Pain.

Pain: no one likes it, but we all have it. Pain is crucial to our survival. It is one of our body’s first threat detectors. Without it we wouldn’t survive; limited awareness to threats, impaired learning from experiences and reduced adaptations to our environment would certainly lead to our demise.

Now, let’s consider our environment is the CrossFit box, OLY platform, gym, baseball field, half/full marathon course, etc. the list goes on and on for our Mobility Fit nation. How does pain fit into this life, and how can it be managed? We don’t want to “kill” or “eliminate” pain, but we want it to have purpose and run its course!

The orthopedic PT stereotype for treating pain is formulaic, protocol-driven, and a little on the boring side. This is where Mobility Fit takes a different approach. We see tremendous variability, challenging problems, and exciting opportunities. The majority of our athletes walk in our door with pain that doesn’t have a specific mechanism or an easy answer. How can someone be this strong and still have pain? How is there this much pain without an acute2 trauma or surgery?

Pain has been scientifically described as a descending mechanism from the brain and spinal cord for many years. Thus the treatment of pain was based on drugs and electro-stimulation technology. Now, with new studies they have found that pain is NOT a “one way street.” It is a dynamic process that involves Inputs, Outputs, and Processing.

What is Input? It is external information from your environment, and internal information from bodily tissues. Example: mechanical trauma to a muscle, bone, or ligament; temperature changes; and chemical inputs like inflammation.

What is Output? How we perceive pain, stress-regulation programs and action program; involuntary and voluntary (like squatting, running, clean and jerking, throwing, etc.).

What is Processing? This is what happens in our communication network of the nerves that allows and keeps the whole system working together.

Why is it important that your physical therapists know this nerdy stuff? Because we are the ones that have the knowledge of what Inputs to put into our athlete’s that will positively affect their Outputs!

Inputs known to greatly affect outputs, and reduce pain include the following:

Cognitive-related brain areas: We realize the vital importance of education. If our athletes don’t cognitively understand their injury and treatment, we skipped one of the greatest influences on their pain reduction. We get the time to educate at each session; knowledge is power over your pain!

graston+scarSensory signaling systems: Skin, organs, muscles, tendons, ligaments, and soft tissue inputs. This is where the rubber meets the road for physical therapists. We have the ability to greatly affect our athlete’s pain and function through manual treatments such as trigger point dry needling and Graston techniques. We are able to literally mold the central nervous system with our hands! Exercise also fits in this category, and it’s our most powerful tool! We have gone to great lengths to assure we are at the top of this field. Our exercise prescription is thoughtful, functional, and progressive. This is where the real healing begins!

Emotional-related brain areas: Pain and emotions are greatly connected. As physical therapists at Mobility Fit, we are given the gift of time to work with our athletes. This allows us to listen and communicate with our clients on the level that most health professionals are not given. Sometimes the power of just listening, acknowledging, and having empathy with an athlete is enough to reduce a pain level.

Our bodies are not fragile. They are strong and meant to move. Your potential is great. Let’s appreciate pain for what it is and its importance, but let’s not let it rule our lives.

Treat. Prevent. Conquer.

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Post by the amazing and talented Dr. Mattie Betts, DPT

Dry Needling: A blog from a layman’s point of view

Since our therapists get certified in Functional Dry Needling, we have DN1had a lot of clients, friends, and family curious as to what Dry Needling actually is. I would have to include myself in this group, asking Kirk and Drew questions like, “Does it hurt? What does it actually do? Is it like acupuncture? Does it feel like getting a shot?” If you know me for a small amount of time you know I am all about questions. My friends call me whiskers… But back to the Dry Needling (or DN as I will later reference it because that is what the cool therapists are calling it and I want to fit in). I know you all have questions like, does it hurt? What does it actually do? Is it like acupuncture? Does it feel like getting a shot? Inquiring minds want to know, and I am here to answer those questions in common layman’s terms. My background in marketing and graphic design will ensure that no scientific terms will be used.

I’m guessing there are two types of people reading this blog. First, the person that wants every single detail and wants to know exactly what DN is, down to the last point. The other is the person that scans the blog post to get the overall information they want. This next sentence or two is for the scanner, detail studier avert your eyes. DN does hurt, and will hurt for a day or two (think muscle cramping and soreness from a really tough workout – my calves felt like they did after I ran the Flying Pig Marathon). The soreness will last a day or two, but is totally worth it because of how good your muscle feels (you may even show off to everyone, maybe even strangers, you know how flexible you have become. You are just that excited.). The results really are incredible; it’s like years have been taken off your muscles. Ok, so maybe three sentences. Detail diggers you can start reading again (although, if I know you, you read all of that anyway, you rebel, you).

So here is how a DN session usually plays out: One of our PTs will identify you may benefit from DN, they will then tell you what they will work on, etc, etc. Once the DN starts, the therapist will be looking for trigger points or knotted up parts of your muscle. They will place the needle into those spots. Here is the weird thing: you really won’t feel that much when the needle goes into your skin. They will sometimes even take the needle down to your bone and you won’t know. You should feel a dull achy pain, sometimes like a muscle burn you feel during workouts. Next the therapist will begin working the needle around trying to get the muscle to twitch. These twitches can be sudden, startling, and sharp but are what the therapist is hoping to see. The twitch is what releases the muscle and retrains it to fire correctly. The twitches will probably hurt and will not be pleasant. At least that is my experience. Are they worth it? Absolutely.

