Diastasis Recti Treatment: Emphasizing an Individualized Approach

Posted on Posted in All Posts, Take Control of Your Health, Women's Health

Hello all!  I’m writing today as a person inspired by new information and am compelled to share with you what I’ve learned.  For those of you familiar with my writing, you’ve seen me post previously on diastasis recti (DRA) and it’s management.   In general, it is an area of great interest for me, helping pre and post partum women (no matter how old their children) recover function, return to activities they love, and feel their best.   Many women, and some men, have been coming to Thrive concerned about the look of their DRA.  As a mom myself, I understand this concern…adjusting to our post baby bodies is effortful and knowing what is in our power to change and how to do it is ambiguous.  As a physical therapist, I look at DRA from another perspective as well: how can we clinicians enable our patients to move with ease, support load through the abdominal wall, and ultimately participate in life fully?  I want for my clients to, without pain, return to activities they love while feeling good about how they look.

Elizabeth D'Annunzio Shah, PT, DTP, MTC, OCS,at course: The Abdominal Wall After Pregnancy & Diastasis Rectus Abdominis
Elizabeth D’Annunzio Shah, PT, DPT, MTC, OCS, and classmates at The Abdominal Wall After Pregnancy & Diastasis Rectus Abdominis.

If you are reading this post, it means that you’re doing the internet deep dive into DRA treatment.  As a clinician, I’ve done that too…spent hours on the computer trying to find a consensus on care.  Do we use a brace?  On which muscles do we focus our intervention?  How do we know when to advocate for our patients to have further medical evaluation by a physician or surgeon?  Who in the community can I send my patients to when they’re done with PT and want to begin more rigorous exercise?  Ultimately, I found that I was in need of a more in depth exploration of the topic, so I took it to the source.  I went to Akasha Studios in Vancouver for a course created by Diane Lee & Associates entitled The Abdominal Wall After Pregnancy & Diastasis Rectus Abdominis, taught by physiotherapists Tamarah Nerreter and Leigh Fortuna.1   Diane Lee is a leader in the field of physical therapy and has, through extensive research and experience, developed the definitive text and related professional educational courses on the management of abdominal wall dysfunction.2

I’m not going to get into the weeds with you on specifics of treatment, but there are a few really important points that I wanted to relay to our readers and persons interested in DRA recovery in general:

1. THERE IS NO SUCH THING AS A ONE SIZE FITS ALL APPROACH TO DIASTASIS RECTI MANAGEMENT.  Just as no two persons are the same, no two DRAs are either.  The separation of the linea alba often times reflects dysfunction, but what generates and perpetuates said dysfunction is different in all people.  While this may seem obvious, many people come to me seeking a quick fix, or looking for the internet resource, book, or exercise DVD that will solve all their problems.  While there are some wonderful resources out there, ultimately creating an individualized approach to DRA management based on the patient’s unique physical attributes, activity requirements, and goals is the best way to enable healing.

2. THERE ARE PEOPLE OUT THERE DOING GREAT WORK IN THIS FIELD.  At the course, I was surrounded by physical therapists and fitness professionals seeking to bring to their patients and clients the most current information and nuanced care possible.   Meeting these people in person, networking and drawing regional connections, and combining our shared experience is essential in distributing information and encouraging the best possible practice as we approach our post partum clientele.   Similarly, I am a part of a wonderful network of women practitioners in the New York metro area the includes doulas, PTs, OTs, group fitness professionals, and personal trainers who’s job it is to know the best care providers are in our region for women’s health, rehabilitation, and fitness.   When you are seeking care for your DRA, regardless of where you live, your care provider should be approaching you with a nuanced, whole body perspective and be informed on the resources available in your community, online, and on paper that might serve to round out your care and exercise experience.

Sometimes, the correct answer to a posed question is vague and yields more questions.  Is there a one-size fits all fix to DRA?  No.  Can person improve the overall health, function, control, and aesthetic of the abdominal wall post DRA?  Yes!  Partner with a passionate practitioner that’s eager to problem solve, and get to work!  In other words, seek out professionals with specific expertise in this area of treatment, readers.   You will be better served this way, and you are worth it!

