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Ask a PT: Am I hurt enough for PT?

“I didn’t think it was bad enough to get help.”

 

“I figured it would go away eventually, but it’s been six months now.”

 

“If I don’t sit/run/walk/drive/sleep on my side, I don’t have pain, so I’m just avoiding that.”

 

I have heard these words, in many variations, more times than I can count throughout my career. Many people feel that in order to get care, they need to be completely debilitated.

 

The truth is, musculoskeletal conditions, like most things in life, are best treated early. The longer we experience pain, dysfunction, and range of motion limitations, the more our nervous system, movement patterns, and behaviors will change in response, and the worse the condition can get. The worse the condition gets, the longer it takes, and the more PT you’ll need to reverse the condition.

 

Let’s take a look at what to do and how PT can help at every stage of pain:

The first four weeks: acute pain

The acute phase of pain can last up to four weeks.

 

Generally, acute pain is more sharp or severe and you can usually trace it back to what caused it. Threw your back out lifting groceries? Rolled your ankle on the sidewalk? Tweaked your neck from staring down at your phone? All of these things can cause acute injuries. As the injury heals, the pain should go away.

 

The key to getting through this phase is to keep as active as you can, and gradually increase your activity as your pain permits. If you get physical therapy at this stage, your chances of recovery are optimal.

 

Your PT will develop a program designed to help you heal from your specific injury, including exercises that help you push past your limits safely. With SWORD, your digital therapist will tell you if you’re performing exercises incorrectly, and your physical therapist gets precise feedback on how you’re doing, so they can update your program as your healing progresses.

 

Surgery is another example of an acute trauma. You can’t wake up from a knee replacement and run a marathon. Your body needs to recover from the trauma of going under the knife, and learn how to function with this new foreign object in your knee. Great PT after surgery is key for making a full recovery – especially if you have big goals in your sights!

 

When to get help for an acute injury:

  • Seek medical attention immediately if you experience a trauma, are unable to bear weight on an arm or leg, have severe pain or are experiencing numbness or tingling.
  • Call your doctor or tell your PT if it’s been a few days and things aren’t improving, or if you have swelling that’s worsening or not resolving.
  • If you’re not sure what to do, err on the side of caution and seek treatment.

4 – 12 weeks: subacute pain

After 4 weeks, pain is now considered subacute.

 

If you’ve been treating your injury with a good PT program, the inflammation will have subsided and things should be getting back to normal. If you haven’t sought care, this is the point where you should really ask yourself: are things still off? Am I still feeling pain? I am moving differently than usual? Am I avoiding certain movements or activities I used to enjoy? If so, it’s time to get help.

If you start a physical therapy program in the subacute phase, the chances of it becoming a chronic issue are much lower. Great PT in the subacute phase can help get you back on track and back to doing the things you love.

12+ weeks: chronic pain

If you’ve been in pain for more than three months, it’s now considered chronic.

 

You may not know how your pain started, or you may remember a specific incident that caused it. There are many things that can cause chronic pain, including acute injuries, overuse and underuse of muscles, other chronic conditions, and even emotional trauma.

 

This pain is less related to damaged tissue and more related to changes in your nervous system. Something has tripped the wires in your brain, and your receptors get stuck on a pain loop. Chronic pain can range from mild and intermittent to severely debilitating, and if left untreated, it can last years or a lifetime, and can get worse as time goes on.

 

If you’re struggling with chronic pain of any degree of severity, please know that you’re not alone, it’s not your fault, and you can manage it. A good PT program will help you tackle all the factors that are contributing to your chronic pain: therapeutic exercise for physical strength and recovery, education to help you understand what’s causing the pain, and behavioral coaching to give you the mental and emotional tools to get back in control.

 

No matter how severe or sustained your pain is, a good PT program is worth it. And you are worth it.

Why does it matter?

Pain changes us. We move differently. We avoid things we think may cause it to worsen. We don’t sleep as well. Our physiology also changes as our nervous system responds to the perceived threat, whether there is tissue damage or not.

 

Sometimes we bounce back. But other times our bodies don’t know how to go back to how things were before the injury on their own. The result is a life lived in pain – and none of us deserve to live that way.

 

The good news is, it is possible to manage pain at any stage. But just like it’s easier to remove a stain from your clothing if you treat it right away, it’s easier to change symptoms before they set in.

 

Does that mean you should call your doctor or PT for every little ache and pain? Maybe not, but here are some general guidelines.

 

If you have mild pain that is improving, your pain doesn’t cause you to limp or move unnaturally, you’re sleeping well and you’re still active, it’s ok to take a ‘wait and see’ approach. It’s helpful at this stage to note your symptoms: when they come up, how long they last, what they feel like. Kind of like having a cold, you should expect your symptoms to improve over 7-10 days.

 

But if your pain lingers or symptoms worsen, the intensity of the pain is moderate to severe, or it limits your ability to do your normal activities, ask for help – even if you think your issue is not that big of a deal.

 

You deserve to get help, and the earlier you seek treatment, the better off you’ll be. One of the great things about the SWORD program is that you can get high-quality treatment without a big time commitment. In just 20-30 minutes a day, you can start working on your pain at its source with your physical therapist at your side – no commuting or scheduling required. Our members do their sessions whenever and wherever they like: early in the morning, late at night, while their child is sleeping, and between meetings.

