What is every 2 year old's favorite question? "Why?" Inquisitive toddlers have a lot to say and even more to ask. Why do you eat that? Why do you run? Why this? Why that? They are like little scientists wanting to know why their world works the way it does. They want to know the reason behind something and "just because" is not a good enough answer for them. It is this kind of inquisitiveness that we should always nurture within ourselves allowing us to remain the scientists that we start out as.
The reason this comes to mind is the staggering amount of information (and misinformation) that is now accessible to so many people through the creation of the world wide web. It is open to anyone (like myself) who wants to share knowledge, opinions, expertise, etc. to the masses. Unfortunately, this is a double edged sword. On the one hand, you have more access to excellent resources on any topic you can possibly think of. On the other hand, you have the same access to questionable resources and information about those same topics which is very concerning. Since this is the case, asking "why" like a two year old to make sure something makes sense will prove to be very beneficial instead of just accepting something at face value.
This is most definitely the case with the health, fitness, rehab and nutrition worlds. There is no shortage of dubious information, outrageous claims and downright zealotry about health and the human body. Perhaps I am becoming more critical of what I read on the internet as I continue to practice as a physical therapist and do my best to keep up with current evidence and literature but it seems as if the frequency of questionable (and just plain wrong) articles and headlines I come across on a daily basis is increasing. This becomes incredibly dangerous with social media's capacity to disseminate information so you get all sorts of myths (and truths, thank goodness) spreading like wildfire. Despite countless individuals and organizations doing their best to discount bad information, beliefs continue to persist and get in the way of facts. There also continues to be this idea that "But I read something or I saw something online" equals truth. It reminds me of this commercial:
Not everything on the internet is true. Somehow it has become the media's job to sell stories and latch on to hot topics rather than report and publish legitimate information as objectively as possible. Bloggers (like me), writers and "experts" among many others are trying to gain visibility within their respective fields in a very crowded health landscape and although the majority of intentions are good, it still does not make something true. Just because everyone is posting on Facebook does not make something true. And just because someone has some letters after their name also does not make something true. With all of this in mind, I strongly encourage you to read and listen with caution and to question everything (including me) as a two year old would. Why? Does that make sense? If I don't sit straight all of the time, I'll develop low back pain?! Gluten is the devil?! (I'll answer those last two for you: No and no.) Take a few minutes to double check what you read and listen to, and seek out credible and reliable sources so that you can truly make healthy and informed decisions.
Like that old saying goes, if it's too good to be true, then it probably is.
Knowledge = Power; Share The Power:
I'm not one to subscribe to a lot of toys or gadgets to provide treatment and help my clients reach their goals but I do get excited when I find one that works and works really well. Thanks to fellow physical therapist, Erson Religioso, I now have in my possession an excellent new tool, The Edge, that makes my job easier and more effective which is great news for my clients. It may not look like much (or it may frighten some people) but it is an excellent all around tool for Instrument Assisted Soft Tissue Mobilization (IASTM).
As much as I enjoy using my hands, there are times when a tool or instrument can really be a huge advantage and difference maker. There are also some tissues in the body that fingers and hands simply cannot have as much of an impact on like metal or other hard objects can. Since The Edge is a 'Jack of all trades' with its variety of edges, it can be implemented in many ways depending on the specific needs of each client and situation. That means having the ability to match the appropriate edge for treatment and truly target the particular issue at hand. The beauty of it is just like many soft tissue techniques, it can be utilized for both prevention and/or treatment for injuries. Admittedly, it saves my hands for other treatments and techniques as well.
With its versatility, The Edge can be used for a wide range of issues like tendonitis/tendinosis, muscle strains, trigger points, etc. It can be used for acute or chronic scar tissue formation especially following surgical procedures so that movement and mobility can be restored. Persistent or chronic muscle tightness (think calf and upper trapezius) tends to respond quite well to IASTM. Any type of restriction in connective tissue like the plantar fascia, iliotibibial band, and joint retinaculums are also prime candidates for tools like The Edge. As you can see, there are many applications for IASTM as it can be the perfect adjunct to other techniques and treatments to help you move better, feel better and live better. Sometimes it can the missing piece to help you get over the final hurdle that has been a challenge to get over otherwise.
