Tomorrow - physical therapy

[shadesofbay3]

need good vibes i guess for tomorrow, when i go back for physical therapy

i fractured L1 in 2010 and my back has just never been the same… right after the accident i went through and completed physical therapy and even rode without pain for a while, but the pain seemed to become problematic and not go away around 2012-2015 (hard to remember)

i have tried many things to improve, including-

-multiple opinions from different doctors to see if there are other underlying issues (apparently i also have kyphosis - don’t know if this is something i was born with?)
-back exercises at home
-had a block and then an ablation… the block worked well but the ablation was not super successful
-chiropractic
-riding with a TENS machine

repeat MRIs have shown that the bone has healed but i guess i have no core strength so i’m hoping going back to PT will help… they wanted to do a fusion but i don’t want that … pain doctor did the ablation in the facet joints in my back, where they now think the pain is coming from

i am very discouraged since i’m only in my early 30s… my horse is retired and i would like to get back to riding… guess i am looking for other people that have been in my shoes. i have posted before on the forum, and it seems most other people with vertebrae issues bounced back quick

[victoriakent]

For what its worth I have had a LOT of back issues (and some breaks) and the only thing that long term fixes things for me is working with a strength coach regularly. Luckily my SO is a strength coach - but I go through bouts where I stop listening to him and then voila, the back pain is back again as soon as those muscles weaken. Of course when I slack off its takes a good while to build back up again, then I cry in our gym about why my back won’t heal faster. Then repeat the entire cycle again.

See if your PT can recommend someone you can work with (even once a week) after you are released from PT who does “post-rehab”. I do also mix in the occasional sports massage, regular stretching, and chiro as needed to help aid the strengthening and wonky muscle pulls.

[shadesofbay3]

Thank you! Stupid question, assuming a strength coach is different than a PT?

[S1969]

@shadesofbay3

Thank you! Stupid question, assuming a strength coach is different than a PT?

I have a strength coach as well as a PT, although I’m released from PT for now (history of lower back/disk issues, as well as running issues e.g. IT band, hip flexor issues). It could be the same person in theory, but in my experience my strength coach works me much harder than I ever worked in PT. The Physical Therapist helped make sure we were working the right things in strength sessions, but I do a lot more in 1:1 strength (2x weekly)

My coach is a certified personal trainer. He designs his sessions based on the client needs/sport.

[CHT]

Good luck!

Keep in mind not all physiotherapists are the same: I have some good and some…less so. The current ones are more hands on and less about setting me up on a therapy machine and walking off to work with other patients. I don’t think there is right or wrong, but just shop around a bit?

A book you may find helpful: " The Pain Truth … and Nothing But!

An Easy to Understand Patient Education Handbook on
Pain Management " Written by: Dr. Bahram Jam, Registered Physiotherapist

I found it very helpful when first faced with chronic pain. I worked through it with a therapist along with exercises modified for my specific issues. The book helps when you have reached the point that your body isn’t in the acute phase of injury/damage.

Good luck with your therapist, I hope it goes great and you start feeling some hope about your back!

[RMJacobs]

@CHT

Keep in mind not all physiotherapists are the same: I have some good and some…less so.

Ain’t that the truth! I’ve done four different rounds of pretty intense, long term PT: one after a car accident when I was 17 (which did nothing that I could determine); one after knee surgery when I was 30 (got a lot of range of motion back, muscle is still atrophied due to 15 years of limping); one when I was about 40 to release an entrapped nerve, which was magical; and one two years ago in my 60s trying to get some range of movement back in my hips, which was useless. I felt I had good therapists for the knee and the entrapped nerve. I thought for the last round, the therapist had no clue what kind of limitations people with RA have. She made me worse, so I stopped going.

Rebecca

[victoriakent]

Not a stupid question at all. A PT is going to be a doctor of physical therapy and in a lot of cases insurance will cut you off after a while. My SO is has a CSCS designation, worked in post-rehab, and specializes in sports performance and personal training, but he is NOT a doctor of physical therapy and has no medical license. He takes a client after they are medically cleared and analyzes their needs and creates a plan based on that. As my chiropractor says “I put your body back where it belongs, your strength coach trains your body to actually hold itself together.”

Like all things, not all trainers or strength coaches are as good as others. My recommendation is find one who is very science based in their approach and who can explain WHY they are having you do each exercise. Too often we see trainers having clients do an exercise because… well no one knows. Beyond “it strengthens XYZ part of your body” (duh) ask how this movement will benefit you, what is the end goal of this movement, how does this relate to the other functions of your body, etc. If they can’t answer these questions that is a big red flag.

[S1969]

Agreed, not a stupid question at all and there are a lot of people in the field that have different backgrounds and can contribute in different ways, but the key is finding the person trained to do what they are delivering.

Like victoria - I also have a NSCA-CSCS certified strength coach that I work with 2x a week
And I connect 2-3 times a year with another coach who is a USAT triathlon coach with other certifications in health/fitness, nutrition and yoga - mainly for triathlon long course training and nutrition
I have a DPT - physical therapist (I am currently released so not seeing him now)
And I see a MD who specializes in sports medicine and non-surgical General Orthopaedics (When needed, for injury/treatment)

If I could only get them all in a room at the same time.

[Sue_B]

I also sustained a non-displaced fracture of L1 plus sacral fractures. None required surgery (or at least, I didn’t go to the hospital since I could still walk using crutches) but I did extensive PT and strength retraining on my own. Granted, I am a medical professional well verses in neuro and musculoskeletal disease and had extensive PT for knee problems in my teens and twenties. The key is rebuilding and then retaining really good core strength by whatever means you can. That is the benefit of a good PT. They can help you devise a program to meet your needs. Takes a good 2 years of dedicated work to build a solid core that is strong and flexible. well worth it!

[Go_Fish]

I have had a lot of physical therapy for many, many issues. I’m a huge fan. However, the outcome of your therapy is entirely up to you. The exercises and therapies that your PT sends you home with must be done religiously. Do not slack off, no matter what. If you want to get better, then be a very good patient.