 

If you’re on the fence about physical therapy, give it a try – you deserve to help your body heal!

 

Want to learn more about SWORD? Fill out this form and someone will get in touch.

 


About the author: Megan Hill, DPT

Megan Hill, Doctor of Physical Therapy, is a licensed physical therapist focused on musculoskeletal rehab and chronic pain management. She dropped her plans to go to law school for physical therapy after a knee injury from the Chicago Marathon left her in need of rehab, and she hasn’t looked back since. She’s on a mission to empower people to manage their health through exercise, education and coaching, rather than relying on passive approaches.

Megan earned a Doctor of Physical Therapy degree from the University of Illinois at Chicago (UIC). She also holds a Bachelor of Arts degree in psychology from Duke University and is a certified running coach.

Megan lives in Denver, Colorado, where she spends every spare second running, biking, hiking, sailing and stand up paddleboarding with her husband, Layton, and dog, Ollie.

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Ask a PT: I’ve done PT and it hasn’t worked—why should I try again?

If you suffer from musculoskeletal pain and you’ve tried physical therapy (PT) before with disappointing results, you might feel like you’re out of options. We’ve heard this many times from SWORD members, who have tried everything to feel better: pills, injections, expensive exams and even surgery – and find themselves still in pain.

If this is you, I’m here to tell you you’re not out of options. Physical therapy can help you, even if it hasn’t helped before. In fact, studies have proven time and time again that high-quality physical therapy works better than anything else for all types of musculoskeletal pain. And it’s also the most cost-effective and long-lasting intervention available. Here’s why it may not have worked for you in the past, and how to make sure it works for you in the future.

Diagnosis: treating pain at its source

The very first step to healing from pain, after all, is understanding where it’s coming from and what caused it. Physical Therapists are uniquely trained to get to the root causes of MSK pain, but their degree of expertise varies, as does their knowledge of the thousands of specific MSK conditions. The wrong diagnosis can put your treatment on the wrong track.

At SWORD, all our PTs specialize in the musculoskeletal system. Each of them has at least 10 years of clinical experience, and their backgrounds vary across a diverse range of specialties. When a member’s condition is particularly tricky to diagnose, our PTs tap into the collective knowledge of our community of PTs to get to the bottom of it.

Diagnosis doesn’t just happen during a member’s first intake call – it happens at multiple points in their journey. When you work with a SWORD PT, they’ll analyze the data from your sessions and spot signs that the treatment isn’t on track. If they suspect the underlying condition is different from the one they first diagnosed, they change the treatment plan, and in some cases, refer you out to a physician for further investigation.

The right treatment program: practice makes perfect

Physical therapists are known to use a host of techniques in their treatment programs – tricks like massage, electrical stimulation and ultrasound therapy. These tend to feel really good right after you’ve had them and they may ease your pain for a day or two, but after a while, you’ll notice your pain creeping back. Meanwhile, that little piece of paper your PT gave you with your exercise program on it languishes at the bottom of your bag, untouched.

A little-known fact about PT is that you don’t need any of the bells and whistles to get better. The one thing you do need is some good, old-fashioned therapeutic exercise. Therapeutic exercise has been clinically-proven time and time again to work wonders for pain management. When you do your exercises consistently, you literally train your pain away. Exercise releases natural pain relievers in your brain, improves blood flow to your muscles and strengthens them so that they’re able to move without sending out pain signals.

At SWORD, our PTs design a program that has just the right amount of work for you to get better, and helps you push past your limits safely. Every time you complete a session, your PT analyzes your results and evolves your program to meet your needs. Some days, this might mean making the exercises a little bit harder. Other days, they might scale things back to make sure you can complete your session safely. Over time, you build your physical and mental strength so you can crush your goals without pain.

Feedback: No more wrong moves

What if you’ve done the exercises prescribed by your PT and it’s still not working? You might be doing your exercises wrong at home. In the clinic, the PT is able to see your body moving and give you advice so you can do every rep correctly. They can even literally move your body into the right position. But when they’re not around, chances are you’ll revert back to the way your body is used to moving – especially when you’re in pain. With nobody showing you the right way to move, your noble attempt to do your exercises could be backfiring without you even knowing it.

That’s where the magic of SWORD comes in. The motion sensors that you’ll wear to do your exercises track your movements precisely – more precisely than human eyes can – and the digital therapist corrects your movements as you’re doing them. Once you’re done with your session, your PT can see how you’re moving and give you advice on how to do even better next time.

Education: knowledge is power

Another myth to bust about physical pain is that it’s all in the body. In fact, the brain is the real culprit. You won’t even feel pain unless your brain intervenes – if you whack your shin at the exact same time you discover you won the lottery, trust me… the lottery will beat out the shin pain for your brain’s attention.

Because of this, it’s important to treat the brain as well as the body. This starts with understanding your condition better – what’s causing your pain, and what you can do about it. If your PT hasn’t given you enough information, your brain may continue to trick itself into thinking your pain is not manageable. You could try to educate yourself, but with so much information out there, it can be hard to filter out the junk. We’ve all been there – a late night session consulting Dr. Google on the source of your back pain might take you down a dark path.

