Shouldn’t it be simple to find a skilled physical therapist? Alas, not necessarily, as my search for physical therapy — make that effective, quality physical therapy — continues. Will it be three strikes you’re out or third time’s the charm?
My objective isn’t rocket science: Achieve improvement in the underlying conditions that constrain and cause pain, and alleviate at least a measure of the pain itself. Pretty reasonable, don’t you think?
Of course, this is a chicken-and-the-egg situation — the less pain you’re in, the easier it is to do the exercises that manage the underlying injury or condition; when you improve the underlying issue, then there’s less pain…
The Thigh Bone’s Connected to the… HIP Bones…
Remember that silly kid song about bones? It’s an irritating ditty with a tune that sticks… “The thigh bones connected to the… HIP bones… the shoulder bones connected to the… ARM bones…”
Right. That’s what pops into my head these days as I come to grips with my (amusing? obvious?) new reality: Physical therapy is trickier with multiple problem points to address — shoulder, back, legs, etcetera — and in the past five months of attempting to find a physical therapist who gets that… well, let’s call it the way it is. Two long waits for an appointment, two different therapists, two locations, six sessions total… and two strikes!
Hey! Anyone for a pinch-hitter? I want out of this game!
And to think I’ve been a poster child for PT success previously, as long as treatment has included a combination of manual manipulation for the affected areas along with exercises with the therapist as well as at home.
Unfortunately, the main healthcare provider in my new locale is, by policy, not delivering any “hands-on” treatment as part of their menu.
Color me confused.
Moving on…
Choosing a Physical Therapist
Funny thing. I’ve been in and out of PT for four years. During that time, four of the five physical therapists, each with their own style, were “good” to “excellent.” Three out of the five worked with me to achieve real progress.
What screwed me up? My moves. Oh. so. physical. And then there is the fact that I still think I’m 35. Okay, 40. Bending, reaching, lifting, hauling.
I know. Dumb. And months later, I’m still paying for the weeks of overdoing it, and I likely will be paying until I can get the therapy I need to help me out of this cycle of pain and periodic immobility.
What I require: a good physical therapist! One who understands that I am a single interconnected unit (that little skeleton song, remember?), and home exercises I’m given for one area can’t cause a massive flare-up in the others. Logical, yes?
Now, here’s my criteria for a good PT:
- Ability to explain what they’re doing
- Ability to listen and adjust based on my physical responses (improvement, pain)
- Interpersonal skill/discretion (compassion, especially on days when pain reduces me to a puddle of tears)
- Knowledge (that they can share and I can learn from)
- Directing me through exercise
- Trying new things (creative problem solving)
- Manual tissue manipulation (neck, back, hip, legs, shoulder, arm)
That last? Absolutely vital. It reduces the pain sufficiently so that (a) I feel more human, and (b) I can begin to work (again) on strengthening and resetting the areas that are problematic.
What else? I always check out the person who is treating me. It’s easy enough to Google and see credentials, experience, and reviews.
Next on My Healthcare Hit Parade
After four years of this, I’m a discerning judge of how to choose a good physical therapist. However, my current conundrum: The choice hasn’t been mine or so it seems, with what appears to be a shortage of providers where I’m located. This makes initial “new patient” visits take months, and months, and months… I’m still waiting just for a routine GP appointment! (Six months and counting.)
And PT? Those were each two-month waits, one after the other, and the result (twice), a bust.
Now, not being one to give up — what help would that be? — I’ve turned again to the Google! And the phone. And a stubborn streak I shall euphemistically refer to as “persistence.” This trio has yielded one more possible provider with a seemingly holistic practice that includes manual therapy. Having had a long conversation with their head honcho — Break out the Moët! That in itself is a good sign! — I’m cautiously optimistic.
I was invited to ask questions. (Imagine!) My questions were answered. (Go figure.) And I was given several resources to read (and sent links on chronic pain).
The best indicator? Wonder of wonders, remarkably, I was assessed in all the parts that are problems… as if I am a single integrated living being! And we discussed a plan of attack. (Common sense can be a scarce commodity, but much appreciated.)
