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By Dan Goldstein, PT, O/SCS, ATC, GFS –
When we experience chronic pain, anywhere in the body, we consciously, and sometimes even unconsciously, alter our movements in order to reduce the immediate discomfort. These compensated motion patterns may alleviate the pain for a short while but they ultimately result in abnormal muscle activity, poor joint motions, with additional breakdown and pain. By allowing the body to become accustomed to moving in unnatural ways just to avoid pain, may actually cause more problems in the long run.
When repeated over time, unnatural body movements can change the natural alignment of bones, which in turn causes discomfort and may contribute to health problems. The aim of physical therapy is to realign and reposition the body to allow natural, graceful movement. Physical therapy, along with identifying the contributing causes of the unnatural movement, has proven to reduce stress and ease pain.
The Physical Therapist’s job is to help reduce pain and restore proper balanced movement patterns in order to return functional independence. The physician provides a diagnosis for the patient’s problem which helps direct the therapist. The typical diagnosis does not identify compensations that have resulted over time, which is where the therapist comes in.
For example, a recent patient (RF) suffered for five months with low back pain on the right side and radiating pain down his right leg. Based on MRI results and an evaluation his physician diagnosed degenerative disc disease (DJD), arthritis and sciatica. The doctor suggested therapy to reduce tightness in his back and leg and to improve spinal motion. A proper diagnosis is helpful but therapy treatment is directed to help the patient progress with their activities without aggravating the underlying problems. RF presented to my office maintaining a forward bent posture, limited spinal mobility due to pain and fear of pain, was limping on the right and reported balance problems. He also had problems getting up from a chair and recently has experienced increasing left leg pain. Over the last few months he has taken medication, sits in his hot tub and occasionally swims.
As his physical therapist, my job was to assess and treat RF by focusing on his muscles, joints, ligaments, movement patterns, walking, balance and daily functional activities. In this particular case, the initial goal was to first reduce the pain he was suffering with. As the pain was relieved, therapy progressed with postural retraining and education on proper gait and balance. Considering the length of time that he had been adjusting his body movements to minimize pain, we were concerned about the stress the unnatural movements were putting on various joints, such as hips and knees, throughout the body. RF was provided a list of appropriate exercises to be performed between therapy sessions. By retraining his body and allowing it to move more naturally, RF has experienced relief from the pain that originally brought him to my office and he has been able to reverse the negative impacts of the compensating movements he had become accustomed to.
As a therapist with more than 30 years of experience, I have seen many patients with the same problems that RF presented with. Physical therapy treatment is never a one size fits all approach; there is no exercise or treatment routine that helps everyone. To be effective, therapy has to be individualized.
By offering an individualized approach to physical therapy, we ensure that our patients maximize their level of function and achieve their goals. If you are like many people out there who have adjusted the way they walk or move to avoid pain, physical therapy may provide you the relief you have been desperately seeking. Retraining your body how to move in a natural and integrated manner enhances more than just your body movement, it also enhances your overall health.
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Dan Goldstein, MS, PT, OCS, SCS, ATC has been providing care for clients in West Palm Beach since 1984. If I can help answer any questions about the uses and benefits of physical therapy please call me at 561-371-6021 or e-mail me at spbalance@aol.com.
