Most physical therapists would consider themselves experts of the musculoskeletal system. Given that we have expertise in this area, there are many injuries or ailments that can be treated immediately by a PT. Most insurance companies no longer require a referral from a physician to start PT, and if after a PT evaluation and treatment, further intervention is required by a physician, then the therapist can help guide you to the appropriate referral. Here are some of the conditions that a PT could see first.

1) Recurrence of a past problem that was successfully treated by PT. If you have had a flair up of a previous problem that you went to PT for, then it is often unnecessary to see a doctor that is most likely going to send you back to therapy. The therapist should be familiar with your case and often the same treatments that worked last time will work again. This is especially common with flair ups of back and neck pain.

2) Muscle strains. Many times, these injures are associated with slipping or an athletic injury in an event. PTs are especially good at treating soft tissue injuries such as, muscle strains, and they have multiple options to make it feel better; like laser, massage, dry needling, E-stimulation and ultrasound. The faster the treatment starts the faster patients can start to feel better.

3) Ankle/knee sprains. These rarely require surgical intervention and often respond well to therapy. If the patient is able to weight bear on the injured joint for multiple steps and it is improving, then further treatment from an orthopedist is not likely. Though it is important to point out that some of these sprains can be difficult to truly evaluate until the swelling goes down. Often once the PT is able to help the patient get the swelling to decrease then a referral to a surgeon might be indicated if they suspect any tearing of ligaments.

4) Arthritic joint pain. Arthritis very common in the aging population. Many of these patients know they have an arthritic joint because they have been told so by a doctor on a previous visit. This does not require another appointment to diagnose the same problem. Many of these arthritic joints are not bad enough for replacement, but will
respond to over the counter anti-inflammatories, stretching and strengthening. The stretching and strengthening piece of the program is something that PTs prescribe every day and are experts at managing. Save your time and money and avoid the same diagnosis from the doctor that you have gotten before and go straight for immediate treatment.

5) Back/neck pain. Back and neck pain that has come on suddenly can be very painful. In many cases, this is caused by disc bulging and should be treated immediately because of the pain and suffering it can cause. Many PTs have had extensive training in the treatment of disc problems and if anyone has had nerve pain associated with the problem you know how painful this can be. Treatments include traction, manual therapy, and directional preference stretching to decrease the disc irritation on the nerve. Patients will also need extensive education about postures to avoid in order to
prevent the problem from getting worse.

If you or a loved one is suffering from any of the above-mentioned ailments, don’t hesitate to call your family PT and ask for an evaluation. These are ailments that we deal with every day and would be happy to quickly treat in an effort to get you back to full function as quickly and cost effectively as possible!

Family Medicine doctors are seen as an integral part of the healthcare delivery model because they are on the front lines treating patients, and whole families in some instances. They are seen as necessary to keep healthcare costs down because they help prevent problems from becoming severe and keep people from flooding the ER for every small event that takes place. The job of the family medicine practitioner is difficult because they seemingly need to know a little bit about everything. It is their job to manage some of the chronic ailments and refer out when people need more specialized care. This model seems to work well and I think it should be expanded.

The family practitioner model should be exported to the physical therapy world as well. The only difference would be that physical therapists would manage the numerous musculoskeletal pains that happen over a lifespan and the doctors would continue to handle everything else. I often hear from patients that they have a problem, but they will wait to bring it up with their doctor at their yearly or 6-month checkup. If PTs did checkups on people on a yearly or every 6-month basis, they could address many of the musculoskeletal issues that go untreated but cause dysfunction and limitation of activities.

When there is sickness in a family what do most people think to do first? Call their doctor to see if they can get in quickly to get medicine or treatment to find out what is going on. PTs could easily serve the same purpose for families. If you have a non-emergent issue such as acute back pain, a twisted ankle, or knee pain your family PT should be able to get you in within 24 hours to figure out how it should be managed. Management of these types of conditions rarely require a doctor and should ultimately be managed by a PT anyway. If we can adopt this model of healthcare with physical therapists for the musculoskeletal system, we could have a positive effect on reducing medical costs.

My message is clear! If you are an outpatient PT you should be offering your services to families and friends as a way to help manage aches and pains while decreasing unnecessary medical costs. If you are a potential patient you should make an effort to build a relationship with a local PT that will be there when needed to help you or your family members get out of pain quickly, efficiently and with a minimum spent on unnecessary visits, procedures, and tests.

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Now that the holiday season is coming to an end, it’s about time for everyone to start thinking about the New Year, namely, how you may want to better yourself and your life. A great way to hold yourself accountable for these thoughts is to turn them into written goals. This may seem like a daunting task for some, but it really doesn’t have to be. As therapists, we write goals for our patients to achieve while in therapy, using the S.M.A.R.T. format. You can use this format as well:

(S)pecific
Think about exactly what you want to achieve this year, both big and small. Maybe you want to climb Mount Everest, or maybe you just want to be able to climb the stairs to your attic. Just be sure to be concise about how you want to achieve your goal. Instead of simply saying “I want to be able to climb stairs better,” you could say, “I want to be able to climb the 12 stairs to the attic without having to hold on to the railing.” Goals could be related to fitness, health, your job, your personal life, or maybe one goal for each. Don’t be afraid to set yourself multiple goals for a more holistic approach to the New Year.

