There's a term we use in physical therapy called "respect the healing process." I've decided to shed a little more light on what we mean by this. Ultimately, the body is supposed to go through certain processes after an injury. These phases are inflammation, proliferation, and remodeling. Each phase has its frustration with respect to our patients. Contrary to popular belief, physical therapy will not make any of these phases go FASTER.
The inflammation phase is the immediate response to an injury. It is the swelling and the PAIN! Physical therapy works to help manage this phase through soft tissue work, light joint mobilizations, TENS units, exercise for facilitation and activation of surrounding musculature, gradual return of range of motion and more. The goal of getting into physical therapy this early is so that we can be prepared to move into the next phase: proliferation.
The proliferation phase is when most of the scar tissue will form. Scar tissue is a key component to healing. Whatever tissue we injured NEEDS scar tissue to heal. It reinforces the injured tissue. During this phase, physical therapy targets progressive loading of muscle and tendon structures through exercise. These techniques coupled with hands on work will help reduce excessive scar tissue formation. These treatments help prepare us for the last phase: remodeling.
The remodeling phase is when we restructure the scar tissue to align appropriately with the component it is trying to heal as well as increase exercise demand and tolerance for the surrounding areas. For example, if the achilles tendon was injured or slightly torn, we will emphasize exercise and hands on work to promote the vertical nature of the fiber alignment in the achilles tendon. This is also achieved with select tissue loading that is usually more weightbearing and functional.
This is the phase where physical therapy transitions to a routine more targeting your goals. If you want to get back to hiking, we will start lunges and squats. If you want to get back to running, we would start light plyometric and speedwork. These exercises are built upon the exercises you've been doing in the proliferation phase. As you can see from the chart above, this is the longest phase of healing. I always like to tell my patients that once you injure a structure or tissue once, you are at a greater risk of injuring it again. Physical therapy will give you all the keys and exercises necessary to reduce this risk as much as possible!
The phases of healing are overlapping in nature but never to be rushed. Physical therapy guides each patient individually through inflammation, proliferation and remodeling to ensure the best recovery and reduce your risk of re injury. A key component during your physical therapy experience at Altitude is that we will identify how you injured yourself in the first place which I have found is the best approach to not letting it happen again! Remember, you can start physical therapy even BEFORE you get injured, too! :-)
For more detailed description of the phases of healing, please see the image above or visit: https://www.physio-pedia.com/Soft_Tissue_Healing
Lisa Corken, PT, DPT
ANSWER: It depends
Yoga is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India. Yoga is one of the six orthodox schools of Hindu philosophical traditions. There is a broad variety of yoga schools, practices, and goals in Hinduism, Buddhism, and Jainism. The term "yoga" in the Western world often denotes a modern form of Hatha yoga, yoga as exercise, consisting largely of the postures called asanas.
Is Yoga safe?
In order to teach Yoga you have to study five areas:
Studies have found the incidence of pain in Yoga practitioners caused by Yoga is more than 10% per year - which is comparable to the rate of all sports injuries combined among the physically active population.
There is some evidence that regular Yoga practice is beneficial for people with high blood pressure, heart disease, aches and pains - including lower back pain - depression and stress.
The National Center for Complementary and Integrative Health (part of the NIH) suggests the above findings, however they note "Although there has been a lot of research on the health effects of yoga, many studies have included only small numbers of people and haven't been of high quality. Therefore, in most instances, we can only say that yoga has shown promise for particular health uses, not that it has been proven to help".
Created by Joseph Pilates in the 19302, Pilates was first called Contrology and inspired during WWI while held in camp for four years. Joseph was a nurse-physiotherapist and his goal was to create lifelong sustainable exercise at a low cost. Pilates recognized that the brain controls mobility and stability of the body. Specific muscles are used in a functional sequence at controlled speeds - emphasizing quality, precision and control of movement. Complex movements are broken down step-by-step to internalize the pattern.
Regular practice should lead to:
Yoga and Pilates compared
Similarities: strength, flexibility, fitness, importance of breath
Differences: Pilates emphasizes core strength while yoga emphasizes flexibility
So should I do yoga or Pilates?
Depending on classification it may make sense for you to do one or the other, or both, or possibly neither!
How do I know my low back pain classification?
See an expert at Altitude! All our physical therapists are experts in identifying movement patterns and dysfunctions as well as classifying the best way to treat your low back pain!
Caitlin Barritt, PT, DPT, OCS
One of the things I absolutely love about the physical therapy profession is our ability to teach our patients how to take care of themselves. We are so fortunate to have the education and knowledge to help our patients prevent further injury to the best of our ability.