A good PT starts the brain training by helping you understand the source of your pain in a no-nonsense way, and guiding you to resources that have been properly vetted to help you learn more on your own. Our PTs start the education process from the very first video call, and curate a library of educational content to help you learn more along the way.

Behavioral coaching: the power to change from within

Have you ever left the PT clinic thinking “I got this!” only to turn up at your next session skeptical and unmotivated once again? Physical therapists are trained to motivate and coach you to make lasting changes, but unless that motivation comes at the very moment you need it, it’s less likely to work. And if you’re not motivated to change, or you’ve forgotten why you’re doing this, or your belief in yourself lapses, not only does it make you less likely to do your exercises, it makes you more likely to think that your pain controls you, rather than the other way around.

When combined with education, behavioral coaching can work wonders for your physical health. Behavioral interventions are recommended by all the leading clinical bodies, including the CDC and American College of Physicians, as an important part of any physical rehab program.

At SWORD, our PTs have at least a decade of experience in motivating and coaching people just like you to take control of their pain and live an all-around healthy lifestyle. Your PT knows how to give you all the tools you need to get better and make long-lasting life changes. And because we know that the best time for coaching is in the moment, they’re available to chat with you whenever you need them. So when you’re unloading the groceries from the car and you feel your back twinge again, you can tell your PT right then and there rather than waiting for your next appointment.

Convenience: therapy whenever and wherever you like

As we’ve learned, physical therapy works… but only if you stick to your program. We hear time and time again that sticking to a program can be tough when you need to make appointments, commute to the clinic, and wait in the waiting room. Some of us are reluctant to even start physical therapy, because we’re far too busy to commit that much time and hassle to ourselves. The pandemic has made this even more difficult: even if you feel safe going into a clinic, social distancing rules make appointments harder to come by.

That’s where SWORD comes in. We’ve brought together the very best of physical therapy with game-changing tech to make it possible for you to do your PT program at home – whenever and wherever you like. Our members do their PT in the nursery while their child is sleeping, in their home office between conference calls, after dinner when the family is in bed, and at 4am before everyone else has gotten up.

Ready to give physical therapy another shot?

Now that you know what good PT looks like, why not give it another try? SWORD Health can help. We combine licensed physical therapists with wearable technology to guide you through a customized program that can help you feel better from the comfort of your own home, on your own schedule.

Want to learn more about SWORD? Fill out this form and someone will get in touch.

 


About the author: Megan Hill, DPT

Megan Hill, Doctor of Physical Therapy, is a licensed physical therapist focused on musculoskeletal rehab and chronic pain management. She dropped her plans to go to law school for physical therapy after a knee injury from the Chicago Marathon left her in need of rehab, and she hasn’t looked back since. She’s on a mission to empower people to manage their health through exercise, education and coaching, rather than relying on passive approaches.

Megan earned a Doctor of Physical Therapy degree from the University of Illinois at Chicago (UIC). She also holds a Bachelor of Arts degree in psychology from Duke University and is a certified running coach.

Megan lives in Denver, Colorado, where she spends every spare second running, biking, hiking, sailing and stand up paddleboarding with her husband, Layton, and dog, Ollie.

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Ask a PT: Should I avoid doing things that hurt?

When was the last time you stubbed your toe? I stub mine all the time, and I can tell you exactly what it feels like: an almost overwhelming rush of pain that radiates from my toe up through my entire body, and then fades as quickly as it came on. I’d say I’m pretty good at riding that wave of pain (although you wouldn’t always know it from the stream of curses that comes out of my mouth!)

 

When I’m struggling with back pain, I don’t do so well. I feel the urge to prevent it, and find myself avoiding things that I know will get my back into those positions that are going to make the pain worse. I’ve perfected this weird move for getting out of bed when I have pain – propping my arm up on the pillow and launching myself sideways so I don’t put pressure on the part of my back that hurts.

 

If you have ever suffered from musculoskeletal (MSK) pain, this might sound familiar. You might understand the urge to avoid movements that cause pain or make it worse. This is natural: pain is the brain’s defence mechanism. We evolved it to deal with acute injuries like a broken leg or a tiger bite. When we feel pain from an acute injury, our brain is telling our body, ‘stop right this minute, or you’ll do more damage.’ This works wonders when you have a broken leg or a tiger bite. But when you’re dealing with chronic back pain, avoiding the movements that cause the pain can make the pain worse over time. The problem is, the brain doesn’t always know the difference, and if we keep avoiding pain, we teach it to recognize all pain as bad. The more you avoid the pain, the weaker your body becomes, making it more likely you’ll feel pain. This is how pain becomes chronic.

 

The culprit in this game of mental mix-and-match: fear.

 

Fear will reliably turn small injuries into chronic pain that escalates for decades. Here’s how it happens.

 

When faced with pain of any kind, we have two options: face it or avoid it. When you face the pain (like in my toe-stubbing example above), you get on the right track for recovery. When you avoid it, you tell your brain ‘this feeling is scary’ and you’ll start to move your body in unnatural ways to avoid feeling it again. The longer you avoid the feeling, the scarier it will become, and over time, your brain will start to think that what you’re feeling isn’t just a little bruising in your back, it’s more like a broken leg or a tiger bite.