Citations:

1. The Abdominal Wall & Diastasis Rectus Abdominus. (2018). The Abdominal Wall.  Surrey, BC: Akasha Studio.
2. Lee, D. (2017). Diastasis Rectus Abdominis: A Clinical Guide For Those Who Are Split Down the Middle. Surrey, BC: Learn with Diane Lee.


 


Elizabeth D'Annunzio Shah Physical Therapist New York CityElizabeth D’Annunzio Shah, PT, DPT, OCS, MTC works with patients of all ages and abilities including recreational athletes, professional dancers and performing artists. She has a special interest in vestibular and balance disorders, movement theory and creative solutions for both neurologically and musculoskeletally impaired persons. Elizabeth is passionate about exercise as a means to maintain health, manage stress and enjoy life! She practices yoga in the Iyengar tradition, is an avid surfer, and participates in distance running events whenever possible. (more)

     

Don’t Survive, THRIVE!

Posted on Posted in Take Control of Your Health

Now is the time to focus on YOU! Pain doesn’t have to rule your life. Physical Therapy is a proven alternative to surgery and prescription drugs. Break the cycle of simply surviving and make this the year you THRIVE.

Check out the rest of our website and give us a call to set up a consultation and find out how physical therapy can help you break the pain cycle and get your life back!

     

Thrive! is Hosting a University of St. Augustine Continuing Education Seminar

Posted on Posted in All Posts, Classes & Courses

thrust seminar

Are you a PT who wants to enhance your treatment effectiveness by improving your skills?  Thrive is Hosting a University of St. Augustine for Health Sciences Continuing Education Seminar. Join us for the THRUST – Advanced Manipulation if the Spine & Extremities seminar April 21-22, 2018. Those PTs with any earned Manual Therapy Certification and S1 USAHS seminar attendance or Fellow of AAOMPT are welcome to attend. For more information on the seminar or to register please CLICK HERE.

We hope to see you there.

     

The Physical Challenges of Curling

Posted on Posted in All Posts, Let's Get Technical, Stay in the Game

When the winter Olympics showcases Curling there’s always an uptick of interest in the sport. Being married to a US Senior National Curling Champion, I’m always intrigued, and have considered trying it, but I don’t want to (literally) hit the ice.

Although Curing can appear sort of silly, with all that sweeping of the ice, it’s actually QUITE physically and mentally challenging. It’s literally a game of “chess on ice,” both brawn and brain are required for a successful outcome! On top of strategy and teamwork, you need strength, cardiovascular endurance, balance and flexibility to successfully compete.

Curling opening ceremony USA Nationals Mixed
Curling opening ceremony USA Nationals Mixed

First, a little about the game:  There are 2 teams of 4 players or in the newer mixed doubles game, 2 players, that “deliver” or slide a 42lb granite stone across a sheet of ice toward a circular target of concentric circles dubbed “the house.” Points are scored for getting these rocks closest to the house’s center with both teams throwing stones in “ends” which are similar to baseball innings. Each game consists of 8-10 ends. Each team throws their stones trying to get as many rocks into the center while knocking their opponents rocks out, similar to shuffleboard.

But why do they sweep in front of the stone? Curlers induce a curl when they push out of the hack in a delivery. They turn the stone clockwise or counterclockwise giving the handle on the stone a turn with their wrist before releasing, thereby inducing a “curl.” The path of the rock can be influenced by the sweepers who accompany the rock with brooms as it travels down the sheet of ice. Sweeping warms the ice in front of the stone, making the stone curl less.  It decreases the friction that would slow down the stone, allowing it to go further. Sweeping can also prevent the rock from curling past its intended target.

What many don’t realize is that there is a great deal of physical activity involved in curling. It is a full body activity and requires an amazing amount of physical strength and endurance to compete.  Sweepers apply and downward pressure and move the brush back and forth while jogging sideways on ice. It involves a push and pull action and can be taxing to the rotator cuff pecs, deltoids, biceps, triceps, lats and forearms. A strong lower body provides a solid foundation and enables one to propel down the ice. A strong core aids balance and comes in handy both in starting and stopping sweeping.

In a typical game, players can sweep between 48-60 rocks per game. It is a test of endurance as it is both aerobic and anaerobic at the same time. It involves bouts of hard exercise followed by active rest and then repeated. In addition to aerobic exercise, anaerobic interval training is recommended at least once a week to promote quicker recovery times between shots and games.