So I’m hopeful. Really hopeful. I want out of the box I’ve been existing in for months. I want to move beyond the frustration of knowing what will help yet being utterly unable to access it. I want to believe that this city I’ve moved to will work out, and routine healthcare is a must! (Note: I’m purposely avoiding discussion of absurd costs, not to mention prescription costs, even with insurance.)
Happy Face? Hidden Face?
On a lighter note, when my mind is occupied, especially with a project I find intriguing (or when my boys are visiting), I’m a happy camper. Pain is easier to set aside, or set “on the shelf” which is how I think of it — still present, still palpable, but more manageable. Unless, that is, it exceeds what I envision and experience as my very own Magineau line.
On one side of the line, I’m fully functional. My public mask may loosen a tad, but it remains in place enough to smile at strangers, carry on conversations, work at my laptop, and go about my business.
On the other side of that damnable demarcation?
I’m crawling out of my skin. I’m up, I’m down, I’m horizontal, I’m inclined. I’m guzzling herbal tea. I’m wrapping parts of my body in heating pads. I’m cursing. I’m crying. I’m counting down to my few hours of sleep when dreaming vanquishes pain. It takes every ounce of will power to get on with my day. And of course, I do. Don’t we all? But I get on with it behind closed doors. Hiding. Hurting. Just dealing. What else is there?
It’s a dreadful, draining way to live. You’re self-involved. You’re impatient. You’re cranky. You withdraw.
You feel helpless. Hopeless. Angry. Especially when you know what will help, you know it isn’t rocket science, and it’s utterly out of reach.
Thankfully, when hard-core (addictive?) pain meds were offered years ago, I refused. That’s one battle I don’t need to fight. And a very recent experience of “therapeutic massage” proved helpful. For a few (blissful, low-pain) days, anyway. But therapeutic massage, which significantly overlaps with PT manual therapy, is not covered by insurance. A 30-minute session is a sizable chunk of change. It just isn’t something I can afford on a regular basis. How ridiculous is it that an effective, non-pharmaceutical means to alleviate pain — therapeutic massage — isn’t covered by insurance?
No, in the American healthcare system, we would rather drug you. It’s profitable! Yes, yes, I know. I get testy on this subject. I’ll leave it alone for now.
Pain Brain
Information is empowering, don’t you think? Among the helpful links provided by the new facility was a video clip, amusing and illuminating, demonstrating changes to the brain that result from chronic pain. I’ve never been directed to information of this sort before, though I’m definitely aware (through reading and my own experience) that chronic pain takes a toll.
Known by some as “pain brain,” there is a sort of rewiring that occurs, and learning about it is helping me understand what the new PT wants me to: Along with working through inflamed soft tissue, reconditioning and strengthening muscle, and restoring flexibility, I need to retrain my gray matter. It’s something I’m looking forward to, an element of healing that has been missing these past years, and an element that I hope will help.
It’s only logical that chronic pain will change us as this article explains; we know that it affects mood, sleep, memory, even relationships. How could it not? The sleep-pain link is obvious enough; sleep-deprivation alone will affect cognition.
Another article I found interesting is from Cleveland Clinic on why the brain hangs on to pain. This is new information, or rather, an expansion of something the last therapist I saw (for my hand) was describing – trying to fool the brain when it recognizes danger (pain), though the original cause (in my case, injuries) is no longer there.
Information encourages hope. And that’s a word I’ve used a few times here. It’s a word I was beginning to forget. It’s a word — and a concept, a belief, perhaps a “practice” — that’s crucial to any sort of healing.
So, will this be it? A place where I can make progress? Might I power past those two strikes and hit a homer? Third time’s a charm?
I don’t know yet. But I’m hoping for yes.
You May Also Enjoy
On and off I’ve had chronic back problems after I drug a sofa up three flights of stairs. Duh! What did I think was going to happen? I didn’t think! I was early 20’s and invincible. While my problems aren’t as chronic as yours, when they’re here, it’s mind numbing pain that’s difficult to sit, lay down or sleep. I sympathize. I have an excellent PT and a great deep tissue masseuse… hope to see her on Saturday! I can’t imagine living with that kind of pain like you do… xoxox, B
A good PT is worth their weight in gold, for sure! Thank you for the positive energy. (And today is a low-moderate pain day, so I’m good! Having a busy, productive day.) ?
