of you out there, or to family or friends you pass this on to.
In Physical Therapy we so often have to deal with fluctuating symptoms that a patient offers. These changes from session to session – from day to day or week to week, can be a real source of confusion and oftentimes can lead you as a patient to poor decision making.
Pam had been seeing some really encouraging progress since coming to Peak Performance PT for her hip. It had actually been a problem for years and she’d had PT before but it mostly entailed typical standardized “hip PT exercises” that one might expect.
Her Physical Therapy Evaluation I performed ended up revealing some important specific issues that I felt would benefit from manual therapy techniques (hands on methods of promoting motion in the joints and/or connective tissues) along with some customized functional exercises (a weight bearing joint like the hip really appreciates exercises that look and smell like the “function” they do each and every day - vs. a generic “give the same exercises to everyone” list of lying down or sitting exercises with the foot off the ground).
Pam was feeling so good that one day over this past weekend she decided to spend a few more consecutive hours working than she had the prior weeks/months. It didn’t seem to her an impressive amount of work compared to “what she used to do” when she was healthy. (Does that sound familiar to any of you out there……”But I used to …” or “That’s nothing compared to ….”?)
Pam made a common fatal mistake – some of you have done, or maybe even right now are doing the same: a good few hours or days = “I’m better” or the opposite a few bad hours or days = “I’m worse.” But are you really sure you’re actual condition is “better” or “worse” – or are you just having a few good or bad hours/days?
Your answer to that question is critical!
Pam’s joy over feeling better lead her to recall years ago when hours of continuous work at her computer was no problem at all, and then mistakenly think her body was right back there too – in a healthier and prepared state, ready for hours of uninterrupted stresses.
Well, unfortunately Pam’s hip quickly reminded her a few hours later that her leap from the sense of “feeling better a few days” to literally being considerably better was a mistake. She needed more time of extended “better” days to add up to actually being able to increase her work by 200-300%.
Pam offered a great insight as to how that happened to her. Think about this a bit – it may resonate with you some.
She shared that “When you’re having bad days you feel like they’ll go on forever” and that it causes so much worry and concern and hopelessness. You get tired of always having to modify your activity, your work, your recreation.
What she said next was really interesting – I guess I never thought of it this way….she said “When you have good days you tend to not think they’re going to stay for long” and feeling that way makes you want to do what you can while you have the chance.
Are you feeling the hopelessness of pain or limitations that are holding you back from your normal activities? Have you had to cut back on your work activities? On your fitness activities? On your recreation, your fun?
You can really dig a big hole for yourself when you experience a few good hours or days and make the leap to thinking you’re all better and ready to roll. The opposite mistake is thinking that a few bad hours or days mean you’ve slipped backwards and the injury is literally worse. Keeping perspective can be really tough can’t it?
At Peak Performance PT we are dedicated to providing our patients with a thorough evaluation and designing a custom treatment program to help you get back on track. Every single day I find myself helping to remind patients to keep perspective on the fluctuations they might have in symptoms. You have to balance the attention to detail of those changes with a “big picture” sort of view – so you don’t make poor decisions that get you in more trouble down the road.
Pam hit the nail on the head for many of you…the frustrations and hopelessness over symptoms that are so slow to change can lead to a sort of time-sensitive pressure to “enjoy it while you can” when you do have a lack of pain.
Give us a call if we can help you or your friends and family with their injury or surgery.
And thanks “Pam” for that little bit of wisdom!
Peak Performance PT would like to announce that our Office Manager, Robert Morrison, is moving on to work his own business.
We thank Robert for his years of service and for contributing to our successes, and really also for helping you be successful.
He has helped tremendously by sharing with each of you what is going on at Peak Performance, developing and working our Annual Coat Drive to donate to our area youth and adults for their winter needs, and providing valuable tips and reminders through the excellent website and newsletters he is responsible for.
He has helped some of you with insurance or billing questions and explaining the ever-changing process known as health insurance coverage when confusions arose.
We believe that each of our staff plays an important part in your recovery, not just your actual Physical Therapist.