If you have any soft tissue issues or just want to stay ahead of the game with preventative treatment, don't miss out on this opportunity. It really can be a game changer!
Knowledge = Power; Share The Power:
After graduating from my physical therapy program I took it for granted that the general public truly knows what physical therapy is. I assumed (first mistake!) most people knew the basics since it is a common and relatively mainstream intervention for injuries...or so I thought. It also seems like most people have sought care from a physical therapist or know someone that has and yet there still seems to be a lot of misinformation out there. Now that I've worked with hundreds of clients and have been talking to many people within my community as I build my practice I have found that there is a huge spectrum of knowledge about what physical therapy is and who it can help as it relates to an outpatient style clinic.
Here are some of my favorite thoughts I've heard over the past several years about physical therapy:
You only work with people after they've had surgery.
It's just a bunch of exercises.
Chiropractors take care of the spine, you do everything else.
You use cool gadgets like ultrasound and electrical stimulation.
I thought physical therapy is hot/cold packs, massage and a couple of exercises.
It's kind of like personal training, right?
This is PT? This is a lot different than I expected!
While there is some truth to a few of these statements, they are pretty amusing if you ask me because there is so much more to physical therapy than these ideas. I especially like the last one.
The most common definition(s) you will see for physical therapists is something along the lines of someone who is licensed to evaluate, treat and/or prevent pain, disability, injury, movement dysfunction, disease and functional limitations using physical, mechanical or chemical means including but not limited to therapeutic exercises, mobilizations and/or manipulations, and modalities (cold/hot packs, ultrasound, electrical stimulation, etc.). The definition I prefer to use is physical therapists are neuromusculoskeletal experts (not to be mistaken with gurus), movement educators and performance enhancers (the legal kind). This means we are specialists in the human body, how it moves and how to address issues like pain, injury, strength deficits, dysfunction, disease progression and performance optimization among many others. No matter what exact definition you use for physical therapy they are very open ended which is great because it means we can work with virtually anyone.
Through our training we have the knowledge to analyze and understand each component of the neuromusculoskeletal system including the brain, spinal cord, nerves, muscles, bones, joints, tendons, ligaments and connective tissues. More importantly, we understand how each of these components interacts with each other to influence and allow the human body to function. In order to address any and all of these components and their impact on the whole system, we have an extremely diverse skill set at our disposal.
To begin with, we perform a thorough physical examination and assessment as it relates to a client's specific situation and complaints. We have a wide variety of tests and measures that reveal valuable information which is interpreted to develop a diagnosis, a treatment plan and a prognosis. As far as treatment is concerned there are several interventions we can choose from in our skill set. The specific mix of interventions will vary from clinician to clinician and from client to client depending on each individual case. They include:
Education: This is quite possibly the most important part of treatment. First and foremost, it is our job to listen so that we know what to teach and explain. It is our job to teach anatomy and physiology, pain science, biomechanics, relaxation techniques...whatever is necessary to help our clients understand their bodies better. It is our job to dispel myths and fears so that the brain and body isn't in a constant state of stress and exacerbating any issues. It is our job to develop a plan and strategies for our clients so that they are able to help themselves and reach their goals.
Manual Therapy: More often than not, physical therapists will be using their hands at some point. It is here that you will see many different philosophies and schools of thought. It is impossible to list all of the manual therapy variations but some of the general categories they would fall under are soft tissue mobilization like trigger point therapy, various styles of massage, active release technique and instrument assisted soft tissue mobilization to name a few, nerve mobilizations, joint mobilizations including chiropractic/thrust manipulations (depending on the state; legal in NY), stretching, and facilitation of movement to retrain motor control and movement quality. How each of these is performed and accomplished will differ from clinician to clinician.
