physical therapist

How to Find the Right Physical Therapist

Ok, you really are injured. Your doctor told you to go see a physical therapist, or maybe you’re realizing this injury won’t heal on its own. Now what? You don’t want to trust your most precious resource, your body, to just anyone, but most people’s first move would be to google physical therapy clinics in the Reno, Nevada area. Is that really how you want to find the person that will be restoring you to your previous glory?

You need to know all physical therapists and physical therapy clinics are not created equally.

If you were to have a surgery, you would most likely have a second opinion. We get multiple estimates before getting our car repaired. Doesn’t it make sense to research your physical therapist? Consider not just price, but quality, convenience, experience, and specialty. There’s no doubt that cost is an important consideration, but remember you only have one body and you want it to feel good. You want to rehabilitate and restore – not just get a rub down with no lasting effect.

So I offer you some tips for determining if a therapist is the right match for you:

  1. If you have no guidance from your doctor or friends, check out apta.org/findapt. Look at the specialties, extra certifications, and education. The letters don’t guarantee a great physical therapist, but it does show an effort on the therapist’s part to go above and beyond the status quo after graduation.
  1. Call the clinic or look on the website to learn more about that specific therapist. You should be able to see each therapist’s specialties, educational backgrounds, and years of experience.
  1. Ask about the size and treatment style of the clinic. Are you comfortable in a big open gym or would you prefer to be treated in a private room? Does that physical therapist have 4 patients in an hour or just one?
  1. Ask how long each visit is with the physical therapist. Many clinics have patients see both the therapist and an unlicensed therapy aide or technician. You want to make sure the bulk of your therapy is with the physical therapist (for example 45 min with the physical therapist and 15 with an aide). Aides can guide exercises if you have already been trained well by the physical therapist. The aide should not be teaching the exercises or performing any hands-on techniques to patients.
  1. Will you see the same physical therapist each visit? Consistency is important. As a therapist, having the patient’s full back story helps us put together the puzzle pieces. Without consistency of care, important details are often lost, which can have a significant impact on the extent and speed of recovery.
  1. Will a therapist take the time to talk to you on the phone prior to your appointment or answer questions and concerns between appointments? Now, realistically the physical therapist may not be able to jump on the phone whenever you call, but it is reasonable to expect a call back within 48 hours.

Once you have spoken to or met your therapist, consider a few other factors that will aid in the success of your care:

  1. Do you like the person? Be honest, this person will be in your face and touching your body, if you don’t feel comfortable with them, it could affect your outcome. Do they listen to your concerns? Were you involved in establishing goals for therapy?
  1. You should feel a difference in one to two visits. Notice I did not say you should be better in one to two visits, but there should be some change. That change may be good or bad. If it’s not good, the therapist should be able to answer why your symptoms are not improving.
  1. Often the symptoms that brought you to physical therapy are not the actual cause of the problem (which is a topic for another post, stay tuned). But frequently a knee hurts but it is because the hip is weak. Did your therapist look at your whole body, not just the injured region?

At Battle Born Health, our therapists have over 25 years of combined experience in Orthopedic and Athletic populations. Our therapists have completed post-doctoral certifications and board certifications. We do not employ technicians or aides. We strive for 100% consistency with patient scheduling.

We provide a free 30-minute discovery session for all potential patients. We would love to talk you, answer your questions about what is hurting or limiting your ability to do what you want to do.  We are different from the rest and would love the opportunity to prove it. If we are not the right fit for you, we are happy to direct you to the appropriate practitioner.

Give us a call!

pain management

How Pain Can Make You Fat

This article originally appeared in the May 2016 issue of Live, Love and Eat Magazine. 

You’re trying to do everything right – you have been working out like crazy, haven’t eaten cake let alone bread for ages, you sleep 6 – 7 hours a night, you’re at the gym at 6 AM at least 5 days a week.  Your shoulder bugs you every time but it’s not so bad that a few Advil can’t ease it.  Despite ALL of this, the scale hasn’t budged and your pants aren’t any looser. The classic theory of counting calories in and out is outdated and can do more harm than good. To quote JJ Virgin, “your body is a chemistry experiment not a bank account.”

Metabolism is what drives the body’s fat burning system. How your body burns calories, uses energy and loses weight, is dependent on multiple factors. Metabolic function, and thus weight loss, is based on our hormones. Hormones are chemical messengers of the body; they send the signals to promote cellular function.  These hormones produce the chemical reactions that govern everything!