After pushing out of the hack, the delivery of the rock requires the curler to balance almost their entire body weight over a sideways turned sliding leg with the opposite leg stretched out behind them. That sliding leg has to maintain that position isometrically using the quads and gluts. Hip flexors, hips, hamstrings and groin muscles need to be flexible. The gluts and gastrocs provide the power to thrust out and the anterior tibialis and gastrocsoleus stabilize the sliding leg during the delivery.

A balanced sport specific training program targets specific aspects of the sport improving strength, balance, cardiovascular condition and flexibility. Throughout the week we will be adding one exercise per day to our blog to help you get in shape and hurry hard. Enjoy and congratulations to all of the Olympic Athletes.

Here is the first exercise in the series:

Balance:  Lower Body lunges with Bosu

While maintaining a straight upper body with the face and chest upright, take a large step forwards on to the Bosu. Looking straight ahead, lower your body until your front thigh is horizontal to the floor, and then push off with the forward leg. Use both legs and challenge yourself further by holding dumbbells. Repeat 10 reps on each leg.

  Dynamic : Groin Stretch Perform before a game to warm muscles, it should not be static but should get you moving.  Lunge directly to the side with toes facing forwards. Push off the foot and return to the initial position to complete one rep. Do 10 reps, rest and repeat for 3 sets.

 

Sport Specific: Sweeping with a Body Bar

To be sport specific and mimic the action of sweeping, place a 10lb weighted plate atop a towel and insert a 15-20lb fitness bar into the hole. “Sweep” across the gym floor in 30 second intervals, left to right and then right to left. Rest and repeat 5-10 times.

  Core strengthening: Ball Roll Out Rest your forearms on top of the PhysioBall with the balls of your the feet on the floor- slowly roll the ball away from the body without rounding the back and return to start to complete one rep. Repeat 5-10 reps per set, build to 3 sets.  

 


Tamar Amitay Physical therapist NYCTamar Amitay, PT, MS, Founder and Principal of Thrive Integrated Physical Therapy, is a highly regarded physical therapist recognized within the New York City medical community as a remarkable clinician, diagnostician and healer. Graduating in 1986 with academic honors from New York University she has over 28 years of clinical experience in rehabilitation and outpatient private practice and working at NYU Rusk Institute, JFK Medical Center. (read more)

     

NYU Student Health Insurance Accepted Here

Posted on Posted in All Posts, Take Control of Your Health

NYU student health, physical therapy, NYU Student insurance accepted here

Good news for NYU students. As of the 2017-2018 school year, Thrive Integrated Physical Therapy is now contracted with your student health insurance plan.

What does this mean to you? Well, in addition to the services provided by your student health center, you can now come to outpatient physical therapy at our facility using your student health insurance.

Getting skilled physical therapy at our boutique downtown location has never been more affordable or convenient for NYU students.

As individual student plans do vary, please give us a call so we can check on your benefits and go over the cost with you.

Give us a call, your physical health is important to us.

     

Snowboarding: Pregame Warm-Up

Posted on Posted in All Posts, Stay in the Game

Winter is here and we have finally had our first real snow! With more snow on the horizon in the next few months, more and more people will be hitting the slopes and snowboarding. While it’s great to head out there and have fun, it’s equally as important to do some activities that prepare you for the challenges associated with snowboarding to limit your risk of injury. Whether you’ve been snowboarding forever or this is your first time, a good routine will help keep you on the slopes enjoying winter longer.

In this post, New York City based Physical Therapist Philippe Corbanese, PT, DPT, will go over a warm-up routine that will target the most commonly used muscles in the sport. When snowboarding, the most commonly engaged muscles are your core, quads, calves and shins. You need to be able to get up from low surfaces, rock back and forth, rotate from your core, and get up from a forward and a backward position. The following is a list of the exercises Philippe would recommend as a warm-up routine to be performed prior to heading out. These exercises do not need to be performed in the order listed. And, as always, before participating in any activity be sure to check with your doctor.

