Physical Therapy

Working with a PT on a semi-regular basis to continue to work on weaknesses and asymmetries is an important part of balancing treatment of injuries with prevention. Everyone should have some kind of prehab prescription program that they're working towards and managing recovery appropriately when signs of injury come up.
 
Transcript: "I'm not quite sure what this question is asking, but how do you balance seeing signs of injury with actually preventing them and what principles have worked best in practice? So I think that what this is saying is, you know, when should you go about treating an injury versus being kind of in the preventative injury realm? And in my opinion, if you're involved in any kind of a sport, you should be working with a PT on a semi-regular basis, at least to continue to work on some of your asymmetries and a lot of your weaknesses, really. I think that it's not uncommon for people to feel little niggles here and there that aren't necessarily a sign of injury. It maybe is related to the progressive overload and their body's response to it in some way, but it's not necessarily a sign that we need to change anything about the training. Maybe we need some more recovery modalities in there, but I think that in general, everyone should have some kind of a prehab prescription program that they're kind of working towards every week, but then managing their recovery appropriately when those signs of injury do come up."

Having a strong relationship with the athlete, understanding them and providing more than 10-15 minute conversations has resulted in successful outcomes.
 
Transcript: "Can you discuss any innovative techniques or approaches you've found particularly effective in rehabbing athletes? I'm not sure that you'll necessarily find my answer super exciting, but since I started my practice and working one-on-one with every athlete for at least an hour, if not more than that, every session, the results are outstanding. And I think that just speaks to the fact that creating a relationship with the athlete, really understanding them for more than a 10, 15, 20 minute conversation, really allows them to buy into the process. And when you have someone that's really bought in, and you have someone that cares equally as much as the athlete does, I think that that breeds success. For more information, visit www.FEMA.gov"

The biggest difference in rehabbing injuries in younger vs older patients is the healing prognosis; due to degenerative changes, it can take longer for an older patient to heal from an injury. It's important to set expectations up front with older patients regarding their healing timeline.
 
Transcript: "Can you discuss any notable differences in rehabbing injuries in younger versus older patients? So this is kind of a good question because sometimes there's this misconception that older athletes are harder to rehab because they don't move very well or, you know, they're really stiff, which can be the case. But really the biggest difference that we see is just healing prognosis is going to be quite different. If I'm working with a 13-year-old that has shoulder pain and a 65-year-old that has shoulder pain for the exact same injury, the healing timeline for that is going to be significantly different simply because of degenerative changes that happen over time. And there's going to be less of a capacity to put on muscle and strength as we get older, and there's less capillary density to stimulate healing. And so all of those things kind of prolong rehab processes when we start dealing with older athletes. So setting that expectation with them up front is always really important."

Common mistakes athletes make during rehab can include slacking off on rehab once they start to feel better. This can hinder the process and prevent progress. Instead, they need to keep pushing and turn up the intensity to retrain the body.
 
Transcript: "What are some common mistakes that athletes make during the rehab process that can hinder their process? I think the one that stands out for me right away is people start to feel a glimpse of feeling better and they start to slack on the rehab. I always kind of say once you start to feel better, that's where we can kind of push this to the next level and start to prevent this from happening again because that's really where your body can start to handle load and start to really progress. It's like we can start to retrain the machine a little bit here. Let's not back off now. Let's say, cool, this is working. Let's keep going and let's turn it up a notch."

We always encourage our patients to stay active while addressing their injury, as time away from the sport can lead to deconditioning and further injuries. Having a good understanding of the sport and programming is essential for manipulating variables that don't stress the injury too much.
 
Transcript: "Encouraging patients to stay active while addressing their injury is something that we try to do with every single patient and I think that it's super important. Number one because when people take some time out of their sport, their injury is probably going to feel better regardless. So that's not, that's really hard for us to say is that because we're actually healing and things are getting better or are we just not doing the painful stimulus anymore. But then also if we take time out of the sport, well now we have this deconditioning effect where cool things feel good, now we have to ramp back up the conditioning and that big change from 0 to 100, if not done appropriately can facilitate other injuries along the way. So we try to keep people active and I think that having a really good understanding of the sport that the person is trying to do is crucial here because there's a lot of ways if you understand the sport, you know of different variables you can manipulate and different things that you can do to keep the person engaged and participating. But maybe with different variables that you can kind of manipulate and that aren't going to stress their injury quite so much. So a knowledge of the sport and a knowledge of the programming of the sport are crucial."

We always ask athletes what their goals with physical therapy are and based on that, we map out how long it will take to achieve that goal. We have collaborative conversations with them to help them reach their goals.
 
Transcript: "With every single athlete that we work with, we always ask them, like, what is your goal with physical therapy? What would be a successful outcome for you? And based on that answer, we always kind of just map it out. You know, if someone's coming back from, let's say, an ankle fracture, you know, what is, what's a good outcome for you? I want to get back to running a eight-minute mile. Great. Maybe another person's goal is going to be, I want to run another marathon. Okay, that's very different from just being able to run to completing something of substantial volume. So those people's expectations are very different and the timeline needs to be different. So we really like to map this out. I will literally just write it on a whiteboard in front of them and just kind of map out, like, hey, this is your goal. This is how long I think that it needs to take to kind of manifest the capacity to handle and work your way up to hitting that goal. And it's kind of a collaborative approach. And I think that a lot of patients get a lot out of those conversations."