Physical Therapy question

T

t_jania

Cathlete
For anyone who's done PT before, what did you think of it? Did you feel it was worth your time? Or did you feel like you could have done a better job yourself just given the proper knowledge and a list of exercises to do?

I've been prescribed physical therapy for my knees. I'd injured my knees doing too much weight with leg press and the goal is to strengthen the muscles around the knee cap so I get stability. Apparently, my knee caps are very loose and flexible and that contributes to my problems.

I've had two sessions so far, 45 minutes each. I'm getting things like leg press on a total gym with my own body weight with 50 reps. Side squats with 30 degree knees for 30 reps per side with no added weight and they won't let me go to capacity as far as what my knees can actually do at this point. Seated leg extensions with maybe 3 pounds.... you know, I'm not feeling it. I wasn't sore the next day (duh) and even though I really put my mind in the muscle and went for the isometric contractions, I'm really not feeling anything. Today, I'm going to tell her to beef if up or quit wasting my time. I get a better burn with no weight exercises with Cathe, you know? Though I must say that my knees didn't hurt the next day either.... that's good. But is it really working?
 
Tammy, I'm certainly not a PT but my husband is. From what I understand, doing rehab is not about getting more fit, it's about gaining lost movement(ROM), reestablishing neuromuscular connections that may have been lost, and reducing pain levels if possible. I wouldn't worry too much about not feeling a 'burn'. You still may be gaining some critical functional strength and neuromuscular connections. If it's helping you reduce your pain, then I for one would say that it's working. If I were you, I'd take your concerns to the PT. It should be noted that, just as doctors, some PTs are better than others. Maybe you could get a second opinion with another PT if you're unhappy.

Carolyn
 
Hello Tammy,

Oh yes, I would say definitely. I suffer with CMP (runner's knee) occassionally and I just got over a bout of achilles tendonitis. The pt help me a great deal. At first I was doing my own thing but the truth is that physical therapy offers you access to equipment that you don't normally have at home. Plus, the massages and heat treatment are helpful. I committed to one month and that was good enough according to my dr. In addition, I did exercises at home to compliment the pt.

Two good books that have help me are: "Treat Your Own Knees" by Jim Johnson (he's a pt) and "The Knee Crisis Handbook" by Brian Halpern (he's a doctor)

HTH,

Katrina:)
 
I just went through physical therapy for my shoulder. Same kind of diagnosis - my shoulder is very loose and unstable which contributed to the injury. Basically, they set up a program for me of exercises that will strengthen the muscles around my shoulder to keep it in place. They showed me the correct way to do them and also gave me a list of exercises NOT to do until my shoulder was better. I only had to go to four sessions and am now able to do the exercises on my own at home. They had me go very low on weights though the entire time. I really wasn't feeling a "burn" just a gentle warmth in the muscle. It is really easy to want to go heavy on all of these exercises, but you have to force yourself to take it slow or you are just going to hurt yourself more. PT definitely is not designed as a "workout", it is therapy. My shoulder is definitely getting more stable and I am slowly increasing the weights. Good luck with the knees!!!
 
When I did PT after my ACL surgery, the point was to NOT feel it after. If I did, that meant I overdid it during the session. I would be there for 90 minutes, twice a week, and the big thing I had to keep in mind was to back off if I felt ANY pain.

PT is not a gym. It's about getting you ready to go back to what you want to do.
 
I've been through PT for my knees a few times, once for something similar to what your describing, and more recently for ACL reconstruction.

I recall the first few sessions being a bit on the easy side, but I think the PT's were trying to assess where I was. Whenever I mentioned that the exercises were feeling too easy, they had no problems making it harder. My later sessions were definitely tough, tough enough that I would sweat up a storm and usually had DOMS the next day.

Does your PT specialize in sports medicine? Did you layout what you wanted to achieve through the rehab? One thing that might be helpful is to let your PT know if you have some kind of fitness goal that your trying to reach with your rehab. During my last round, we set my goal to be back on skis next season, and my PT focused a lot of training toward that. It has been very effective.

ETA: Also, I'll bet that your PT is focusing a lot on your form, which is why your going light. Keep in mind that if you're suddenly doing stuff with improved form, it's likely to be harder with less weight, reps, etc.
 
I've found some PT useful (especially a PT who gave me exercises to do on my own after a session with him, using equipment I have at home, and just checking in occasionally to see how my progress was going), but some I found to be a waste of time and money (someone basically watching me while I did exercises I could do on my own) and even negative (testing my knee on a device that had me do leg extensions as hard and fast as I could for 20 reps, and have to repeat it because they didn't get a good reading, having my knee go 'crack' and have subsequent pain---which they then treated, charging me to rehab a new injury that was caused by their machine! I quite right after that and did my own rehab--just to get the info that the last 5 percent extension of my quad was where I am weak.)