Exercise 1: Side to side trunk rotation. Begin this exercise by standing with your feet wider than shoulder width apart and without moving your legs rotate from your waist back and forth from left to right throughout your full range. Try your best to control the motion and not just use momentum. Perform 15-20 repetitions, going through the full range for 2-3 sets.

 

Exercise 2: Toe touches with opposite hand. Start with feet shoulder width apart and while keeping your knee as straight as possible bring your leg up and touch your toes with the opposite hand. If you can’t quite touch your toes it’s okay just try your best to maintain good form. Perform 10-15 repetitions with each leg for 2-3 sets.

 

Exercise 3: Body weight squats. Start with your feet approximately shoulder width apart and feet in a neutral or close to neutral position and squat as low as you comfortably can. Perform 20-30 repetitions for 2 rounds.

 

Exercise 4: Static lunges with trunk rotations. To perform this start with feet shoulder width apart and bring one foot back so that you are in a long stride stance. Keep your weight primarily through your heel on the front foot and toes on the back foot. Focus on bending your back knee and bringing it close to the ground. When you reach the bottom of the range rotate towards the front leg, back to neutral and then back up. Perform 10-15 repetitions for each side.

 

Exercise 5: Calf stretch against wall with straight knee and bent knee. To perform this exercise place one foot forward and one foot back behind you while keeping your knee straight and hands against a wall. Press back and direct the force through your heel. Hold for at least 30-60 seconds and repeat on both sides for 2-3 repetitions. Get back into the same position but instead bend the back knee while keeping your heel down and shift the weight towards the front of the back foot. Hold for at least 30-60 seconds and repeat on both sides for 2-3 repetitions.

With this warm-up you should be better setup to enjoy the slopes and limit the risk of injury.

 


Philippe Corbanese Physical Therapist SoHo NYPhilippe Corbanese, PT, DPT, is a staff therapist here at Thrive PT in NoHo New York. He has worked in a variety of settings and has treated patients with neurological, orthopedic and sports injuries. These experiences led him to his specialty in sports and orthopedic injuries. For the past five years, he has worked extensively with professional athletes on the US Women’s Rugby team, and the Harlem Wizards as well as collegiate and recreational athletes. (read more)

 

     

Lower Back Pain and the Case for Early PT Intervention

Posted on Posted in All Posts, Take Control of Your Health

Hello friends.  It’s that time again…a new year!  With it comes the promise of new commitments, resolutions made for health and fitness, and renewed zeal and engagement in activity .  We at Thrive want to be part of your move towards greater activity, and are here as your musculoskeletal experts to answer questions, prepare you for sport, and help you heal aches and pains.   That said, I must warn you of a lurking impediment to your wellness.  You’ve guessed it, the NEW DEDUCTIBLE.  Spending time and money on your care is less appealing when it’s an out of pocket cost, and we are intimately familiar with financial stressors and the challenge to access care when it’s at your own expense.

it's time to talk about lower back painSo, without further ado, I am going to make the case for coming to physical therapy (PT) early, and argue why it might save you money, lost time, and pain (both literal and figurative) on the back end.  For the purposes of discussion, we’ll focus on low back pain management.

Anecdotally and empirically, back pain is one of the leading reasons persons come in to PT.  In addition to being difficult physically, emotionally, and financially on the individual, it’s can be costly to health care organizations and employers as it is a common cause of missed work and long-term disability.  In fact, it is the number one cause of disability of persons under the age of 45.1  In recognition of the fact that pain left to fester leads to poor health outcomes, it is imperative that patients go directly to physical therapy when they begin to experience pain.  It’s been found that persons at high risk for low back pain who received early therapeutic intervention have less chronic pain, utilization of healthcare monies, missed work, and medication usage than those that don’t receive care.2 Further studies find that persons with acute low back pain who engage in education, manual therapies, and exercise have improved mood, health, and quality of life than patients who wait for treatment.3

Despite the considerable evidence that therapeutic intervention is integral in pain reduction, resumption of activity, and return to work, you’d be surprised how often people take the “wait and see” approach.    This is especially true in the bleak mid-winter that is January and February.  That stops now, because as you now know, informed reader, the earlier you receive treatment, the faster you improve!   The faster you improve, the less time and money you spend on medication, missed work, and medical appointments!  So you see, I have made the case for PT as a savings vehicle, both of future time and money.  It is settled, deductibles be damned.  We at Thrive look forward to hearing from you and being part of your rehabilitation as you strive for wellness in 2018.