 

The wild thing is, the pain reaction can continue even after the thing that caused you the pain in the first place has healed, because you have created a new pathway in your brain that is easy for the signals to travel down.

 

The good news is there’s a way out of this conundrum.

 

Both the body and brain are plastic – you can train them out of their bad habits with a little knowledge and persistence and get your pain under control, for good. Here’s how:

Understand what’s causing you pain

First and foremost, you need to understand the cause of the pain. This process is often more about understanding what’s not wrong with you than understanding what is. The reality is, the cause of most MSK pain is treatable – there is a less than 1% chance that your pain is caused by a serious underlying problem. This is true no matter how fierce your pain is. Your physical therapist’s first job is to find the true source of your pain. They’re trained to find out whether the pain you feel in your shoulder is coming from your shoulder or referring from somewhere else, and to recognize when the pain might be caused by something more serious, like a neurological issue, an autoimmune condition or cancer.

 

Once you understand what’s causing your pain, part of your brain will realize that you don’t need to be afraid. This is great progress – our next task is to work on the other part that’s still afraid of pain.

Feel the pain and face it

 

The next step is to face the pain. It won’t be easy, but like many things in life, it’ll be worth it. Don’t be discouraged if you don’t get it right the first time. You’ll have to try it many times for it to become a habit, but the more you practice, the better you’ll get.

 

Next time you encounter the pain, your job will be to feel it. Really feel it. Don’t judge your pain or yourself – replace that judgement with a heavy dose of curiosity. Where is the center of it? Where does it move to? How does it feel in your body? Is it hot? Cold? Tingly? Stay with the pain until it subsides, and observe how it leaves your body. Does it come on suddenly and leave as quickly as it came? Or does it fade more slowly? What does that feel like?

 

Being curious about your pain will help you accept it as part of your life, an important step in your journey to overcoming it. This practice is possible to do alone, but having a PT to support you through this process is really helpful. Cognitive Behavioral Therapy (CBT) and mindfulness-based practices can be helpful, too (and that is why we integrated CBT into all of our programs).

Move, move, move

There is one thing that’s been proven time and time again to work for easing MSK pain… movement. Our bodies were born to move. Movement gets our blood pumping, strengthens our muscles and releases natural painkillers from the pharmacy in our brain. It’s important when you’re in pain to move in the right way.

 

You’ll need to get your body into the positions that will help you heal, and make sure you don’t do anything that will hurt you further. It’s a fine balance, and one that physical therapists are trained to perfect. A skilled PT will work with you to build a plan that has just the right amount of work for you to get better, and help you push past your limits safely.

 

SWORD PTs create programs that change and evolve as our members get better, breaking down those impossible tasks into the micro-movements that help you build strength safely and do the things you’ve been afraid to do (like sit up straight in bed).

 

When you’re working with a PT-designed exercise program, you might be surprised that some of the movements cause you a bit of pain – this is OK! You have to move past the pain. Your PT can help you get to the other side.

Ready to start your journey to a pain-free life?

If you want to make your pain a thing of the past and are looking for a physical therapist to guide you on your journey, SWORD can help. We combine licensed physical therapists with wearable technology to bring you high-quality physical therapy that you can do from the comfort of home, on your own schedule.

 

Our members have reported a 70% decrease in pain, making them 64% less likely to consider surgery and 36% less likely to resort to medication. They’ve discovered that they have the power to overcome their pain, with their trusty physical therapist at their side.

 

I know that you can do it too!

 

Want to learn more about SWORD? Fill out this form and someone will get in touch.


About the author: Megan Hill, DPT

Megan Hill, Doctor of Physical Therapy, is a licensed physical therapist focused on musculoskeletal rehab and chronic pain management. She dropped her plans to go to law school for physical therapy after a knee injury from the Chicago Marathon left her in need of rehab, and she hasn’t looked back since. She’s on a mission to empower people to manage their health through exercise, education and coaching, rather than relying on passive approaches.

Megan earned a Doctor of Physical Therapy degree from the University of Illinois at Chicago (UIC). She also holds a Bachelor of Arts degree in psychology from Duke University and is a certified running coach.

Megan lives in Denver, Colorado, where she spends every spare second running, biking, hiking, sailing and stand up paddleboarding with her husband, Layton, and dog, Ollie.

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Ask a PT: Does walking really help with pain?

If you’ve ever stood on the sidelines of a sporting event, you’ve likely witnessed many falls, trips and tackles. Whether the players are small children or professional athletes, the advice from the coach may have simply been to “walk it off.”

While that is not always the best solution after an acute injury, walking can be a really effective way to manage chronic pain.

Why does walking (and other exercise) help relieve pain?

Motion is lotion. Movement increases blood flow, which brings nutrients to our tissues. It also helps those that don’t have blood flow, like cartilage. Cartilage lines our joints, absorbing impact. It’s surrounded by a liquid which provides it with nutrients, flowing in and out of it like a sponge. Exercise, like walking, causes loading that fills and squeezes that sponge, particularly in the joints of our legs and spine.