Long ago in the evolutionary process, our bodies held on to weight whenever it was under stress. This allowed our ancestors to survive periods of famine. Those who were able to hold on to fat survived and those people became our ancestors. That means you can thank your Great Grandma for making you SO very good at holding on to fat. Nowadays, if our hormone levels get out of whack (from illness, medications, diet, etc.) our body goes into that same protective mode as if it were preparing for famine, thus it holds on to weight

Now you’re probably thinking “what can I do to control this stress reaction?” First, you need to understand the connection between the brain and the body.  Imagine our nervous system as a 2-sided coin – one side is the sympathetic and the other is the parasympathetic. The sympathetic nervous system controls our Fight or Flight response (FoF) which shifts into gear when we are stressed. The parasympathetic is responsible for our Rest & Digest (R&D) phase.

Imagine this scenario: You’re out on a walk and you encounter a tiger. Your body immediately kicks into Fight or Flight mode and floods your system with cortisol, which is a stress hormone that helps mobilize glucose to the muscles so you can run, jump or fight. This rush of cortisol increases your heart rate and helps push more blood and energy to the muscles so you can dart to a tree and climb like your life depends on it.  When cortisol rises it stops the non-essential hormones from working. As you run from that tiger you really don’t need to ovulate, digest your food or regenerate healthy skin – you just need to get the hell out of there.

That’s the way it’s supposed to work. Once you get to the tree, the tiger goes to find someone else for dinner. Now it’s time for R&D so I hang out drink some coconut water and relax. The cortisol will drop and everything else starts to work again.  Cortisol is important for short-term stress, but when we have chronic stress, the continual release of it becomes a problem.

Exercise is important, our bodies were built to move AND rest. When we move correctly our body will increase metabolic processes, allowing it to use energy and produce metabolic waste. Detoxing this waste is a crucial part of weight loss, so if we don’t rest and digest the liver can’t access the nutrient chemicals needed to detox the body. These metabolic toxins build up and the body thinks “I need to get this toxic stuff far away from my brain, my heart, and my lungs!” If the body can’t break down the fat-soluble toxins, it wraps them up safe and sound in a fat molecule and stores it somewhere safe, far away from the brain and heart…like on your ass.

In our society today, we tend overdo things. The first person to complete the 26.2 mile run to Marathon died, but for some reason we all think it is a rite of passage as an “athlete.”  It’s important to understand that stress to the system in small doses allows us to grow stronger; too much stress and we break down.

Physical stress such as exercise produces a spike in cortisol, which can be good. We need to exercise to break down tissues and encourage it to heal bigger and stronger. The problem occurs when we keep stressing the system without rest. The body cannot keep up with cortisol production and the adrenal system starts to fail (exhaustion).  When the adrenals are exhausted, sex hormone production is lessened so you can say goodbye to the idea of six pack abs.

Pain is also seen by the body as a stressor, depending on the intensity and frequency, a chronic stressor. Therefore, the body responds by increasing cortisol production and goes into flight or fight mode whenever it’s stimulated. Physical pain can continue to increase and spike cortisol which ultimately changes our body’s healing process and starts a chronic pain cycle.

pain management

As a physical therapist, I work to figure out why pain keeps occurring, then we work to change the patterns of muscular strain. Other important variables to address are diet and stress relieving activities to increase healing process and stop the downward spiral.

Remember: train smarter not harder. Pain is a signal from your body, begging you to stop (we’re talking about sharp, localized pain, not the muscular burn of activity). Your body will not get stronger through pain, it gets weaker, less tolerant and less efficient.

What can you do about all of this?
  1. Modify the movement or amount of resistance to reduce the pain
  2. Rest! Sleep at least 8 hours, try for that 7 days a week. If you are getting less than 7 hours a night, it isn’t worth it to get to the gym.
  3. Workouts should be short and intense, but not every day. Studies recommend 2 to 3 days consecutively then 1 to 2 days of rest. You can have active rest days using a walk outside or yoga for recovery.
  4. If you notice on an exercise day you are more exhausted, your body is showing signs of adrenal fatigue, force yourself to take a break.
  5. Eat nutrient dense whole foods – not processed bars, or shakes. Clean, organic proteins and LOTS of veggies for the nutrient profile that helps with anti-inflammation and detox.
  6. See a physical therapist to evaluate the movement dysfunction that is causing the pain. A good therapist can determine why the pain is continuing. With a good rehab program, the muscles can be re-trained and restored.
  7. Remember self-care is not selfish. When you spend time caring for yourself, you can recharge your own battery and then have time and energy for others.

Danielle is a Doctor of Physical Therapy and a Health Coach.  She is the co-owner of Battle Born Health in Reno, NV and has been practicing physical therapy for 20 years. Driven by her personal health issues, she completed training under the Kalish Functional Medicine Mentorship program and is certified as a Transformational Nutrition Coach. Danielle is passionate about finding the root cause of the problems, whether they are muscular, hormonal or dietary (and usually they are a combination of all) and helping people find the answers on how to become stronger than yesterday.