Why Go Directly to a Physical Therapist?

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Direct Access in physical therapy means that you can go directly to a PT for evaluation and treatment of pain and other movement related issues.

Yes, by law you may visit a licensed physical therapist without supervision, orders, or prescriptions from other health care providers.

[Mud bathing, bull riding, and bone setting are also things that the law permits you to do without approval of other health care providers, but we won't get into that.]

So what's in it for you? Why deviate from the traditional model where you are referred to physical therapy by a physician or other specialist?

1. Three certain things in this world are death, taxes, and rising (insurance) co-pays and deductibles. In most instances of musculoskeletal pain, you'll leave a physicians office with a prescription for pain relieving drugs and a script for physical therapy. Going through a trial of PT first saves you some time and co-pays. Which leads to point number two.

2. Physicians perform a systems review to identify "red flag" situations that warrant immediate attention. Physical therapists are trained and qualified to do this and specifically find root causes of movement related problems. Treating mechanical (movement related) problems requires mechanical solutions, and most physicians don't have the time, training, or desire to get into the nuts and bolts of movement.

3. Time is of the essence. Rest is good, up to a point. If medicine and a few days of rest are not helping your condition, the last thing you need is more medication with more rest. Rest does not identify and address the factors that cause pain or poor movement.

Seeing a PT sooner than later may substantially impact the extent to which you reach full recovery. For example, physical therapists attempt to address that painful plantar fasciitis or lateral shift of your spine before the mind and body begin to compensate and ingrain dysfunctional movement. Which leads to the final point.

4. Independence:  A vast body of evidence from virtually every medical discipline shows that chronic pain is a major dilemma. The more someone adapts a fear avoidance mindset and depends on health care providers, the poorer the outcome. PT is a conservative, patient empowering, proactive means of addressing the root of movement related problems.

No, we don't fix every painful condition for every person. But doing all that we can to set you up for success, and building on that, a little at a time, often goes a long way.

What's the catch? After all, I'm a biased source for talking about the benefits of Direct Access to physical therapy.

The catch is that most physician groups have seen the validity of these claims. They seek to work cooperatively with therapists who they trust to communicate with them if the patient is not improving.

Insurance companies are absolutely on board with this. After all, they are the ones with the most incentive to scrutinize practice patterns and determine what's beneficial and cost effective. For many reasons, very rarely are surgeries, MRI's, and other diagnostic tests deemed medically necessary before you have had a trial of conservative care.

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News story on Direct Access in Pennsylvania: CLICK HERE.


top 8 exercises for physical therapy

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And so it's on! I've officially opened the doors to my new physical therapy office in Mechanicsburg, working with Brian and Steve.

There have been a few new clients. A half dozen or so from my previous workplace have hunted me down. I'm doing a lot of set-up and administrative this-n-that, but it's a much slower pace than I'm used to.

So with that in mind, I present to you the top 6 exercises for your local physical therapy office.

1. The Flex and Twist: Bend with your back, not with your legs. That's right, disengage your leg and core muscles. Just go ahead and hang on your lumbar discs and ligaments. This technique works especially well when moving large awkward objects in confined spaces.

2. Down Hill Sprints: Who says you're not fast? No other exercise provides immediate improvements in peak running velocity like down hill sprints.

I'm sure the PTs in Gloucestershirestownvillesburg fully endorse down hill sprinting.

3. Sprint Through the Woods: If downhill sprinting seems a little extreme or just doesn't tickle your fancy, then you should try sprinting through the woods. When I was young my father told me that's always a great idea. And this is no trail run. You want a fast and direct route through the rocky outcrops, the cragier, the better.

4. Rekindle that drive in any once loved physical activity. Cold days in March are the perfect time to stretch that routine single into a triple.

Now is the time to relive your BMX and skateboarding hay day. Take up ice skating, test your ski jump proficiency, or strive for your fastest time in the 26.2 mile run.

The bottom line is to go for it. Or else you're just scared.

5. Stay Put: If you're not really the active type, into moving your body and all that, you still have plenty of terrific options. If you can muster the courage, try prolonged sitting marathons. Those who easily get bored with the same workout routine can mix it by sitting in the car, the chair, and the couch.

Don't check your posture. Heaven forbid get up. In fact, don't even think about thinking about movement.

6. P Insa90 X: For those of you serious about your local PT office, do a prolonged and repetitive DVD series. For PT extreme benefit, go from a relatively inactive lifestyle to exercising 60+ minutes 6 days per week. Really, who has time to read over the precautions and pre-test instructions? 

7. Repeat It - Swing your hammer or golf club or tennis racket a few thousand times with one arm. Roll your head in large sweeping circles. Test the integrity of your achilles tendons and patellar ligaments with a few hundred jumps on concrete. Hold your arms up above shoulder level for as long as possible.

8. Impact - If you fail to get injured doing those things, then just go ahead and jump as high as you can and land on your knees or tailbone. Run into the wall. Repeat.

What are your favorite exercises for physical therapy?

Office is open at 8 a.m.

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Ben 3:15

Okay here we go bragging on Ben again.