Movement of all kinds, including walking, can also make you less sensitive to pain. If you stub your toe before riding your bike, you’ll feel it more than you would if you stubbed it right after getting off your bike.

This happens for several reasons. One is that exercise releases hormones and neurotransmitters. These work to reduce pain and improve our mood – even decreasing symptoms of anxiety and depression. The other is that while we’re moving, we’re concentrating on something else: our breathing, the sounds, the landscape, and making sure not to trip over the cracks in the sidewalk. Of course, your mileage (literally) may vary: the amount of exercise it takes to decrease pain as well as how long the pain-relief halo lasts after exercise varies from person to person and the type, type, difficulty and duration of exercise you’re doing. But trust the neuroscience – the pain relieving effect of exercise is the real deal.

How to walk your way to pain relief

Walking is a simple, low-impact way to incorporate movement into your life. If you can, head to a local park or track to walk outdoors. Being outside benefits our mood and health. If that won’t work for you, you have other options! You can walk indoors using a treadmill or even walk laps around your home or another building (just make sure to change the direction you’re walking your laps every 10 minutes or so). You don’t need any equipment, but a good pair of closed-toe shoes will help. Make sure they feel comfortable and fit well.

First, check with your doctor about health considerations, such as heart or lung problems that may affect your ability to participate in a walking program. If you have one of these conditions or are experiencing pain that’s causing you to limp or worsens with walking, ask a physical therapist for guidance.

Once you’ve been cleared by your doc, start with a small amount of walking three days per week – try 10-15 minutes. Build the amount of time you’re walking by adding 2-5 minutes per walk until you can do 30 minutes, then add in another day of walking. After a week or two, add a fifth day of walking to your schedule. Here is an example:

 

Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Week 1 10 Rest 10 Rest 10 Rest Rest
Week 2 12 Rest 15 Rest 18 Rest Rest
Week 3 20 Rest 22 Rest 25 Rest Rest
Week 4 30 Rest 30 Rest 30 Rest Rest
Week 5 30 Rest 30 Rest 30 Rest 30
Week 6 30 Rest 30 30 Rest 30 30

You can always move days around, but try to spread your walking out. It’s more beneficial to walk every other day than to walk three days in a row, then take four days of rest.

Once you are walking for 30 minutes at a time, five times per week, you have a choice. You can stay there – that’s a great amount to make a habit! If you’d like to level up, you can extend the length of your walk, add a sixth day of walking, or mix up the terrain or speed. Walking up and down hills or alternating 1-2 minutes of fast walking with 1-2 minutes of easy walking during your walk makes a 30 minute walk much more challenging.

Remember, consistency is key! And if you don’t enjoy walking, there are many other types of exercise that can help you manage your pain and overall health, including running, cycling, swimming, yoga and strength training. Talk with your physical therapist about your interests. They will help you create a long-term plan you’ll enjoy.


About the author: Megan Hill, DPT

Megan Hill, Doctor of Physical Therapy, is a licensed physical therapist focused on musculoskeletal rehab and chronic pain management. She dropped her plans to go to law school for physical therapy after a knee injury from the Chicago Marathon left her in need of rehab, and she hasn’t looked back since. She’s on a mission to empower people to manage their health through exercise, education and coaching, rather than relying on passive approaches.

Megan earned a Doctor of Physical Therapy degree from the University of Illinois at Chicago (UIC). She also holds a Bachelor of Arts degree in psychology from Duke University and is a certified running coach.

Megan lives in Denver, Colorado, where she spends every spare second running, biking, hiking, sailing and stand up paddleboarding with her husband, Layton, and dog, Ollie.

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Ask a PT: How do I make working from home less of a pain?

During COVID-19, those who can work from home are doing so. If you’re among them, you might be feeling some pain in your back, neck, legs, wrists or even elbows. You’re not alone. You might think your suboptimal workspace is the reason your back is hurting. Bad ergonomics certainly won’t help, but the real reason you’re in pain is that you’re probably not moving enough.

 

For many of us, working from home means moving less – no commute, no in-person meetings, no socializing in the kitchen… it all adds up to a whole lot of sitting. And the fact is, no amount of “good posture” can help you if you’re sitting in the same position all day long.

 

The best position for your body is the next position, so scheduling in some movement breaks is the best medicine.

Level 1: Just stand up

Take an assessment of your day. How long are you sitting in one spot? How often are you getting up to move around?

 

Commit to increasing your movement – taking a break every hour to stand up and sit back down hourly can help relieve the aches.

Level 2: Add some movement snacks

We often think of exercise in terms of big chunks: a 30 minute walk or an hour-long bike ride. While it is important to incorporate regular exercise in your life, movement “snacks” – small bouts of activity that last one to 10 minutes – can be really helpful for staving off musculoskeletal pain.

 

Ideally, take a few minutes every hour or two and walk around your home. If you have stairs, go up and down them a few times. Even if you are confined to a small space, walking back and forth will help reset your body.

Level 3: Try our WFH Workout

Once you’ve added movement snacks to your schedule, you can also add these exercises at your desk (or the kitchen table you have made into your office) to help keep your body happy. Try incorporating them into your routine one to three times per day.