I think PT's can be great for diagnosing, setting up an exercise prescription, and making sure you don't overdo, if you tend to, but I'd get as much info from them about exercises you can do on your own, so you can maybe check in with them from time to time, but don't have to go 3-4 times a week just to have them watch you workout.
 
Hey Tammy

I'm a sports P.T. If your therapist is working on knee cap (patellar) stability then they are working more towards quality and/or timing of your quad firing while trying not to further irritate your knees. Mostly we would work on the VMO (vastus medialus obliques) which is the inner most of the 4 quad muscles. This muscle helps keep the patella tracking properly in its groove.
If the patella is not tracking properly (is sloppy), you can have Arnold size quads and you'll still have alot of knee pain.

Do let your therapist know your P.T. sessions have not increased your knee pain. That would be grounds for increasing the intensity of your sessions. However, even if you do not have an increase in knee pain after your sessions your weights should not be increased if that patella is not tracking properly.

We also would give exercises to do at home. But sometimes for various reasons we would hold off on the home exercises for a while.

The problem with treating athletes is I would tell them to do 10 reps. and they would go off and do 100. This will increase your knee problems. But you'll find that out pretty quickly :) .

This is just general information. But again they are most likly working on the quality and timing of the different parts of your quad rather than just general strengthenig.

All that said if you are not happy with your progress you are free to switch therapists.

Good luck!
 
Kathryn

You are right in some ways. There is no reason for me to sit and watch someone exercise if they have great form and they are not at risk for further injury. However if it is a muscle imbalance you better believe I'm watching every rep. and constantly giving feedback. It's like breaking a bad habit. We have a muscle memory where when we do a movement we use our muscles in a certain order every time. If that order is causing us injury than it's my job to help change that order or to get one part of the muscle to fire harder and or faster than another part of a muscle.

The shoulder is very complex so if you have a shoulder injury please get it taken care of before it snowballs.

The machine that hurt you... Yeah I've used it before and I'm sorry it caused you more problems.

If I had someone like you as a patient I would be giving you exercises to work on at home and check in once a week to make sure you were getting the right results.

Again, if you are not happy with your therapy by all means switch therapists (we really don't mind) or even switch clinics if the one your at is not sports centered enough.
 
After my ACL reconstruction, I did my home exercises religiously to regain my ROM. The surgeon was floored when I came in for my first post-op visit. After 4 weeks, my ROM was where they would have expected it to be at 3 months. Yes, I did do that at home - but without the help of the PT, I wouldn't have been back to Tae Kwon Do and Cathe at 5 months. I could have gone back at 4 months, but elected to "play it safe". If I was doing it all on my own, I'm very confident that I would have overdone it and hurt myself.

Every time I mentioned to my therapists what I wanted to be doing, they told me to slow down. I wasn't ready yet. And, of course, they were right. You can really mess yourself up if you're not careful.
 
You all are fabulous! Thanks for your replies and the book suggestions and you knowledge.

Today is my 3rd PT session. I did talk with my therapist about my goals and my doctor, too. The goal is to get back to exercising normally and that means impact and weights and I said so.

The main reason I asked this question is because when my DH had PT, he said it hurt and burned and all sorts of things. I was surprised when I found it easy. Gaining strength in the stabilizers while not inflamming the knee is the goal so I am ok for now with the pace. I'll be talking with my therapist today in about an hour and I'll let her know how I felt after. Perhaps she'll adjust today or maybe she'll still be assessing my situation.

And yes, there's lots of equipment to use that I don't normally have access to and that's really cool.

And yes, I was thinking of it as a gym instead of therapy. I think I need to re-boot my brain!!

Thanks everyone! And if anyone has more to add, please do. I'll be checking back often. :7
 
i had pt on my shoulder and it is gone thanks to pt. she'd put on a cold compress or warm cant remember,massage with a cream then do some very light exercises and then another compress. also did excercise with a light band at home. now that arm is slightly stronger than the other but i can now go back to lifting heavy weights. i think it was from doing s&h too much.

laura
 
>KathHowever if it is a muscle
>imbalance you better believe I'm watching every rep. and
>constantly giving feedback. It's like breaking a bad habit.

That would be great, but the woman who was supervising my PT (not a PT, but some kind of assistant) never gave any feedback (except to tell me to do my extensions and other reps faster! and to show me how to use an adductor/abductor rotation machine that was new to me). She basically just stood by with with a chart where she wrote down what I was doing (I assume so: she never said what she was writing).
 
Jessie, my therapist, said that they're starting slow with me to make sure they don't irritate the knee. She started telling me what the next steps are going to be, for example, one exercise is done on a 4 inch step and we'll work our way up to 6.

I'm feeling fortunate that my therapist makes comments and corrections on my form. She said my form is great for exercise, but for PT, she wants me to do something a little different to hit the quad more. Nice!

Though I still don't feel 'worked out' I have realized I'm not supposed to. I'm healing and I have no knee pain right now so that's a blessing.

Thanks again, ladies! You all are wonderful!
 
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