But there are lesson here that are not readily apparent to most people who want to get bigger-faster-stronger-awesomer and have it all in 6 weeks.

Last weekend Ben hit a pretty major goal, squatting 315 pounds...for twenty reps. TWENTY continuous reps! At a body weight of less than 170 lbs. You don't just roll out of bed one day and say, "I'm able to squat over 300 pounds twenty times, and I'm gunn do it."

Ben didn't start there. He started the journey about a year and a half ago with a stubbornly painful fractured spine with disc herniation, staring hard at a health care professional who instructed him to walk the dog but not run or do any type of strenuous activities.

Which I suspect meant no dead lifts. Or squats. Or flips of any variety.

Ben seeks and applies understanding. He regularly works brutally hard, suffers even, with his eye on the good that comes from it. He started with a little specific corrective exercise and low impact training. And then a little more.

There has been structured variation of training, but Ben has never complained about needing to "mix it up because I get bored." He's never worried about muscle confusion, or found excuses that raise barriers. He has focused his efforts instead of trying to achieve 3 or 4 incompatible fitness goals at the same time.

He's found a rhythm of hard work and recovery over a long term. And this is what you get.


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Jump Training (Part 6): Two Warnings

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So you're in! You decided to make a serious effort at a jumping focused, comprehensive training program. You're going to correct movement impairments, warm up appropriately and practice technique, and do plyos to amp the brain for explosive movements. In addition, you're going to hit the weights to gain strength and lean body mass or to maintain lean body mass while you lose body fat.

All this leads us to point 9 in our 10-point jump training series:

9. STOP with the overkill

My guess is that you are going to over do it. You won't over train because you're stupid, but because we all tend to fall into the "all or nothing" and "more is better" traps. We go all out gung-ho. We improve for a while and then hit a wall or get injured.

So this is a reminder that it's far easier to overdo it in the short term than it is to practice long term, disciplined moderation. There's magic in the rhythm of hard work, rest and recovery. Except for flexibility work and corrective exercise, everything you do should pass two tests:

Is this activity helping me to get stronger and bigger - or- maintain lean body mass?
Is this activity teaching my brain to utilize my body explosively?

Again, there are two typical patterns here:

A big guy or gal wants to lose ten or twenty pounds. So they start running three days per week along with higher rep weight training, you know, for toning. All the jogging teaches their brain to be efficient more than explosive and cuts into recovery from weight training. If you don't believe that too much cardio is counterproductive, go ahead and try to argue with these guys or those guys. Or try doing a lot of cardio and adding serious weight to the bar on squat and dead lift days.

Thin folks need to ask themselves or their coaches why they are supposed to be doing mile (and longer) runs in the off season. Is it so they can eat more? How are you supposed to add muscle with all the practice and other demands? Why are you always running bleachers? I'm not saying bleachers are easy, but they effectively conditioning the brain and muscles for small, high rep single leg leaps.

But instead, the big guys and gals would do well to remember that trying to train your way out of poor eating habits is always a bad idea. The thin athletes need to hit the iron brutally hard at regular intervals, do limited but intense sprints and plyos, and otherwise rest, rest, rest.

The bottom line is that you won't reach your ultimate potential for jumping if you're chronically overtrained, spinning your wheels instead of following a focused progression toward strength and power. You're not going to be able to fit in a lot of traditional cardio. You're going to have to get your calorie control and endorphin rush elsewhere, like plyo jump/sprint circuits!

If you think a runners high is nice, you've never tried heavy 20 reps squats 
or nasty "core" finishers to your weight training sessions.

And lastly, lastly regarding improving your jump:

10. Genetics
Poor genetics for jumping.

No, this is not where I tell you some secret on how to improve your genetic potential, which was set long ago. Yes, genetics do dictate our ultimate potential. But I'm pretty sure that potential is overrated.

Everyone has potential. But how many people get even close to their genetic potential in any given area?

You're potential to be awesome is plenty good enough. So what's the use in worrying about genetics? Please don't read about all these modifiable factors and instead of going out and doing something, sit around complain about the one factor that's out of your control?

So there's your second warning: about how lame it is to pull the genetics card.

You know that 9th grader who can almost dunk? Sure, he has good genes. But  he also has probably grown up in a supportive environment and jumped and reached and fell ten thousand times in his youth before finding a passion for basketball and training his ass off in the last few years. And with a little luck, no fitness folks have had the chance to make him work on his "cardio base" or some other fictitious load of crap.

So good for him. 

Trust me, a 6'2" 35 year old guy doesn't suddenly force his will into basic gymnastics due to good genetics.

And a tuck jump over 5'. Yes, adding credentials for this series.

And you? Your video, next? You may not dunk. Or flip or clear 5 feet. But maybe you'll do far more. Who knows?

The only thing I can guarantee is the joy and satisfaction of the process. The goals and mini goals, the disciplined effort, the sweat, the risk, the victories and defeats, the planning for next time. That will keep you ticking, inspired, with a healthy mind and (usually) healthy body.

And that's meaningful.

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