 

Reference(s):
1. Mayer TG, Gatchel RJ. Functional restoration for spinal disorders: The sports medicine approach. Philadelphia: Lea & Febiger, 1988.
2. Gatchel J, Polatin P, Now C, Gardea M, Pulliam C, Thompson J. (2003) Treatment and cost-effectiveness of early intervention for actue low-back pain patientsL a one-year prospective study. Journal of Occupational Rehabilitation, Volume 13 (Issue 1), pp. 1-9.
3. Wand B., Bird C., McAuley J., Doré C., MacDowell M., De Souza L. (2004) Early intervention for the management of acute low back pain: a single-blind randomized controlled trial of biopsychosocial education, manual therapy, and exercise. Spine, Volume 29 (Issue 21), pp. 2350-2350.

Elizabeth D'Annunzio Shah Physical Therapist New York CityElizabeth D’Annunzio Shah, PT, DPT, OCS, MCT works with patients of all ages and abilities including recreational athletes, professional dancers and performing artists. She has a special interest in vestibular and balance disorders, movement theory and creative solutions for both neurologically and musculoskeletally impaired persons. Elizabeth is passionate about exercise as a means to maintain health, manage stress and enjoy life! She practices yoga in the Iyengar tradition, is an avid surfer, and participates in distance running events whenever possible. (read more)

     

What to Expect At Vestibular and Balance Physical Therapy

Posted on Posted in All Posts, Let's Get Technical

As a physical therapist that treats persons with dizziness and balance deficits, I’ve come to realize that people do not know what to expect when they attend physical therapy (PT) for these issues. Due to the lack of exposure to this treatment and unfamiliarity with how it works, people come to their first session with trepidation and fear. So, let’s see what I can do to clear up some of your queries and give a more clear vision of what will occur in PT.

WHY DO PEOPLE GET DIZZY?

There are so many reasons! As I’ve previously mentioned in an earlier blog post, some of the reasons are:

• Inner ear dysfunction having to do with loose calcium deposits. This condition is called Benign Paroxysmal Positional Vertigo (BPPV)
• Nerve changes in the inner ear, often but not always associated with aging
• Fluid imbalance in the inner ear, called Meniere’s Disease
• Strokes in the part of the brain called the cerebellum
• On rare occasion, tumors
• Concussions

Each of these issues requires a different management strategy. Some are movements meant to shoo the calcium deposits out of the canals, and others are aimed at getting your brain used to, and less responsive towards, dizzying movements. That’s why it’s important to work with both your doctor and PT in an effort to maximize your success and initiate the process of understanding your unique scenario.

Vertibular Physical Therapy in New York CityI GUESS I’LL COME TO PT TO WORK ON MY DIZZINESS. HOW DO YOU KNOW WHAT’S CAUSING IT?

The purpose of the initial evaluation is to better understand the nature of your dizziness. Physical therapists can help illuminate what the cause is and how the symptoms might be made better. The therapist will do an ocular examination, motion sensitivity testing, postural awareness testing, and dynamic balance testing in an effort to tease out the cause and identify the most dysfunctional systems. Included as well is positional testing of the inner ear to identify if there are loose crystalline bodies in the canals. Suffice it to say, people are varied and so too is their dizziness. So the first visit, and maybe the second or third, is aimed at giving a more clear picture as to the nature of the problem.

I HATE FEELING DIZZY. WILL MY THERAPIST MAKE ME DIZZY?

Sometimes. The path to solving a problem means that we might provoke the symptoms to understand the cause. This unfortunately means that, at times, persons will experience their dizziness in PT. It is always my recommendation that a person plans to give themselves a few minutes of rest after their first PT visit, like for example sitting or lying with their eyes closed for 10 minutes prior to leaving the clinic. I also encourage that they don’t attempt to drive for the remainder of that first day. Have a friend or cab driver on standby! The good news is that, once the problem and triggers are understood, the therapist and patient can work together to build a treatment program that allows for progressive and tolerable movement forward into greater life participation and less discomfort. As with all PT, the patient should feel better over time, and therefore the dizziness provoked in the clinic should be gradually less and less.