We couldn’t provide you the quality care we work towards without the diligent and caring efforts of each of our staff.
So please join us in thanking Robert for his work and wishing Robert the best in his new endeavors.
The Peak Performance PT staff remain excited about our future.
We continue to see an increasing base of referring physicians and surgeons but especially have seen a growing number of word of mouth referrals from prior patients like yourself.
So many of you have also offered your heartfelt and sincere words of thanks and success stories as well.
Thank you – I know that your words of encouragement and successes have been uplifting to prospective patients searching our website for information about Peak Performance.
We look forward to serving you and your family and friends in 2012!
Mike Napierala
Owner, Peak Performance PT
You can leave a message for Robert at the bottom of this post if you would like to do so.
HOME SAFETY CHECK:
Image: Rawich / FreeDigitalPhotos.net
If you have fallen previously, you may be feeling nervous, anxious, or even helpless about moving around in your home, or in new environments.
We at Peak Performance PT want to make sure that you are able to do the activities you desire.
Here is something you can do TODAY to “fall- proof” your home! (See prior posts on medical checks, and assessing your risk for falling.)
Remember, this is only one starting point. You still have your physicians check, and exercise which will be the next and final Fall Prevention Program.
Let’s go through your home room by room…..
FLOORS: Be sure to look in each room.
- Ask someone to move the furniture so that you have a clear path from room to room.
- You can either remove throw rugs, use double sided tape to hold them down or make sure they have a non-slip backing so they don’t slide around or bunch up.
- Always keep objects like magazines, shoes, or towels off of the floor. If it is difficult to do so, there are a wide variety of “reachers” available at local stores (i.e. Debbie’s Supply in East Rochester), or on-line, that will allow you to reach high or low places to pick up light weight objects without getting into a position that puts you off balance.
- Coil up or tape cords and wires next to the wall so that you do not walk over or trip on them.
STEPS AND STAIRS:
- Always keep stairs free from ANY objects.
- Fix loose or uneven steps.
- Have an electrician, or family member put in a light at the top AND bottom of the stairs! Both top AND bottom should have light switches. If they can get light switches that glow, that is even better.
- If you have a light that is burned out, ask a friend or family member to change it.
- You should make sure your carpet is firmly attached to EVERY step, or remove the carpet and apply non-slip rubber treads instead.
- Place a bright colored strip of tape at the top and bottom of the last stair, especially in stairwells to the basement, or garage, where it may be difficult to see.
- Fix or attach handrails to both sides of the stairwell. They should run the entire length of the stairs, and be able to hold your body weight if you were to slip and grab a hold of them for support.
KITCHEN:
- Rearrange your cupboards to have the things you use most on the middle shelves. Waist to shoulder level shelves will be the easiest to reach.
- If you must use a step stool, get one with a bar to hold onto. It is MUCH steadier than a chair!
BATHROOMS:
- Put a non-slip rubber mat, or self stick strips on the tub or shower floor.
- Have a carpenter or handyman (or woman), attach grab bars inside the tub/shower stall, and next to the toilet if necessary.
- Consider a night light in the bathroom, and/or a non-skid shower chair.
- Avoid pulling yourself up by the sink. They are often not secured to the wall well enough to support your weight.
- Consider a hand held shower head if you need to sit in your shower.
BEDROOMS:
- Place a lamp close enough to reach while you are in bed.
- Keep a flashlight nearby your bed also.
- Clear a path from the bed to the bathroom. It should be lit by at least a night-light, preferably one that goes on automatically when it gets dark.
- Keep emergency contact numbers in large print near each phone.
LIVING ROOMS:
- Avoid sitting in low furniture or chairs with no arms, as these are difficult to get out of. Remember, you should always be able to touch your feet on the floor when seated. If not, try a pillow behind you. Use chairs that are firmer, and have arm rests.
GENERAL:
- Wipe up ALL spills immediately.
- Change the batteries in your smoke detectors when changing your clocks for daylight savings time. If it is too high, ask for assistance.
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