Wednesday, March 16, 2011

Ask the Physical Therapist–March 16

Earlier in the week I posed a question regarding physical therapy and said that I need to touch base with an expert.  Well, Dan from Orleans Park Rehab (the guy that kinesio taped my arm) replied to my question.


Dan Lent-Koop, MPT, CHT


I know from working in physical therapy (many, many moons ago) that you have to work an injured body part.  But where is the line between aggravating the injury and rehabilitating the injury?


The line, so to speak, is established in the physiology of tissue healing. It is important to always go back to the science of it all. When you tweak or injure something there is typically pain. Pain is your body’s own natural protective mechanism. It signals that continued performance of whatever you’re doing will result in further tissue damage. We are taught as athletes to ignore pain and push on. While there is some truth to this be it the result of lactic acid during the final hard sprint, the chemistry of pain will best you every time.

As a therapist, I am trained to evaluate pain and its origin. There lies in the clinical experience of a good therapist. When to push and when to hold back is based on the individual case. Years ago, injuries were splinted and patients were immobilized until the tissues were well-healed. We now know better.

Assuming your injury is not profound, range of motion activities should be performed even in the acute phases of healing. These activities aid in promoting blood flow through the injured area and can reduce the presence of swelling. It also prevents the development of shortened muscles around the injury. These are commonly known as muscle contractures and can be even more difficult to overcome than the original injury.

Now if you ignore pain, push too hard, and overstrain the healing tissues, it is very likely going to prolong the healing process. If a little is good, it does not necessarily mean that more is better. Tolerating modified activity, moving through the available tolerated range of motion, for limited duration at limited intensity is exactly what is needed. Listen to your body. It will tell you when too much is too much.

Your best bet is to do everything possible to maximize the healing environment for your tissues. For healthy people, the body is trying to do exactly what it needs to do to heal itself. We can promote this by keeping the injured area from getting too swollen. The acronym R.I.C.E. should be employed. Rest the area as noted above. Ice the region for 15 minute intervals. Compression; wrap the area to promote venous return. Elevate the injury above the heart.

In Good Health-

Dan Lent-Koop, MPT, CHT

Wow – thanks Dan.  That answered my question!  I have started back to swimming with my shoulder and there has only been mild discomfort.  The bench press will still have to wait.  I am thinking of starting the 100 push up challenge at the intermediate level.  This should allow for me to build up the shoulder without further injury.

If you have any questions for Dan then leave a comment or send me an email


Matty O said...

Great advice! Thanks for sharing this post!

Tri4Success said...

Excellent post we can all benefit from. Thanks for sharing.

runnergirl training said...

Nice post! Great information! Thanks for sharing! Thanks for the blog follow. I'm following you on Twitter now, I'm @runnergirltrain

Jill said...

I think I am going to be in PT for the rest of my life; this was great to read!!!

Ransick said...

Great post. I'm coming back from a shoulder overuse injury (or middle aged new triathlete learning to swim injury). I've found it is a balance between PT helping the issue and compunding the issue.

Heidi Austin, PT, DPT said...

love it.... PTs rock :) ! you coming out again for NOLA 70.3 ?

Caratunk Girl said...

This was awesome. Thank you so much for sharing, this was some really great stuff.

Matthew Bradford said...

James, Didn't you do the Rouge to Orleans? Just saw these results and recaps and thought you'd be interested