Recent Physical Therapy Experience

One of the things on my “to-do” list for last year was manual physical therapy. In early October, I began seeing a physical therapist that uses both manual and traditional physical therapy modalities.

Why I sought out PT

Ever since I became ill with POTS and ME/CFS, I have struggled to regain my core/hip flexor strength and have been prone to patellofemoral pain and random issues like a nerve impingement. In addition to those chronic issues, I recently strained a calf muscle and it has been extremely slow to heal. I had been chomping at the bit to start running again (which is super exciting), but these issues were a hindrance. I was also hoping to improve overall function and energy/efficiency. Dr. Peter Rowe recommends manual PT to his patients for this reason.

Side note, the way my calf strain occurred is hilarious. I was goofing around and running with my kids, when suddenly my younger son ran right in front of me. I went from full stride to a superhero maneuver in a split second to avoid plowing into him. My calf was like, “Who do you think you are?” and got promptly injured.

What this PT is like

In the initial hour-long appointment, I was evaluated for strength and mobility in the areas of concern. Then, the PT did manual work on tight areas. Manual work is very similar to sports massage or orthopedic bodywork. Finally, I was given a set of exercises and stretches to do twice per day at home. It took roughly 30 minutes for me to complete each exercise/stretch session. In addition to the exercises and stretches, I use massage tools like a mini foam roller and Yoga Tune-Up ball to maintain the manual work.

Follow-up sessions lasted about 30 minutes. They included manual work and review of the exercises. The PT would watch me do the exercises to check form and to determine when I was ready to move to the next progression. She would also add in new exercises or stretches as she saw fit.

Each office, practitioner, and patient is different, but I went in for appointments roughly every two weeks. I felt prepared to do the exercises on my own, I have the necessary equipment at home, and can replicate most of the manual work myself with tools, so this schedule worked well for me.

Pros

Having to do the exercises and stretches twice per day has improved my strength where I previously felt “stuck”. I have done many of these exercises before, but doing them twice per day rather than twice per week made a difference. The exercises I had to start with were pretty remedial, so it was okay to do them this often. It’s important to note that as you progress to more challenging moves and loads, you do not have to do the exercises as often.

It is helpful to be guided through a strength progression by a professional. Not only does in ensure proper form, but then the exercises are tailored to meet you where you are at. For example, before PT I was already doing single leg Romanian deadlifts. First of all, I was doing them incorrectly by opening my hip and second, I probably wasn’t ready for them without first establishing more basic movements.

The manual work helps to accelerate the results. I had been dealing with a consistent nerve pain starting in my hip and ending with a hot feeling at the top of my foot whenever I would flex my hip joint for almost two months. Since manual PT and my at-home maintenance, it is a rare occurrence.

Most insurance companies cover this type of work, so it can be relatively affordable if you choose a provider in your network. It is also something that you don’t have to go to very frequently if you feel comfortable replicating things at home. Even if you don’t feel comfortable with it right away, it is something that you can work towards so that PT becomes less of a burden.

Cons

Because insurance is involved in this type of PT, it is restricting. So, I had to narrow the focus of the areas I wanted addressed. Also, insurance will only cover it for a certain number of sessions/period of time.

Due to having to narrow the focus to a limited area, this work isn’t conducive to the manual physical therapy work needed to boost overall energy (the type Dr. Peter Rowe discusses). For that, you would most likely need to find a provider who doesn’t submit claims to insurance. The downside of that is it becomes very costly. I don’t think I will pursue that type of treatment anymore for that reason in addition to the fact that I don’t want to have frequent appointments at this time.

The twice-per-day sessions are exhausting. Now, I love exercising, and motivation isn’t an issue. However, I found that my muscles did not recover as I expected. I had to take that into consideration and adjust accordingly. Some days I would take off completely, some days do less sets in the evening, etc. After about six weeks when the movements progressed to be more difficult, I switched to once per day. Then, once I was doing more advanced progressions, it evolved to a few times per week.

Update and Final Thoughts

After several sessions of PT, I felt like I was on a good trajectory and decided with my PT to discontinue sessions. For the most part, I have been doing fairly well with my areas of concern. However, running has still been a finicky thing. It is taking a lot of trial and error for me to successfully return to running. I’ll discuss this in a future post.

I think PT would be a great idea for people returning to more movement if they find themselves injury prone. In particular, this would be useful for people that were bed-bound or sedentary. Muscular imbalances can occur during that time and sometimes it takes a professional to get things going in the right direction. My advice would be to make sure you take it extra slow in progressing to more movement, especially if you want to return to a sport.

Have you seen a manual or traditional physical therapist? How has it impacted your health?

Disclaimer: I am not a medical professional. Statements on this site are not meant to be taken as medical advice. These statements reflect my personal experiences having mild-ish post-viral POTS and ME. Due to the wide spectrum of these diseases, comorbidities, and everyone being different, your experiences may be very different than mine.

Note: If you post a comment, this site does NOT have a feature to notify you of responses to your comment. I have not found a good solution for that yet. However, I usually respond to every comment in a timely manner, so be sure to check back.