  1. Seated trunk rotation: An easy movement to keep the spine mobile. Keep both feet planted on the ground. Turn to the right. You can use your left hand on the outside of your right thigh to get more movement. Switch sides. Do 5 times each way.
  2. Head tilt: Sitting up straight, tilt your head toward one shoulder, then return to the center. Switch sides. Do 5-10 each way.
  3. Single leg balance: Standing on one foot recruits your foot, leg, hip and core muscles and improves your balance. It’s easy to do while talking on the phone or waiting for something to print, simply stand on one foot. Keep your hips level and your knee slightly bent. Try to hold it for 25 seconds. Switch sides.
  4. Heel raises: As we sit, our blood tends to follow gravity and pool in our legs. Our calf muscles help pump that blood back to our hearts. So stand up, go up on your tiptoes, and lower back down. To make it harder, do one leg at a time. Do 10-20 times.
  5. Chair taps: Get your heart rate up and remind your back it’s strong with this modified squat. Scoot your bottom to the edge of the chair. Place both feet on the floor, about shoulder width apart. Lean forward slightly and stand up. Now lower yourself down to tap the chair with your bottom then stand up immediately. Do not sit down. Doing this with a rolling chair adds an element of danger, so stick to using chairs without wheels. Do 10-20 times

Now that you’ve gotten moving, how do you feel?

Is anything feeling “off” or sore? Are you noticing pain that lingers, even when you change positions and do exercises?

 

If so, SWORD Health can help. We combine licensed physical therapists with wearable technology to guide you through a customized program that can help you feel better from the comfort of your own home, on your own schedule.

 

Happy snacking!

 

Want to learn more about SWORD? Fill out this form and someone will get in touch.


About the author: Megan Hill, DPT

Megan Hill, Doctor of Physical Therapy, is a licensed physical therapist focused on musculoskeletal rehab and chronic pain management. She dropped her plans to go to law school for physical therapy after a knee injury from the Chicago Marathon left her in need of rehab, and she hasn’t looked back since. She’s on a mission to empower people to manage their health through exercise, education and coaching, rather than relying on passive approaches.

Megan earned a Doctor of Physical Therapy degree from the University of Illinois at Chicago (UIC). She also holds a Bachelor of Arts degree in psychology from Duke University and is a certified running coach.

Megan lives in Denver, Colorado, where she spends every spare second running, biking, hiking, sailing and stand up paddleboarding with her husband, Layton, and dog, Ollie.

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Pandemic runners: how to prevent and care for novice running injuries

As people across America heed orders to stay at home, more people have begun lacing up their sneakers and getting outside. Now, after weeks of rapidly increasing mileage, I’ve begun seeing the aftermath of the COVID running boom: people who haven’t run or exercised in years are experiencing sudden, unexpected aches, pains, and full-on injuries.

This isn’t surprising. Over my years of working with people with musculoskeletal injuries, I’ve heard the same complaints numerous times from patients who’ve ramped their mileage too quickly. Often, it sounds something like: “Everything was going so well – I could run eight miles! – then suddenly my knee hurt so much I could hardly take a step.”

I understand the enthusiasm. It’s fun to feel the endorphins and see yourself getting better at something. But despite our bodies’ ability to adapt to stress and become stronger, injuries can happen when there’s too much stress or there’s not enough recovery between loads.

While this can happen with experienced athletes, running-related injuries are particularly common among new runners. In the first year and half of running, more than 8 out of 10 novice runners will experience an injury that’s severe enough to take them out of running for at least a day.

Some of the most common running-related injuries are:

  • “Runner’s knee” (patellofemoral pain syndrome). Runner’s knee is characterized by pain in the front of the knee, usually under the kneecap. Your knee might pop or grind, but you won’t feel clicking or catching, and it won’t buckle (if it does, see a physical therapist). It might feel sore when running, going up or down stairs, walking downhill, or after sitting for long periods of time.
  • “Shin splints” (medial tibial stress syndrome). Shin splints are a term for pain, achiness or tenderness along the shinbone. Without adjustments, shin splints may progress into a stress fracture, an injury that requires weeks off running.
  • Achilles tendinitis. Achilles tendinitis is characterized by achiness or pain along the tendon on the back of your ankle, tightness in the calf, and stiffness when you wake up in the morning. Going up on your tiptoes may feel especially painful.
  • Iliotibial band syndrome (ITBS). ITBS typically presents as aching or sharp pain on the outside of your knee or on the outside of your hip, especially when bending or straightening the knee.

How do you prevent these injuries from happening?

While there’s no way to guarantee you avoid injury, there are general principles that will help reduce the risk:

  • Build your volume (the amount you run) slowly. Increasing by 10% a week works for most people. Slow and steady increases in running volume will win the race.
  • Don’t increase volume, intensity and frequency at the same time. If you’d like to run more miles per week, don’t start running faster and more often at the same time. Pick one thing to increase at a time.
  • Warm up prior to exercise. While jumping out of bed or up from your desk and starting running may seem efficient, it’s also a recipe for injury.
  • Incorporate a strength routine. Exercises with weights or bodyweight can greatly reduce injury risk. Not sure where to start? This routine is a great option of a no equipment-required program you can do in a small space.

