2006-05-12 / Columnists

Eye On Physical Therapy

By Dr. Tim Rohrs, DPT

Last weekend, I attended a continuing education course with one of my therapists. The topic of this particular seminar was cervical related dizziness, headaches and migraines. Over the course of the weekend we would pair up with other physical therapists to practice the manual techniques that we had just learned during the lecture portion of the presentation. The physical therapist I was paired up with was a very nice woman who was a therapist with over 20 years experience. As I was experiencing some neck pain and numbness and tingling in my left hand, I was looking forward to letting her practice on me and perhaps getting some relief.

As we practiced the various manual techniques, I soon came to realize that, to put it nicely, she had a "heavy" hand. She was causing me some discomfort. Not wanting to cause any hard feeling by criticizing her, I started to make a "cringing" type face to let her subtly know that I was in pain. The face did not work. My next approach was to give her a thumbs up sign to let her know when something felt good, but no thumbs up and the cringe face when it hurt. Again my body language was not reaching her. I soon started to give her the thumbs up for a good gentle technique and a thumbs down for pain. She made a comment that let me know that she thought the thumbs down was a critique that her technique and skill were not accomplishing the goal of the lesson. In fact, the thumbs down was to let her know she was causing pain. Finally, I told her that my lower back was hurting from lying supine on the table and would no longer be able to serve as her lab partner. The muscles of my neck were sore for four days. It felt like they were bruised and if I looked in the mirror they would be black and blue.

When I returned to the office, I had a new respect for watching patient's faces for signs of discomfort. I had always instructed them to let me know if anything I was doing was causing pain. Now I watch their faces closely for signs of distress. Some patients are under the mistaken assumption that they should endure any pain or discomfort in the pursuit of pain relief and healing. If a manual or soft tissue technique is being used to decrease spasm and muscle tone, causing pain and tenderness is contradictory to that goal. How can a muscle relax if it feels like it being injured?

I would suggest that regardless of the health care practitioner, doctor, or physical or massage therapist that you let them know if they are causing you pain or irritation. It is quite possible that they are unaware of the pain they are causing and need and want to know about it. Happy Mother's Day!!

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