The answer that any business-minded physical therapist will tell you is that you should ALWAYS come see us! But that’s not always feasible for everybody… I will tell you that I firmly believe you should seek guidance whenever you start a new workout or exercise routine to ensure proper form and reduce your risk of injury. As human movement experts, physical therapists are more than qualified to help smoothly transition and initiate new exercise regimens.
In my 8 years of working as a physical therapist, I’ve learned a lot about what someone’s body can tolerate in terms of exercise and physical activity. Here’s a pretty unpopular opinion: body aches and pains are normal! Of course everyone wants to be pain-free all the time, but that’s just not reality. In fact, it’s why the phrases like “it hurts so good,” and “feel the burn,” even exist! Working out and exercising pushes our body beyond its limits so it can continue to strengthen and improve.
Back to the question at hand: self care versus physical therapy. As I mentioned above, always seek advice and instruction prior to initiating any new workout or physical activity to avoid injury. That being said, my advice, which may differ from other physical therapists, is to evaluate your pain/discomfort on three aspects:
If your pain is piercingly sharp, my recommendation is to seek physical therapy right away. If the pain lasts longer than 48 hours, I recommend getting it checked out. Lastly, if the pain is super consistent - for example every single time you step downstairs it hurts in exactly the same way - having someone fully evaluate it is the best way to go.
Our body will have aches and pains here and there when we transition into a new workout routine, or go skiing for the first time in the season, or initiate a running program after sitting on the couch for months. These are expected and relatively normal. However, if you notice that the pains become sharp, last a long time, and are consistent - give us a call! To get you started with your new routine or evaluate your pain, we can utilize our telemedicine platform! This allows us to gather a full history of your pain/injury and complete a movement screen. Then we can get you started on your road to recovery as quickly as possible through exercise and advice - and ultimately avoid serious injury!
Lisa Corken, PT, DPT
If you’ve ever had pain in your jaw (or currently have pain in your jaw) you’re not alone! According to the National Institute of Dental and Craniofacial Research, the prevalence of jaw pain is about 5-12% of the population. It is more common among individuals aged 20-40 years and is about twice as common in women as men. Jaw pain can range from a mild annoyance to something which is so severe that it limits an individual’s ability to talk, eat, and brush their teeth. Many providers - physicians and dentists alike - don’t quite know the best way to address their patients’ jaw pain, and many people have no idea that physical therapy can be so helpful in treating this condition. Before I tell you how physical therapy can help, let’s get a little better understanding of the anatomy of the jaw and the various things that can go wrong.
When we talk about jaw pain, we are usually referring to the temporomandibular joint, known as the TMJ for short. You can feel this joint just in front of your ears, try it! Place your fingers at the back part of your cheekbone just in front of your ear and open and close your jaw. That’s your TMJ! A fun fact is that you can also feel the TMJ move if you put your finger just inside the tragus of your ear, which is the little cartilage flap on the front of your ear. If you place your finger just on the inside of that and open and close your jaw, you can also feel your TMJ moving. The joint you’re feeling joins your mandible (jaw bone) to the temporal bone of your skull. There is an articular disk that separates the two joint surfaces.
When you come to physical therapy for jaw pain, you might be told that you have temporomandibular dysfunction (TMD for short.) This just means that something in that joint, or the structures surrounding that joint, isn’t functioning properly. Symptoms of this can be pain, clicking, popping, grinding, clenching, or tightness. It is important to note, though, that popping or clicking on their own don’t necessarily mean that something is wrong and that you need to seek treatment. In the absence of any other symptoms (such as pain or tightness,) clicking and popping can be just fine. Sometimes, you can also get symptoms which might not seem directly related to your jaw but can be associated with jaw dysfunction. These can include neck pain or stiffness, headaches, ringing in the ears, and even dizziness. These symptoms can be caused by dysfunction of the joint, the muscles around the joint, the articular disk, or any combination thereof. Your physical therapist will help narrow down which structures to focus on based on tests and measurements performed at your first visit, as well as from taking a thorough history to better understand how your symptoms began.
Treatment for TMJ pain often includes a combination of techniques including joint mobilizations, soft tissue techniques, home exercises, and even dry needling. Your therapist will tailor your exact treatment plan to you based on their findings at your initial evaluation. With this individualized treatment plan, physical therapy can be highly effective at treating any unpleasant jaw symptoms you might have!
Heather Shaughnessy, PT, DPT
Bob Cranny, PT