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What to expect with physical therapy

Going into any doctor's office for the first time can be a bit nerve-racking. What are they going to do? What am I going to have to do? What am I going to find out? There are so many unknowns. So while I cannot speak for every PT clinic, I can tell you what you should expect with Body Fix 180, not only on your first visit but throughout the whole process.

Body Fix 180 comes to you. You will be seen in the comfort of your own home or, should you choose, the comfort of a local gym or your office.

The first visit is called the initial evaluation. This is when the physical therapist will listen to you talking about your pain/problems, asking questions to help your answers direct what they need to hear to make the best judgement on potential issues. Next the PT will ask you to do different things to assess your range of motion/flexibility and strength. For example, if your back is hurting they may ask you to touch your toes or attempt to. The goal during this part of the exam is to find any impairments that may be causing your pain or a result of your pain. While some of this may be uncomfortable, the PT will not force you into more pain. Next, the therapist may ask you to perform certain tasks (that you've deemed hard or painful) such as running, squatting, lifting weights, etc. Here the PT is looking at the quality of your movement to determine if your form is problematic or in some cases to see that you are safe to continue to do certain things, even if you hurt. The whole purpose of the exam is to gather information so the PT can better treat your symptoms not to provoke your pain. Don't be worried that the PT will hurt you, that is not their goal.

The initial evaluation or eval helps the PT determine a plan for you based on all the measurements/tests and what you've had to say. Each component is its own piece of the puzzle. So you may find that each evaluation is slightly different between 2 people or even between 2 therapists.

My plan for the following visits and even starting with the first visit is this:

Calm it down and restore basic movement: The goal here is to get control of the pain, aka put out the fire, which may be done with hands-on techniques like massage or joint mobilization/manipulation or with tools such as dry needling. In this same stage, we also want to restore any loss of range of motion you have through exercises and again hands-on techniques. Loss of range of motion can occur due to guarding, pain, lack of flexibility or not having that motion to begin with. Your PT should be able to tell why and can direct your course of treatment to resolve this issue. It is important to also begin to restore any strength but through various basic exercises that does not fuel the fire. In summary, this stage, the PT may work on you and then instruct you to do exercises to increase the gains made and continue to progress on your own. This stage may last 1-3 visits.

Fix foundational issues and retrain: In this stage, the goal is to fix any issues that may be the culprit of your pain. If your pain has been that of a gradual onset, this stage is crucial. Pain does not just happen. There is always a reason: poor form, over training, lack of recovery or weakness in related parts of your body. This stage will address some or all of those issues. Making sure your recovery is appropriate, your training has the right ramp up and your form/strength is adequate for your activities. This stage may or may not still have some pain associated with movement and loading. The exercises will change from the first stage and some may carryover. It is possible that the first visit has exercises for the first 2 stages. This stage will be 1-2 visits but will carryover from the first stage as well into the next.

Build up your strength: This stage is designed to make you stronger and begin to increase your loading capacity. Loading = healing. The goal is to make you resilient. This is where most people tend to stop PT because they will have minimal pain throughout their day-to-day tasks and they think they are better. While you may be better, you may not be "healed". It is crucial to discuss this with your PT- they may want to space out your visits every 2 weeks or even 1x per month. You are doing the exercises on your own with guidance from the PT for proper progression and loading. Loading is all about the dosage and giving your body time to build up. This is true with lifting weights, running, biking or any type of impact that your body may experience. So your PT may be just fine with reducing visits but make sure you express to them you are feeling good so they can give you appropriately hard exercises. This is the stage where we reduce your likelihood of returning for the same issue. The visits of this stage 1-8 depending on where you are and where you need/want to be.

Testing in chaos: You will find most people don't make it to this stage. They are already feeling good and doing most things again. This stage isn't absolutely needed but depending on your lifestyle may be beneficial. This is usually 1 visit or just monitoring the patient over 2 weeks-1 month as they return to normal activities ensuring there isn't a flare-up or an overlooked issue. PT clinics tend to treat and work in a controlled environment. But life isn't controlled. You may find with a PT session you run without pain but in the race you have pain. A race isn't controlled and there are other factors so don't be surprised if the PT wants to push you to a new level or even wait until after a race to discharge you from their services.

Note that each stage varies in length and visits per person. For the most part you are going to see more help from the PT in the early stages with the visits being more frequent to get the pain in check; and then a gradually decrease of hands-on with a greater increase in exercises for you to do over greater lengths of time to your restore your independence in your health and recovery. You may still have pain through all stages but it should not be the same pain and should be decreasing as you go along.

By no means, does Body Fix 180 use the "cookie-cutter" approach where every body part gets the same exercises. Unfortunately that happens and you will have a 30 year old with knee pain and a 75 year old with knee pain doing the same exercises. That may provide some relief but the more specific your program is to you and your life then the faster you get better. Body Fix 180 uses the patient plan as outlined above with your specific needs and goals intertwined.

Hopefully this gives you a better idea of what to expect when having physical therapy. If you have had PT before, you may find this to be different. That's because Body Fix 180 is different. We work for you and your goals, not your insurance and not a boss telling us to keep you longer to make more money. (Yes that happens!)

If you still have any questions about what to expect or want to know more about Body Fix 180- phone calls and text messages are free! 940-489-2407

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