What if it’s too late for prevention?

If you’re already hurt, take a three step approach:

  • Modify the load. The first question most runners ask is whether they have to stop running. That depends on your pain. Skipping one to three days of running can sometimes completely resolve the issue. Here are some good rules:
    • Don’t run if your pain:
      1. is present when you’re walking prior to running
      2. causes you to limp
      3. starts immediately and gets worse during your run
      4. starts after your run and lingers for hours.
    • Reduce your volume and run with caution if the pain:
      1. goes away as you warm up
      2. goes away as you warm then returns at the end of the run
    • Continuing running, but keep an eye on your symptoms if the pain:
      1. starts in the middle of a run
      2. feels better as you run,
      3. doesn’t bother you after the run
  • Identify and treat your weaknesses. If you don’t have a strength routine, now is the time to start one. Here’s a simple at-home workout that doesn’t require equipment.
  • Rebuild slowly. If you’ve taken a break or reduced your volume, or if you want to begin running more than before, take a long-term approach. Running a bit less today is better than not being able to run at all in a month.

With these tools in hand, you should be off and running in no time. Sometimes, though, despite our best efforts, we can’t solve our own pain. When that’s the case, a physical therapist will help get you back on track. Reach out to one if your pain doesn’t improve with rest, strengthening and changes in the amount you run, or if you feel severe pain, numbness or tingling, or a progressive loss of strength.


About the author: Megan Hill, DPT

Megan Hill, Physical Therapist, is a licensed physical therapist focused on musculoskeletal rehab and chronic pain management. She dropped her plans to go to law school for physical therapy after a knee injury from the Chicago Marathon left her in need of rehab, and she hasn’t looked back since. She’s on a mission to empower people to manage their health through exercise, education and coaching, rather than relying on passive approaches.

Megan earned a Doctor of Physical Therapy degree from the University of Illinois at Chicago (UIC). She also holds a Bachelor of Arts degree in psychology from Duke University and is a certified running coach.

Megan lives in Denver, Colorado, where she spends every spare second running, biking, hiking, sailing and stand up paddleboarding with her husband, Layton, and dog, Ollie.

Categories
Ask a PT

Virtual PT: What works and what doesn’t?

COVID-19 has sped up a trend that’s been coming for quite some time – people and clinicians are getting more comfortable with telehealth, which is good news for employers and plans looking to reduce costs without compromising on outcomes.

 

When I tell people that I work for a digital musculoskeletal (MSK) therapy provider, I’m met with a combination of curiosity and skepticism, especially from my clinician friends. The most common response is something along the lines of “that sounds cool, but virtual PT can’t possibly work as well as in-person PT.”

 

I’m proud to tell them it does. In fact, SWORD’s solution has been clinically-proven to outperform gold standard PT programs (three one-hour in person sessions per week) by 30%. Plus, with SWORD, members report 70% less pain, and are 64% less likely to consider surgery and 36% less likely to take medication.

 

But not all virtual MSK solutions will work as well.

 

There are three main pillars that have to be met in order to deliver high quality MSK care virtually:

  • Programs must be tailored to the member’s needs and adequately supervised;
  • Results only happen if the members actually do their exercises, and do them correctly;
  • Education and behavioural coaching are essential to achieving lasting changes.

Here are three questions to ask if you’re considering a digital MSK solution:

Is the program designed and supervised by a licensed PT?

It might sound obvious, but virtual MSK programs need a real physical therapist managing care in order to get the best results.

 

We have years of clinical training in diagnosing and treating musculoskeletal conditions. We understand underlying patterns to diagnose referred pain or other conditions as early as possible, and we monitor every patient’s progress to make sure they’re getting the best treatment possible.

 

At SWORD, members only ever interact with a physical therapist who is there every step of the way, from diagnosis to recovery.

Does the member and the PT both get feedback on performance and progress?

Feedback on how the body is moving is critical for effective PT.

 

We can’t do our jobs properly unless we understand exactly how someone is moving and their subjective experience of the session (Was it painful? Was it difficult? How are they feeling?).

 

In the clinic, the PT is able to see how their patient’s body is moving with their own eyes. We’re trained to identify movement patterns that are causing issues or indicative of problems and adjust our patient’s form accordingly.

 

When they go home from the clinic, patients often leave with instructions on a piece of paper. Those paper instructions may not even make it out of a purse, and even when they are followed, we have no idea if the person is performing exercises correctly. This means the recovery process can be slow.

 

At SWORD, we use wearable inertial motion sensors that are even more precise than the human eye. They give the member real-time feedback on how they’re doing. If a member performs an exercise incorrectly, our Digital Therapist will correct their form. This feedback not only helps members learn new movement patterns, but it also helps them stay accountable and stick with their program.

 

These sensors also give the PT live feedback on exactly how a member is performing every stretch and bend, and we use that feedback to evolve their program and catch any red flags that come up through the course of their treatment.

 

Since joining SWORD, I’ve been amazed at how much information I’m getting about how my members are performing. I can progress their programs with more certainty, and have seen members start feeling better quickly.

