Coach Tip Tuesday: Physical Therapy Isn't a "One and Done"

Happy September, my friends!! And Happy Coach Tip Tuesday!!

How many of you have ever been in Physical Therapy (PT)??  And how many of you were COMPLIANT Physical Therapy patients (meaning that you did your exercises the way you were instructed in addition to attending your in-person sessions)???

I see you out there, cowering and trying to hide because you were not a compliant PT patient.  And the truth is, we’ve all been there.  Physical Therapy isn’t glamorous.  It's not very fun.  And as such, we talk ourselves into disliking it and thinking that it’s something that we should dread, rather than embrace.

Well, I’m here this week to change that!!  This week, my coach tip challenges the widely held perceptions of Physical Therapy: 

Physical Therapy isn’t “one and done;” it’s an ongoing process.  

I know, I know.  SO MANY of you out there think that PT is just for people who are recovering from surgery or who have experienced VERY BIG INJURIES.  This is false, my friends.  It’s simply false.  Let’s look to our friends at Wikipedia for a definition of Physical Therapy:

Physical therapy, also known as physiotherapy, is one of the allied health professions that, by using evidence-based kinesiology, exercise prescription, health education, mobilization, electrical and physical agents, treats acute or chronic pain, movement and physical impairments resulting from injury, trauma or illness typically of musculoskeletal, cardiovascular, respiratory, neurological and endocrinological origins. Physical therapy is used to improve a patient's physical functions through physical examination, diagnosis, prognosis, patient education, physical intervention, rehabilitation, disease prevention and health promotion.

Let’s pay particular attention to these two parts of that definition: “treats movement and physical impairments” and “used to improve a patient’s physical functions.”

How many of you out there have one or more movement or physical impairments??  Spoiler: Every single one of you should be raising your hand right now.  Yes, that’s right.  EVERY single person has some sort of impairment; it could be an imbalance, an old injury, a result of sitting too much, a result of moving in a particular way that isn’t 100% compatible with your physical structures (your anatomy).

Every.single.one. of us can benefit from improving our physical functions.  Every.single.one.  Maybe you change the name of what this (without even realizing it) to “strength training” or “mobility work” when you are not actively working with a Physical Therapist, but the idea is the exact same: each of us has something that needs strengthening and constant attention so we can avoid injuring ourselves.  And just like all things in endurance sports, consistency and frequency are the keys to success here.

If you are in PT, and you start to feel better, it’s BECAUSE of the work you are frequently and consistently doing in PT, not in spite of it.  This means that it’s important to keep up those exercises and that attention to detail even beyond your official sessions or prescription for PT.  Stopping the things that are allowing you to feel good is the equivalent of making withdrawals from a bank account without ever making new deposits.  Eventually, you will overdraft and pay the price.

It’s VERY easy to pay attention to things when we are symptomatic (meaning that we are uncomfortable or experiencing pain).  It’s also VERY easy to think that when we feel good we just magically feel good, and then we don’t “need” to do certain things anymore.  But the truth is that it’s not magic; we feel good because of the work we’re putting in, so we need to keep putting in the work.

I highly recommend that endurance athletes have an assessment conducted by a Physical Therapist to assess areas that could use some attention.  You don’t need to be hurting or in pain; you can simply just want to make sure that you’re paying attention to the right areas as you work toward your goals.  In essence, this helps you to “sharpen the axe.”

If you are someone who has been in PT due to an injury, I strongly recommend that you keep up with your exercises so that you don’t end up BACK in PT for the same injury.  (I can tell you that having to go back to PT multiple times because of the same thing is a very frustrating experience, especially when I know that my lack of attention to my exercises and self-care was the root cause of why I had to go back.)  

These days, the pact that I’ve made with myself is this: If I “don’t have time” to do it right (meaning do my PT exercises before I do anything else), I don’t have time to do the things I want to do (such as riding my bike or running).  Why do I set this boundary for myself??  Because I have learned, through my own personal experience and by working with many athletes, that doing the things that keep me moving well enable me to do the things I DO love to do longer and without injury.  What I actually don’t have time for is a massive injury that sets me back by months and months.

PT isn’t a one and done.  There is a reason that you ended up there in the first place, and those reasons rarely magically disappear.  Do yourselves a massive favor and realize that PT is an ongoing process that will help you stay healthy, happy, and progress toward your goals, and you may go further than you ever dreamed you could. :)