Frequently Asked PT Questions with Jared Caroff, DPT
posted on October 7, 2019
As a physical therapist, I get asked a lot of questions about pain and what to do about it (both in and out of my office) and I love being able to use my background and knowledge base to help guide people in the right direction. I figured that this would be a good way to go over some of the most common questions I’m asked and hopefully help guide you if these are questions or issues you have dealt with. To preface all of this, I want to say that if you are dealing with an injury it might be a good idea to be assessed by a medical professional in person first. Nothing beats a hands-on assessment with someone’s undivided attention to see what the underlying issue may be. With that being said, let’s dive into some of the common questions I’m asked!
Low back pain can be very complex based on your injury history, how long you’ve had it, what the symptoms are, etc. Again, I recommend that you get assessed by a physical therapist or a physician. That being said, here are some of my recommendations to start helping you help yourself. First, you need to get enough sleep and make sure you’re hydrated. Pain levels can increase with a lack of both of those two things. Do those two things first, then you can keep reading… You need to keep moving! Although you’re having pain, find ways to exercise or just move that are relatively pain-free or that don’t provoke the symptoms as much. For example, if a barbell back squat causes low back pain, try doing a high box squat, goblet squat or safety bar squat. Change it up, but don’t give up squatting (or whatever the movement was) altogether if you can work around it. If you stop moving altogether to “rest”, there is a lower chance your pain is going to go away. This might sound simple but find out if there are any positions that feel good and positions that don’t (like sitting or standing, bending forward or backward, etc.). Try to avoid staying in positions that aggravate your pain and go into positions that don’t hurt. For example, if bending forward and sitting increases your pain, try changing positions in your chair at work every 10-20 minutes, get up and walk, and use a lumbar roll against your back while you sit. You could also try laying on your stomach or propped on elbows when you get home to extend your spine and stay away from the nagging position. In summary: sleep plenty, stay hydrated, don’t stop moving and/or exercising, work around your pain (not into it), and try to stay away from positions that make it mad and go into positions that don’t. Be patient, and over time you should start to notice improvements.
Again, not to beat a dead horse, go get assessed… Now, some of the things I notice in people with knee pain are weak and/or immobile hips and ankles and a weak core. The knee primarily acts as a hinge joint and is meant to be stable. Because of this, if there are mobility restrictions or weaknesses in the joints above and below, excess forces can be placed through the knees and begin to cause irritation. If you’re unsure what is weak or immobile, try performing some of these: half-kneeling soleus stretch, hip 90/90 stretch, banded hip abductor walks, sidelying clamshells, Copenhagen adductor exercise. See what seems to be difficult and keep working at it. If the knee pain is more of a tendinitis issue, I do recommend using isometric (static holds) and/or eccentric (the “down” part of a movement) exercises for the quadriceps and hamstrings. This can be with a squat or deadlift, RDL, quad extension, hamstring curl, etc. Just don’t let the exercise increase your pain levels more than 2-3/10 from where they started. Again, these are only some of the recommendations. In summary: get your ankles and hips both strong and mobile and don’t be afraid to load the knee but do it safely and without increasing your pain too much. There are a million reasons you can have knee pain, however, just working through some of these movements may help.
I hope that this little “FAQ” was beneficial. If you ever have any questions feel free to find me around the gym (either working front desk in the early morning or attempting to pick up objects and place them back where I found them) or just shoot me an email (firstname.lastname@example.org). Stay strong friends!