 

There are many solutions out there that use video to guide people through exercise programs. While they may be good for helping people see how to do an exercise, they don’t tell you if you are doing them correctly, and the clinician on the other end is flying blind. Just like that piece of paper from the clinic, they aren’t going to get you the results you need, especially for serious chronic or post-surgical issues.

Does the program combine education and coaching?

I became a PT after I experienced the benefits of great physical therapy first-hand.

 

I had just injured my knee running the Chicago Marathon. I love to run, and this injury was devastating. My PT helped me get back on track – not just by prescribing me an exercise program, but by helping me understand why I got injured in the first place, giving me the tools to prevent it in the future, and making me believe that I had it in me to make a full recovery.

 

I’m grateful to this day for her guidance and support – and she has inspired me to become the PT I am today.

 

Great physical therapy is more than just an exercise program – because pain is complex and healing involves both body and mind.

 

Physical therapists are trained to incorporate pain education into their treatments, helping patients understand that hurt does not equal harm, their bodies are strong and adaptable, and that they do not need fixing – they are the most important factor in their own rehabilitation.

 

The words we use to empower our patients are critical. Discussing pain from a less-trained perspective can result in increased fear, decreased belief in one’s ability to heal, and avoidance of activities – all of which can contribute to the persistence and aggravation of pain.

 

At SWORD, our PTs develop coaching programs that incorporate education as well as motivational techniques. These programs are specific to each member and are adjusted as they progress along their journey, so they don’t just get better, they stay better.

 

Want to learn more about SWORD? Fill out this form and someone will get in touch.


About the author: Megan Hill, DPT

Megan Hill, Physical Therapist, is a licensed physical therapist focused on musculoskeletal rehab and chronic pain management. She dropped her plans to go to law school for physical therapy after a knee injury from the Chicago Marathon left her in need of rehab, and she hasn’t looked back since. She’s on a mission to empower people to manage their health through exercise, education and coaching, rather than relying on passive approaches.

Megan earned a Doctor of Physical Therapy degree from the University of Illinois at Chicago (UIC). She also holds a Bachelor of Arts degree in psychology from Duke University and is a certified running coach.

Megan lives in Denver, Colorado, where she spends every spare second running, biking, hiking, sailing and stand up paddleboarding with her husband, Layton, and dog, Ollie.

Categories
Ask a PT

Ask a PT: Why do I feel pain in my shoulder if it’s coming from my neck?

Have you ever felt pain in one area of the body, only to be told by a clinician that the real source of pain is somewhere else?

 

You’re not alone – this is quite common.

 

In fact, 12% of SWORD members end up getting a program for a different area of the body than the one they feel the pain in. It’s called ‘referred pain’ and it’s one of many things that physical therapists are trained to look out for.

Your brain on pain

Here’s why it happens: pain is complex and involves both the body and the mind.

 

Our body is like a giant antenna, capturing signals that travel to our brain. All the pain happens in our brain: the brain controls where and how much it hurts. So, pain is an experience that can be influenced by multiple factors.

Imagine stubbing your toe at the same moment as finding out that you won the lottery. It’s highly unlikely you’d feel the pain in your toe, as your brain would have more important things to focus on.

 

When you feel referred pain, it’s caused by signals from different parts of your body converging in the same place in your brain. You might have knee pain that’s actually caused by hip arthritis, or shoulder pain that’s actually stemming from an irritated nerve in your neck.

The danger of treating the symptom and not the cause

When you treat the area that the pain is referring to, rather than the true source, the best possible scenario is that nothing will happen – the pain simply won’t go away. Worst case, the original condition could get worse and you could end up considering medication, injections or surgery.

 

In about 1% of cases, pain isn’t caused by a musculoskeletal issue at all.

 

A wide range of disorders can manifest as physical pain – from anxiety, to neurological conditions, and even cancer. If this is misdiagnosed, someone may run an entire course of treatment for their pain without clinical supervision, only to find that they have a condition requiring a different kind of treatment altogether.

How physical therapists prevent misdiagnosis

Physical therapists like me are trained to find the real source of pain – a process that requires years of clinical training. We understand underlying patterns to detect referred pain or other conditions as early as possible, and can recommend you see a clinician if we think something else may be at play.

 

At SWORD Health, we’re proud that our members only ever interact clinically with a licensed Doctor of Physical Therapy.

 

In addition to making sure we’re treating the right condition, we continuously monitor how you’re performing, adjust your prescription as you progress, and motivate you every step of the way, ensuring you don’t just get better, you stay better.

 

Want to learn more about SWORD? Fill out this form and someone will get in touch.


About the author: Megan Hill, DPT

Megan Hill, Physical Therapist, is a licensed physical therapist focused on musculoskeletal rehab and chronic pain management. She dropped her plans to go to law school for physical therapy after a knee injury from the Chicago Marathon left her in need of rehab, and she hasn’t looked back since. She’s on a mission to empower people to manage their health through exercise, education and coaching, rather than relying on passive approaches.

Megan earned a Doctor of Physical Therapy degree from the University of Illinois at Chicago (UIC). She also holds a Bachelor of Arts degree in psychology from Duke University and is a certified running coach.

Megan lives in Denver, Colorado, where she spends every spare second running, biking, hiking, sailing and stand up paddleboarding with her husband, Layton, and dog, Ollie.