Ruminations on sports, training, health, and wellness

Physical Therapy Works!

It started out as just a sore back. Nothing unusual; I had just spent the last 10 days driving a total of 3,099 miles and sleeping on an antique mattress on the floor of a classroom while working 16 hour days at the Tour de l’Abitibi. Anybody would have a sore back after that.

Except this wasn’t any old sore back. After my second massage client, I asked Dr. Rodulfo the chiropractor to adjust my lumbar spine. Snap, crackle, pop, and it did feel better. After my third client, Abbey the athletic trainer ran high-volt electrical stimulation through sticky electrodes along my sacrum with an ice pack on top. After my fourth client, my eyes welled up with tears while I lay on a rolling table and steel orbs traced circles along my spasming spinal erectors. After my fifth client, Rob the acupuncturist dry needled around my lumbar spine, sacrum, and hips — those two needles in my hips were enough to briefly consider not being friends with him anymore, but they provided some short term relief. An hour later I was home, in bed, with a hydrocodone and a very furrowed brow. I just turned 27 — the same age my dad was when he first herniated a disc and became a back surgery candidate.

A morning trip to the orthopedic walk-in clinic yielded a promising diagnosis: my x-rays looked great and showed no evidence of spinal trauma; this was a case of a good old muscle spasm. Armed with a prescription for muscle relaxers and orders to take it easy for a few days, I embarked on getting over this small road block (which, I learned, is easier said than done with a back spasm).

Ten days later, still putting on my socks and shoes laying on my bed like a dead bug because bending over was too painful, the orthopod at my follow-up appointment wrote me a prescription for physical therapy. I’m a big believer in PT — I worked at a PT’s office for over two years while I was in graduate school, and that same PT had healed my torn rotator cuff with exercise prescription.

My insurance, which I buy privately through an exchange, covers prescription pain and muscle relaxer medication at $5 copay. While tremendously useful in acute situations, these medications have well-documented, common, potentially harmful side-effects and are not recommended for long-term use.

Physical therapy, which my doctor prescribed 2-3x/week for 2-6 weeks with an excellent prognosis for full recovery from my injury, is covered at 50% coinsurance plus $50 copay per visit. It’s virtually guaranteed to make me healthier faster, and thus less burden on the healthcare system. There are no Tier 1 or Tier 2 approved providers within 250 miles of my home.

So the average consumer is looking at $10/month for something that could eventually make them sicker, or $400-$1800 for something that will almost certainly make them better than before. The irony was not lost on me.

Armed with determination, I went to my first appointment with my good friends at Physical Therapy of the Triad. Dr. Krishinda Lee met me with a smile and a clipboard, putting me through a thorough physical exam to determine the degree of my dysfunction. Then she had me stretch — 5 stretches took 40 minutes. She contorted me in a pretzel and hung me off the table by a nylon webbing strap. It was glorious. I went to work virtually pain-free all day.

The next morning, the familiar ache was back. I popped pills, and then I went meticulously through the process Krishinda had detailed. Lo and behold, it felt better — much better. I gave swimming a shot; I focused mostly on pull-buoy exercises and avoided flip-turns, but the lengthening effect was palpable and a good bake in the sauna post-swim was positively magical.

Every day so far, I’ve been doing my stretching routine. It’s tedious, but I focus on being really present throughout each stretch, letting my body talk to me and tell me when it’s ready to go a little deeper. Today I swam and felt good enough to do real flip-turns and whip kicks, in addition to freestyle drills and endurance sets. Then I went for a massage, something I had actually been avoiding because of my tendency to over-respond to manual therapies — it seems to wake things up without bedding them back down. To my delight, the therapist thoroughly tenderized my quads, hamstrings, and hips. I felt so good, I went out and biked 20 miles when I got home — on my race bike, with a 9 cm drop between the saddle and handlebars. I could feel my back, but it was more like I had a pebble against my skin, not the deep and persistent pain I had been battling. It wasn’t until this evening I realized I forgot to take my pain meds this morning, after having been leashed to the bottle for two weeks.

I go back for my second physical therapy session on Monday, and I’m excited to report my progress. It’s not very often that therapists get reports like “I’m really happy with the speed of my recovery!” That’s with just one PT session, and rigorous adherence to doctors’ orders. PT works, folks.

My takeaways from this experience:

  • Back pain is miserable. Take care of your back, and take action as soon as you have a problem. I really feel for all my clients who have to deal with this.
  • Physical therapy is a partnership between a skilled practitioner who can diagnose internal problems from observing external cues, and prescribe specific movements to correct imbalances, and the patient, who must commit to unwavering resolve and intention in owning their recovery.
  • The medical complex in the United States is filled with phenomenal practitioners across a spectrum of specialties driven to help those in need, but the payments system is really broken. We need unprecedented reform to focus on preserving wellness as well as treating sickness.
  • An ounce of prevention is, really and truly, worth well more than a pound of cure.

Go forth, people, and thrive!

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