How to find a good physical therapist, Part 5: The PT’s I observed as a student

Hi everyone!

I hope you’ve all been finding this series interesting.  I thought it would be good to write up all of the different experiences I had finding the right PT to help me, to encourage you not to give up if even the second, third, or the fourth person isn’t able to help you.

As I’ve explained previously, it was the fifth physical therapist I found who was able to actually help me.  (However, it was technically my eighth attempt at physical therapy overall, because at first she referred me elsewhere).

That was basically the conclusion of the different PT’s I sought out as a patient.

However, during my observation hours for PT school, I actually had the chance to meet three more PT’s, and see how they treated the SI joint.  I didn’t go too far in-depth with any of them, but I did get the chance to observe some additional perspectives, so I wanted to include them at the end of this series to give a complete list.

Tom– I only observed one appointment with him and an SI joint patient.  Whereas my primary problem throughout my journey would be that one of my hip bones would rotate backward and get stuck, this patient’s primary problem, according to Tom’s evaluation, was that one of her hip bones was hyper-mobile and would routinely rotate forward.

Tom showed this patient some different Muscle Energy Techniques than the ones I had used.  (Technically speaking, the specific form of MET that I have used to rotate my hip bones is not the only form of MET people use for the SI joint.  It was the most effective for me, and is what allowed me to get better).

Tom’s techniques were a little bit different, and some of them actually required assistance from a partner.  He was able to adjust her in the office, but asked if she could find someone to help her out at home.

The techniques he showed her reminded me a little bit of the adjustment techniques Vicki Sims writes about in her book (which I have been meaning to review for you all at some point).

It was a little bit unfortunate because this patient lived alone and did not have anyone around that she could ask on a regular basis, but she was at least going to come back and have Tom adjust her at least once a week.

He also taught her some core strengthening moves, and how to contract the transverse abdominis muscle at times throughout her day when she needed a little extra support (for example, when she had to press down hard on the brakes while driving).

Paul & Natasha

This story is a little bit awkward.  I’ve touched upon it previously but I wanted to give the whole story here, just because I think it illustrates a few things that are so difficult about trying to find help.

Paul and Natasha worked together at the same physical therapy practice where I was shadowing.  They were actually both certified in aquatic physical therapy, and both were highly-regarded, experienced physical therapists.

However, they were pretty different in that Natasha seemed to have a very good understanding of SI joint dysfunction, and had successfully treated patients with it. Paul, on the other hand, did not seem to have much of an understanding, and I couldn’t really tell if he’d ever treated patients with issues with it before.

I had a really awkward moment when Paul offered to let me get in the pool and try out some of the exercises he gave to patients.  My right SI joint was locked up at the time, which meant that I was having trouble moving my right leg even as I was using an Aqua Jogging belt and water running, letting my legs hang beneath me.

And Paul just did not understand what I was trying to tell him.

“Swing your leg!  All the way!” he kept trying to tell me.  And what he was saying to do, technically, was correct.  He was instructing me on how to water-run with proper form.

The problem is that, anatomically speaking, my jammed SI joint was not going to let me move my leg the way he wanted me to.  No matter what I did.

I tried to explain what was going on, and that it wasn’t an issue of not knowing what proper form was, so much as not being able to have it.  But my words just didn’t seem to resonate– I couldn’t get through to Paul (and it was extremely awkward, because I wasn’t there as a paying patient, but as a grateful student on the receiving end of a favor!).

I tried to compensate, straining to get my leg to move through a larger range of motion, but ended up with knee pain for a few days afterward.  (Remember, everything in the body is connected, so when I tried to push through the limited range of motion at my hip, my body tried to make up for it with my knee).

Natasha, on the other hand, seemed to have a much better understanding of the SI joint.  I tried to ask (without coming right out and saying it) how she knew so much compared to other PT’s.  Like Paula, she said it had become an interest of hers over time.  As she saw patients suffering from issues with it, she had been moved to learn more about it, both on her own and in different classes she took.  Basically, although she never specifically took a class on the SI joint, she picked things up here and there (including learning about the Muscle Energy Technique) and developed an approach over time.

By the time I met Natasha, I was almost at the end of my own journey.  I hadn’t had my epiphany yet where I realized my joints would actually stay much more stable if I stopped going to the chiropractor, and only used the Muscle Energy Technique on myself.  So they were still rotating out of place and locking occasionally.

However, I mainly had the routine I’d already developed with Paula down pat.

Natasha was able to add a few more things into my routine, however.  At the time, I wasn’t doing any stretches for my hip flexors, because my joints locked up every time I got into the proper position.

She noticed my muscles were so tight I didn’t really need to do that full stretch anyway, and helped me modify it in a way that was super gentle.  It was really great to be able to start stretching that muscle, because it was sort of like the missing piece.

Natasha is also the one who really put things together for me, intellectually, that it theoretically was going to be possible for me to get all the way better.  Again, Paula had really helped me develop my routine.

Natasha is the one who told me that, if I finally built up enough muscle strength, I’d eventually be able to walk around, and turn, and twist, without thinking about it so much, and my joints would stay in place.  She knew, because she’d seen it with other patients before.

So, I will always be grateful to Paula, for being the person who really got me kick-started out of my rut.

However, I did learn a lot from Natasha, and her approach is definitely going to influence how I treat patients in the future as well.

Okay… I think that’s the conclusion of this series. 

I hope you all found it helpful.

As always, if you have any comments or questions, you can email me at sunlightinwinter12@gmail.com, or leave a comment below.

Thank you!

2 thoughts on “How to find a good physical therapist, Part 5: The PT’s I observed as a student

    • sunlight in winter says:

      Hi there! Yes, Paula was able to identify which way my hips were rotating. Basically, if one of your hip bones is rotated backwards, it’s going to make the leg appear slightly shorter on that side. So, she would have me lie on my back in a certain way (to make sure my weight was distributed as evenly as possible) and would then compare the length of my legs, as I laid them out straight. (This isn’t something that just anyone can do– it does require a trained eye).

      Over the course of several visits, she said that my hips had been rotated in the same way each time, so it was probably safe for me to assume they were following the same pattern when I was at home, and adjust them that way. Then I would come in for my next appointment to confirm that I hadn’t been doing something wrong.

      Like

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