Exercise: This can be broken up into two subgroups even though they overlap quite a bit. The first being neuromuscular re-education which is a fancy way of saying movement retraining. Think balance, control, reaction and technique. Single leg balance is a perfect example of an exercise that would be considered neuromuscular re-education. The second group is therapeutic exercises and functional activities. Traditionally you can think of strength training, flexibility and range of motion exercises fitting into this category as well as activities of daily living like walking, stair climbing and carrying objects. You would obviously need good technique and control in order to accomplish these more traditional types of tasks. With any of these exercises, what sets physical therapy apart is they are prescribed and progressed very specifically to achieve certain goals that can be tested and measured. It is much different than a general fitness plan.
Modalities: This is where the gadgets can be listed like electrical stimulation (my favorite), ultrasound and mechanical traction. It would also include things like heat and cold therapy. In many cases, these passive modalities are used for pain control which is very helpful and a good adjunct to treatment but they will rarely ever resolve the underlying issues. That is what the education, manual therapy and exercise is for. There are other times when modalities are used therapeutically like electrical stimulation to improve activation (and strength) of the quadriceps after knee surgery or cold therapy to reduce swelling and inflammation.
Long story short, physical therapy is an extremely versatile and comprehensive solution to issues related to the neuromusculoskeletal system. You might even consider physical therapists to be jacks of all trades as we have a wide array of skills to choose from in order to help our clients reach their goals.
So if you have neck or back pain, we can take care of you. If you just had surgery, come on in. If you feel like you have balance issues, we've got that covered. If you can't play your favorite sport, we would love to fix that. If you have pain/chronic pain and you can't figure out why, we'll figure out why. I could keep going. As you can see, physical therapy is an excellent first option if you have pain, suffered an injury, have functional limitations, etc. and you want to resolve these issues so that you can move better, feel better and live better.
Knowledge = Power; Share the Power:
In five days, the gun will go off for a truly spectacular race in the Shawangunk Mountains. The Josh Feldt/After the Leaves Have Fallen 20k race is set on the beautiful carriage trails of Minnewaska State Park and takes its competitors around two serene glacial lakes and up to Castle Point which has some of the best views in the park. Even though it has a later start time of 11am, it might still be on the chilly side with temps in the high 40s and current forecasts suggesting clouds and a slight chance of showers. But don't let that deter you from participating in a great race put on by the Shawangunk Runners especially if you're looking for one more serious challenge for your racing season before winter comes.
Here is a brief preview of the course:
The first 2 miles offer modest ascents/descents as you run clockwise around Lake Minnewaska. The next 3 miles mainly alternates between flat and gradual but steady climbs up to Lake Awosting. After that you'll hang a right to circumnavigate Lake Awosting counterclockwise for about 3 miles. The loop around the lake is mostly flat with a few rollers mixed in but the footing here is a little more challenging than the rest of the course since it is certainly a trail less traveled in the park. Leaving the lake you begin your ascent to Castle Point which has some steeper sections. After reaching Castle Point and taking in the views the rest of the course (roughly 3 miles) is almost all downhill. There are a few rollers but you can make up some time here after all of the climbing done in the first 9 miles of the course. The last hill is right before the finish line as you make your way back around Lake Minnewaska. Overall a fairly challenging course but one of the most beautiful trail races in the area.
As you can probably gather, I will be there racing but I will also be setting up before the race to offer free knowledge, information and advice as well as fielding any questions you may have for me or about Momentum Physical Therapy of New Paltz. Take advantage of this opportunity while you can!
For any last minute runners, there is still time to register online by going to the Shawangunk Runners website or by clicking this link to take you directly to the registration page. By the way, this race is a bargain at only $15 so hurry up and join all the other runners for a great event this weekend.
Hope to see you there!
Dr. Greg Cecere
Your personal physical therapist, movement educator and knowledge dispenser.
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The contents of this blog is meant for educational purposes only. Momentum Physical Therapy of New Paltz and Dr. Greg Cecere are not responsible for any harm or injury that may occur due to any information on this blog as it is by no means a substitute for a thorough evaluation by a medical professional.