The Basics of Physical Therapy: What I Tell My Patients Most Often

Disclaimer: With this and any other blog post, please note that nothing written here is a substitute for getting specifically tailored advice from a specialist/provider.

Much of the physical therapy information I share with patients comes from Dr. Aaron Horschig of SquatUniversity.com. While the information is geared towards lifters, I find his information to be well researched and widely applicable.

The main idea is that pain often comes down to mobility and stability issues that can be corrected over time with consistent use of proper stretches and stabilization exercises.

While specific evaluation of a patient is necessary to gear a treatment plan for someone, there are some broadly applicable themes for most cases.

Let’s look at the shoulder for instance. Stiffness and tightness around the shoulders might be due to stuck or spasmed muscles around the shoulder such as the trapezius (trap) or latissimus dorsi muscles (lats). Alternatively, you might be dealing with the very common issue of under-trained or underactive rotator cuff muscles, which are meant to stabilize the shoulder joint.

It’s entirely possible to have both going on at once. If so you might practice different mobility/stretching work for the shoulders first, or even a foam roller lat release. Then after your body is moving properly, you might practice some kind of external rotation stabilization exercise at the shoulder, making sure to pause for at least 5 seconds at the most challenging part of the movement.

Essentially certain prime movers/big muscles can often overpower our smaller stabilizer muscles.

So first we work to loosen up these overpowering muscles before getting the stabilizers to do the job they were meant for. It’s important to note that pure strength of the stabilizers is not the goal. We need the body to get into this subconscious habit of turning on the stabilizers when we move, not to just contract them strongly with specific exercises, and be ignored otherwise.

Often the progress is a combination of fast and slow. It’s fast because when you get the right combination of exercises, and properly mobilize and stabilize the shoulder joint, you can do relatively light weight pain-free movement immediately in some cases. However, the pain will likely return automatically without consistent effort to retrain the body into this new mode of movement.

Another common painful area that can respond well to physical therapy is the lower back. However, the lower back can be more complex to evaluate and treat. The root of the problem might originate all the way down at the foot—or anywhere in between, especially the ankles, knees, or hips.

The overall principles are the same though: evaluate which areas aren’t moving properly, and then what stabilizer muscles aren’t activating properly, loosen/move the former and train the latter, usually in a more static movement-resisting fashion.

There are a couple different options for making this information more specific to you. Squatuniversity.com has a ton of videos all over the internet you can search for that go over specific problem areas, so that’s an easy way to get started looking into your own challenges. You can always work directly with a physical therapist on these issues. I’m also happy to point you in the right direction during our sessions.

Feel free to send me a text at 919-809-9355 to get started.

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