Should I stick with this PT or move elsewhere?

[AceDeuce]

I recently went to a physical therapist in my small town (Mt. Pleasant, Michigan) for my back pain. The lumbar area of my lower back on the right side experiences tightness in the mornings or if I get too intensive with my weightlifting or sit for prolonged periods of time (something I've tried to severely limit). I also recently heard a "crunching" in my upper back as I was doing front barbell split squats. The pain in that area is more acute and intense (probalby a 3 or 4 out of 10) but is only noticeable at all if I hyper extend my thoracic spine over a foam roller or similar device. The upper back injury occured about a month ago and the lower back injury has been on and off for roughly 2 years. I have ceased deadlifting or back squatting for some time now and it never hurts IN the gym, but the tightness will not go away.

The rehab has had me doing 10-15 minutes of electrical stimulation on those areas, followed by a light massage for 10 minutes followed by "therapy" which consists of:

1. Glute bridging (although no instruction was given to me on how to perform it properly...good thing I have some experience here I guess)
2. Prone unilateral leg extensions (I assume to get the glutes firing, although again, I wasn't given much "coaching", rather a simple "lie on your stomache and lift each leg off the ground 10x"
3. Standing hyperextensions with a theraband under my feet and being held at chest level (eek!)
4. Tricep stretching (wtf?)
5. Arm "cycling" on some machine to "loosen up your upper back"

I have 60 days that my insurance will cover the PT so I want the best treatment possible, and although my experience is limited, this does not feel like it is doing "enough", and the fact that they are actually promoting back hyper-extension makes me wary of their methods.

Should I seek another professional? Problem is I live in a small town and there may not be enough qualified people that understand the needs of someone as involved in weightlifting as me. I'm sure if they had it their way I would stop all lifting and just let things rest, but I truly do not feel that is necessary.

Then again maybe this is the introductory steps in the program and it will get more "intensive" later? I guess I was just hoping that my PT might have actually touched a weight in her/his life and could understand where I'm coming from...

Any thoughts? Advice?

[bryanc]

Sounds like you need to talk to your physiotherapist about these issues. The rehab process is not a one-way street where you are the passive recipient of "rehabilitative healing". If you think you can take more, then you need to make that known. If you have concerns that something has not been explained to you, then you need to make that known. Perhaps there is a method to the supposed "madness", that just needs to be explained to you for you to feel like you are getting appropriate care. Or maybe the therapist has underestimated what you are ready for. Or perhaps there hasn't really been a good clarification of what goals you are rehabbing towards. Or maybe you really do need to change therapists.

Talk to your physiotherapist.

[UConnJulie]

I agree with Bryan, however, it sounds as if you are getting "standard" care which IMO doesn't cut it. I have worked with many therapists who just don't have a good understanding of the higher functioning client.

Did your physician refer you specifically to this therapist?

[AceDeuce]

No, my physician just gave me a referal to the PT that I found. She actually recommended I go to the U of Michigan Spine clinic, but unfortunately that is a 2 hour drive from where I am currently at...

[UConnJulie]

I found two Mount Pleasant's in Michigan when I tried to Mapquest it ... so not sure if either of these is near you ...

Steve Houghton in Haslett should be good ... Steve.Houghton@att.net
Michael O'Hearn in Saint Joseph ... mohearn@lakelandregional.org
They both teach in the certification program that I think is excellent. Their training is such that they will work to get to the bottom of your problem, not just prescribe some basic exercises.

If you go to this website, there are a bunch of other program graduates listed under Michigan. You might be able to track them down through your insurance provider network or local phone book.


You can also try looking under the APTA's website. You can enter your search criteria with zip code, distance, and specialty. Keep in mind this will only list those therapists who are APTA members and not all of us are. I did a search here. You will most likely be better off with someone with "OCS" (Orthopedic Certified Specialist) or "SCS" (Sports Certified Specialist) after their name, but this is not necessarily a guarantee of the quality of his/her work.

Honestly, I would talk with your therapist, but if you get the idea that she really doesn't understand your problem or know what she is doing, then search for a better qualified therapist. I hate to say it, but there are a lot of bad therapists out there unfortunately.

[AceDeuce]

Just so I have the date remembered (4/6/08)...I injured myself yesterday on the eccentric portion of a 1-leg calf raise. Left side of my back this time, just superior/medial to the little bump of the ilium, near my lumbar spine...YAY!

Front squats with 195 and 1-leg RDL's with a 95lb DB didn't do it...it was the gd calf raise. bleh

P.S. I stopped going to the PT because in their words "we don't really know whats going on, or what to do"

I can't find any GOOD therapists close enough to Mt. Pleasant, so I guess I'll have to wait a month or so until I can move back to Ann Arbor, or possibly elsewhere.

[UConnJulie]

Bummer.