IMG_0257After a few rounds of releasing the trigger points, your DN session will be over. Your treated muscles will be sore. It will feel like you had a really intense workout and they may feel really stiff or tight. If you have ever had a Charlie horse in the middle of the night or cramped during a workout, it will feel a lot like that. So same thing with experiencing one of those, you need to make sure you keep moving, stretching, and drinking water. If you had a muscle in your leg worked on, it may be a little difficult to walk. That is perfectly normal. I was hobbling around like a pirate with a peg leg after having my calf worked on. Drew encouraged me to still go for a run that evening, so I did. It was a little rough going at first but after a few minutes I definitely knew which calf he had worked on. It felt so much better than the other one. The calf that did not get DN felt terrible compared to my freshly worked on. It got me thinking that both my calves had felt like this and I just thought it was normal. My next thought was, “When can I get my crappy calf worked on and where has this been all my life?!” True story.

In summary, DN definitely hurts during the session and you will feel sore for a day or two AND it is so worth it. If you would like to know more of the science behind it, schedule an appointment to talk to one of our amazing therapists. If you want to know my concise opinion, here it is: embrace the suck because it is totally worth it.

Until next time!

Kari

Quantity vs. Quality

Services1When I think of quantity versus quality, I generally would assume that the quality item is  going to cost more. We are conditioned to think that if we want something of a higher  quality it is going to “break the bank”, especially in something like Physical Therapy or  Performance Training. You may think, “If I want the best, I am going to have to pay the  premium.” SPOILER ALERT: At Mobility Fit, we offer exceptional quality Physical  Therapy and it WON’T cost what you may think.

If you walk into a large corporate or hospital-based Physical Therapy clinic and observe what is going on, this scene is more than likely what you will find: A patient, we will call her Sally, comes in at her scheduled time of 2:00pm. Sally talks with her therapist, we will call him Steve, and lets him know how she is feeling today with her knee injury. Five minutes go by with this “check in”, and Steve stretches Sally for about 5 minutes. He then reviews her exercises with her for 5 minutes and lastly, passes Sally off to an aide to continue with her exercises. Sally’s appointment with her therapist is now over and Steve’s next patient is already on his table. Fifteen minutes is all the time Sally spends one-on-one with Steve, if she is lucky she may get up to 25 minutes of Steve’s full attention.

There are several problems with this scene.  The first glaring problem is restricted time: therapy clients cannot receive the best care possible in just fifteen minutes.

Here’s why:

  1. There is no time to problem solve. Steve doesn’t have enough time to really figure out the underlying issue with Sally and he only treats her surface or presenting issues. Yes, her knee hurts, but why? Could it actually be a lower back or hip issue that is causing unequal weight distribution, which is causing the pain? Steve will never know because he is not allowed to spend enough time with her to get to the root cause….his next patient session is already starting.
  1. Because Steve doesn’t have enough time with Sally, he can’t customize her care. Sally may be a Boston Qualifying runner, but because Steve doesn’t have the time to put together an advanced program for her, she will do the same exercises as a 70-year-old, sedentary man. This “cookie cutter” approach to rehab will get Sally back to the status quo, but will not meet her needs as an athlete.
  1. Because Steve has to cycle so many patients through at a time, he loses track of what is best for the patient. I cannot speak for every Physical Therapy clinic out there, but I have unfortunately found this to be pretty standard and have seen how there is too much emphasis placed on the bottom line and not on doing what is best for the clients.
  1. If Steve sees patients every 15 minutes, and sees them each twice a week, he will see upwards of 40-60 different patients per week. Or you could look at it as 80 to 120 appointments a week. This is common in many of the Sports Medicine PT clinics in the area. Keeping up with the progress and exercises of this many patients is difficult, as you can imagine. Steve has to rely on charts and protocols for each person, having no time for creativity, problem solving, and personalization.

The biggest problem with this whole scene: THIS HAS BECOME THE NORM IN THE PHYSICAL THERAPY INDUSTRY.

Here is what I want you to walk away knowing: you can get more out of your physical therapy with the Mobility Fit Method.

Here’s why:

  1. Services4Our therapists spend the maximum amount of time with you as allowed by your insurance, NOT as determined by a penny pinching executive. We find out how much time we are allotted based on your coverage and have it covered, one-on-one with a Physical Therapist. For insurance companies this ranges from 30-90 minutes. So at minimum, our clinic doubles your session time when compared to most other Physical Therapy clinics and then you are expected to stay after your session to complete additional work.

So I have to ask you; why would you not want to get more one on one time at essentially the same cost? If anyone has a good answer to this please email me!

 

  1. We customize each visit to your specific needs, and About.headerspecific to the activities you want to return to. You won’t be sent home with a piece of paper that looks more like an exercise list from a 1980’s Jane Fonda work-out to fix your knee pain. Sorry if you were hoping for one. What you will get is: a customized therapy session that incorporates cutting edge methods, manual therapy, maybe some dry needling, Graston, or cupping and a list of personalized exercises to do at home. All of these methods will get you stronger than ever for your running, training, weight lifting, or sport.

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  1. We answer to a higher calling. Our main objective is to give the best care possible to each individual that walks through our door. For us, leaving at the end of the day, confident that we have given the best care available is more important and rewarding to us than any paycheck ever could be.

The choice is yours and you have options:

Do you want their quantity OR our quality?

 

 

 

TO BE SURE THAT I AM CLEAR- I do not think that any of this is the therapist’s fault. These time constraints and quantities are forced upon them, not allowing them to do their job the way they may want to, or to the best of their ability.