Full disclaimer: I am not a physical therapist and this only reflects my personal experiences. If you think you may be injured or if something doesn’t feel quite right, please seek advice from a professional PT or Doctor.
I’ve written about my time with physical therapy (PT) a lot. I spent all of 2013 in PT, first for an IT band injury that threatened my entire year’s plan of completing the NYC Half, Tri and full marathon within a calendar year (known to my friends as the NYC Triple Crown) and later for preventive work (known to us as pre-hab) throughout the year. I’ve since gone off and on for issues that plague: extreme calf tightness, hamstrings so tight I yelp in pain if anyone touches them and now pesky ankle tear. I’ve spent so much time in Finish Line Physical Therapy‘s great care that I mostly know how to diagnose myself but need a professional to confirm it and drill out treatment. Non-runners and runners alike have questions around PT and I hope to provide some insights from my years of experience on the table screaming as my muscles protest:
When should I go to PT? You experience pain or discomfort before, during or after your work outs: the general rule is never to push through pain that’s a 4 or higher on a scale of 1-10. If it’s that high and/or steady, stop immediately. I know you want to finish it out, but you’ll probably make it worse. It’s not worth it.
Picking a place: PTs have gone through extensive training and every studio and PT will have different focuses and expertise. Finish Line is more hands on; I was most comfortable there because the owner is a running Coach and Ironman, so I knew I was in good hands. My PT, Brynn, is also a marathoner who understands that I will always ask “when can I run?” or “how much can I run on it without making it worse?” It’s good to find someone who understands your priorities and levels of crazy.
What is done during a session: there’s a diagnosis period where you talk about your aches and pains.
- What hurts?
- When does it hurt?
- How often?
- Where exactly does it hurt?
- What type of pain is it (intermittent, constant, throbbing, stabbing)?
- On a scale of 1-10?
- What makes it better?
- What makes it worse?
- Has this ever happened to you in the past?
- What worked then?
- Let me see you do XYZ.
After this is done, they issue different types of treatment for your injury. I’ve undergone strengthening exercises (my IT band was being pulled tightly because my side hip and glutes weren’t firing properly), soft tissue work (think a massage but more painful), stretches that are assigned, heat administered to loosen up muscles, compression pant sleeves (air inflates the pants to compress your muscles and promote circulation to speed up recovery after a long run or race) and an Alter G anti gravity treadmill (imagine a treadmill with an air filled compartment on top. You put on shorts that zip into the top of the compartment and it fills with air. This keeps you buoyant and holds up a portion of your body weight. You can now run while not putting the normal pressure on your joints/injury. It helped me make sure I could run without inflaming my IT band more and can HOPEFULLY use it to test out my ankle soon).
You’ll get homework and are expected to do it: I’m supposed to be doing trigger pointing my calf (putting a lacrosse ball or a trigger point ball under my calf and rolling it out), compression wrapping it and doing two different mobility exercises every day. And I’m not. This means I’m only adding time to my recovery because I’m not doing all I can. It’s something you have to be aware of and make decisions on what’s going to help you in the long run: the extra 15 minutes of sleep or your PT?
Never blame your PT or your sport: this is a big one for me. Every injury I’ve had is because I didn’t do what I was told/knew to do in the first place. Brynn always asks “are you stretching after your runs? Are you rolling out? Do you trigger point? Taking ice baths?” and my default response is to always laugh and say “of course not!” If I was, I probably wouldn’t be there. In my defense, I see myself as Brynn’s job security because I’ll always be back. I continued to run on my torn ankle for 9 months and now I haven’t been able to run in OVER 100 DAYS while I heal because I’m stubborn. My IT band issue could have been avoided if I had only rolled out at least once a week. Tight calves would have been staved off by a little yoga. The most important thing is to remember what got you here and how you’ll keep looking forward. Learn from your mistakes and try not to repeat them.
You may cry for a few reasons: getting worked on hurts and sometimes your sessions unintentionally turn into real therapy. My most painful session went like this: Thursday I did my first spartan work out with stair repeats and burpees, Friday I went out and dehydrated myself, Saturday I did a 2ish hour brick (bike then run hills) and Sunday I ran 6 miles with my friends and finished with squats. When I went in for my Monday appointment it was painful to straighten my legs because my hamstrings had had it. Brynn looked at my legs and said “WHAT DID YOU DO TO YOURSELF?!” She was then charged with loosening up my legs with soft tissue work, including sticking her elbow in my glute to break up a knot. can’t remember if I actually cried, but I do remember being in a LOT of pain as my poor choices were sorted through. Also, we spend so much time together we talk about life issues. Wedding planning, training, friendships and career frustrations. Our latest decision is that I need to move to Miami, stumble upon the Rock and become his best friend. (Side note: if he doesn’t live in Miami and I’m mistaken, please let me know).
I am a huge proponent for physical therapy and it’s been very useful for me. If you’re toying with the idea, a consultation can never hurt. Share you PT stories in the comments!