(M)easurable
Goals should be measurable so that you can track progress. How will you know when you reach or are close to reaching your goal? Make sure that your goals answer the questions “how much?” or “how many?” How many times do you want to be able to climb the stairs to your attic (or Mount Everest)? How much weight do you want to lose? How many blocks do you want to walk? Tracking your progress through measurable goals helps you stay motivated and appreciate exactly how close you are to achieving your goal.

(A)chievable
While it is always important to set your sights high and challenge yourself, steer clear of impossible goals. A lot of people will fall into this trap this year. Don’t be one of them. Consider your accomplishments from this year as a point of reference. If this past year was spent trying to master a layup, do not expect to go pro by the end of 2020. Set goals that you can envision yourself accomplishing.

(R)elevant
Your goals should be relevant to your own wants and needs in your day to day life, so your goals will definitely not be the same as, say, Lebron James’. Think about the tasks around your home that are difficult or you hope to improve upon. For example, a stair climbing goal would not be as relevant for someone who lives in a first-floor apartment as it would be for someone who lives in a 3-story house. The same can be said for work-related goals as well.

(T)imely
Set yourself a time frame for when you want to complete each goal. Please keep in mind, not all goals have to be long term. In fact, short-term goals can propel you toward your long-term goals, by providing a gradual path to goal achievement. For example, for someone whose long-term goal is to be able to run a 5k in under 25 minutes, a short-term goal might be, “In six weeks, I want to be able to run 1 mile in under 10 minutes.” You may have one short-term goal for each long-term goal, or you may have five, it’s your call.

As long as you use the S.M.A.R.T. format, goal writing should be a breeze. Remember, they should be specific enough to describe exactly what you wish to accomplish, measurable to be able to keep track of them, achievable so that you aren’t wasting your time, relevant to your daily life, and provide a time frame for when they should be completed. Good luck and have a Happy New Year!

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Hey Superdad…your body is not as young as you think it is.

Last week I wrote a blog about women and the effect that stress and anxiety can have on their pain and overall fitness. This is a topic that gets lots of attention in the media, but what doesn’t get much play, is what expectations we have of Dad and his fitness level. We are in a time when Dadbod is seen as funny and even desirable in some cases. How did we get to this point and where should the conversation go?

Males traditionally feel less pressure to take care of themselves physically and emotionally. I would say this has a lot to do with the societal norms of the husband that works and brings home the lion’s share of the income and so there is less responsibility for maintaining his health and wellness. The mentality is also likely responsible for the 5 years longer that women live versus their male counterparts. This is likely an antiquated thought process that is unhealthy and counterproductive to positive relationships. Even if both spouses are working, usually the males are making more money. Shouldn’t it then be incumbent upon men to take care of their health even more since family financial wellness is their responsibility? The answer is yes…but we (men) get around this by subscribing to the thought that if we are still doing well in our job and bringing home the bacon then everything else is not as important. Men can let this slide for a while, but eventually the music will have to be faced and why not get a handle on health now while it is not as far gone.

Here are a couple easy ways for 30-40 something year-old guys to get back that healthy feeling from our high school and college days that we are so fond of talking about!

1) Exercise (no brainer): Getting back to exercising regularly is not an option, it is a must. Though guys may be staying thin, they are not physically fit if they are not exercising. Women call this “skinny fat”. Exercise is one of the pillars of health that everything else is built upon. Regaining the physical strength and physique from your yester years will not only make you feel physically better, but it is a huge emotional and mental boost as well. It doesn’t have to start off intense and it doesn’t have to be more than 2-3 days per week but it does have to start and become consistent.

2) Make time: Many fathers get stuck in the habit of thinking they have no time for exercise because they are constantly doing activities with the kids when they aren’t working and don’t have time. For your sanity and health you need to MAKE TIME. Your children will not suffer and in fact will likely benefit from Dad taking some time for himself and showing them how important it is to take personal time for personal wellness.

3) Meditate: Whenever I mention meditation I am already prepared for the laughing and sneers I get from men. Contrary to common belief, women and men don’t have different levels of stress necessarily, but women report it more and show more outward signs of it. Men seem to talk about it less and suppress it more so as to not seem weak, but men seem to manifest their stress in different ways, such as yelling/screaming, drinking excessively, weight gain, cardiovascular disease, infidelity and a whole host of others that we do not have enough time to go into. Meditation is a successful tool to manage the release of stress hormones in the brain. Often this stress hormone is cortisol and decreasing that in the brain can improve concentration, improve sleep, decrease fat deposits around organs, and
diminish overall stress.

4) Find a new hobby or rekindle an old one: Stop for a moment and take yourself back to your teens and twenties. Remind yourself of the hobbies you had that filled you with joy and took up many of the free hours you had during those days. You don’t have to do it at the same level but it is likely that you will still find it fun and allow you to improve your mood. Because you had more energy when you were younger it is likely something very active. Many times these old hobbies can check the box for stress relief and exercise. It certainly doesn’t have to be exercise as long as it brings joy and relaxation.

Try to get back to your true self. Take responsibility for your life and the body that you have been given. You will thank yourself down the road and those loved ones around you will also thank you. Show your community, your loved ones, and most importantly your children what it looks like to be a healthy adult.