Finding What Works

Finding What Works

Physical therapy is more than just handing a person a list of exercises. It’s even more than finding the exercise that works for that person’s body. It’s finding the exercise that works for that person’s life.

I saw a fellow today who was unable to set aside time in his schedule to do his back exercises. He worked two active jobs and couldn’t pause what he was doing to stretch. While in the clinic, the exercises helped relieve his pain. When I’d see him the following week, he’d report little improvement. He wasn’t doing his exercises in-between visits which would have likely helped.

People with back pain often demonstrate a “direction of preference”. That is, an exercise in one direction helps to decrease their pain and improve their mobility, while exercise in the opposite direction may exacerbate their symptoms. This is where finding the right exercise for a person’s body comes into play.

Determining which exercises will help most is the cornerstone of my work.

A direction of preference may be a forward bending movement, a backward bending movement, or a sideways movement. In this case, this fellow had a forward bending direction of preference.

Now, in years past, I would have admonished him for not doing what we saw would help his pain. These days, I take a different approach.

I looked to find a way that he could incorporate forward bending types of movements into his regular day so that he didn’t have to make time to do his exercises.

What worked for this fellow won’t work for everyone. He was quite limber, so getting into a deep squat position wasn’t a challenge for him. In a deep squat position, the back will round into a flexed (forward bent) position. This is consistent with his direction of preference. He noted that it was a position he could get into on a regular basis.

When he returned today, he was happy to tell me that he had been doing his exercises, and, as a result, his back was doing much better. One of his jobs was in construction where he found himself having to check a number of electrical outlets. He saw this as an opportunity to squat instead of bend. In doing so, he was able to incorporate forward bending stretches into his workday, and that made all the difference!

A big part of being a physical therapist is problem-solving. Being able to spend one-on-one time with our patients is key to our success. Determining which direction works for them, and figuring out how they can implement that into their daily lives can make all the difference.