It’s great to hear that you are trying out another therapist, D.A.!
No two therapist are equal!! From what I’ve read on your blog, you have experienced an assortment.
In my late 30’s, I had success with a physical therapist that treated specifically whiplash after a car accident. Only 6 – 30 minute sessions to do the stretching techniques to loosen the strain and then to teach me the stretching exercises (no massage) that I would need to use the rest of my life when it flares up.
The second time was a sports injury playing racquetball which completely destroyed my ACL. My doc said it was a sprain to ice and walk an hour every day to build muscle strength in my legs. Doc was wrong. After 9 months, still in pain, so she sent me for an MRI and surgery was required. Physical therapy was painful but necessary for range of motion. There was bending my leg, learning to walk again and balance exercises (no massage) for 6 weeks, weekly, then the rest of the exercises was up to me in my free time after work.
After a divorce, I found massage therapy to be most beneficial. When income was ample, I would go when in need of pain relief. I’ve experienced all sort of massage therapy. If I were extremely wealthy, I would go weekly with mixing up an assortment of massage therapist as all have different expertise.
Unfortunately, I’m no longer in that luxury work world affordability anymore. So I use a hot bath tub to soak and over the counter Aleeve for inflammation and nerve pain. I also microwave wet hot towels to wrap around my neck and osteoporosis arthritis areas.
So I’m wondering if a physical therapist, a massage therapist or a combination of therapy might be of value to your overall wellness goal.
Either way, getting out of your home environment into another environment even just for an hour a week for a short period would be nice and a type of self therapy; even if it is a discovery of what is available to you where you live now. Both my parents found going once a week the library good therapy.
Hope relief!!
Very interesting. It was my third physical therapist that finally relieved my post-operative back pain. The first two didn’t touch the body. Like you, I thought that was curious. It was my body, after all, that was hurting. They prescribed exercises, put me in the pool, stood me on balancing tools, and even tried the magic of light to make the pain go away. After a few applications of her special light to my back, I went back to the neurosurgeon and he referred me to a physical therapist with certification in functional manual therapy. He had no use for the toys and tricks the other PTs were using, he dug into my back and even inside the pelvis (that hurts mightily). He stretched muscles, he leaned on them with the weight of his elbows. He did everything but slap me around like a Marine recruit. (He was, as a matter of fact, a former U. S. Marine.)
His therapy was painful in the administration, often leaving me barely able to walk. But within an hour, my core muscles had relented and allowed me to move about pain-free.
I once told him that he seemed not to care about my pain. He looked at me and said tenderly – marine tenderly), “I care about your pain but I’m not intimidated by it. On your back now.)
I will always look for that certification: CMFT offered by the Institute of Physical Art in Steamboat Springs, Colorado.
In my adventure in back surgery, no health professional helped me any more than the physical therapist, at least the one with CFMT after his name. He made me a great fan of his profession.
Very helpful (and hopeful) information, kind sir. I hope your back is doing well. Coming “back” from back surgery must be extremely challenging.
My last physical therapist – the one that was so good – did indeed dig his thumbs into certain spots, and put his full weight into specific stretches of my hips and pelvis, not to mention using his palms to stretch me along my spine. Not exactly comfortable, but extremely helpful. I am stunned that I have been unable thus far to find a PT who uses this, what I considered routine, practice.
As I begin with this third PT, I will now ask about the certification that you mentioned. Thank you so much!
OH I SO GET IT what YOU have been through!
MAYBE WE NEED TO LET THEM KNOW WE ARE TELLING THE WORLD HOW THEY PERFORM?
I have been told as of yesterday I have COMPLEX MIGRAINES!
TOOK Over THREE YEARS TO COME TO THIS…… and I had to go OUTSIDE MY REGULAR CARE and pay THOUSANDS to get this diagnosis!
KNOW anyone who has this type of headache…….?
I will be doing MY OWN INVESTIGATION.
POTS have been thrown to the wayside and now THIS!
BIG HUG
XX