HOW LONG WILL IT TAKE TO FEEL BETTER?

It depends! As I imagine you’d guess by now, different problems have different time frames of healing. Recovery from a stroke can take months, while some forms of BPPV can improve in one to two visits. It’s dependent on the individual. You’re thinking, “How vague?!” To this I’d respond, “I know!” The key is to get the process moving, and start the work of healing. To that end, I encourage anyone with questions or the desire to live without dizziness to contact your doctor and therapist.

 


Elizabeth D'Annunzio Shah Physical Therapist New York CityElizabeth D’Annunzio Shah, PT, DPT, OCS, MTC works with patients of all ages and abilities including recreational athletes, professional dancers and performing artists. She has a special interest in vestibular and balance disorders, movement theory and creative solutions for both neurologically and musculoskeletally impaired persons. Elizabeth is passionate about exercise as a means to maintain health, manage stress and enjoy life! She practices yoga in the Iyengar tradition, is an avid surfer, and participates in distance running events whenever possible. (read more)


     

School Backpack Safety

Posted on Posted in All Posts, Sidelined

As “Back to School” shopping begins, it’s important to do your homework to keep your child free from backpack related injuries.

Over 5 thousand emergency room visits a year by kids 18 and under are reportedly due to school backpack related injuries.  A major problem – kids carrying heavy loads in their school bags! Studies found more than half the students surveyed were carrying loads that exceeded the maximum safe weight for kids.  Finding the right sized school bag and teaching your child how to properly wear a backpack is just as important as lightening the load they carry to and from school each day.

TYPES OF INJURIES

A heavy backpack, or one worn incorrectly, can leave your child at risk for injuries like neck, back and shoulder pain. A school bag that is loaded up can significantly load the spine and surrounding joints. Wearing it improperly such as over one shoulder or sagging too low can place added stress on the vertebrae, discs, nerves, and muscles. It can also foster bad posture.

WHEN YOUR CHILD’S BACKPACK DOESN’T PASS THE TEST

If that school backpack is creating some issues, your child may start to complain of different symptoms. They include:

• Pain while wearing the backpack
• Headaches
• Shoulder pain
• Low back or neck pain
• Tingling in arms or legs
• Red marks on your child’s shoulder where the straps are worn
• Stooped posture

backpack safety thrive physical therapy soho nycTIPS FOR WEARING A SCHOOL BACKPACK

• LIGHTEN THE LOAD!  Your child’s backpack should not exceed more than 10 – 15% of your child’s weight (ex: If your child weighs 100 lbs. the backpack should be 10-15 lbs.)
• Wear both shoulder straps that should be padded for comfort
• Waist belts can help distribute and support the load
• The size of the backpack should match the size of the child
• Backpacks should sit near your shoulders NOT above them
• Backpacks should sit in the contour of your low back
(Think of your belly button line and it should not fall more than 2- 4 inches below that level)
• Choose a bag that has multiple compartments. Place heavier items closer to body and lighter ones away. Also keep sharp objects in compartments away from the body
• Avoid placing child’s name on the outside of the bag
• Place a reflector on bag to allow cars to see your child at night

ALTERNATIVES?

To help lighten the load on your kids, speak with teachers to see if there are electronic versions of textbooks available or if you can purchase two textbooks – one to keep at home and the other to keep in the classroom. Some teachers send home lighter pamphlets to complete throughout the week which help avoid students having to lug a heavy book back and forth.

If you think your child is experiencing some discomfort due to a backpack – speak with your physician or physical therapist who can evaluate and determine if that is causing your child’s symptoms.  A physical therapist can also design a strengthening and flexibility program for students to help them tone up for toting those backpacks this semester.

Image above shows Thrive PT Amy McGorry demonstrating the proper way to wear a backpack. Image courtesy of Home & Family on the Hallmark Channel.


AmyMcGorry Physical TherapistAmy McGorry, PT, DPT MTC, is a senior staff physical therapist at Thrive PT in NoHo New York. She received her Bachelor’s of Science in physical therapy from SUNY Stony Brook in 1991 and earned her doctoral degree in physical therapy from the University of St. Augustine in 2011. In 2005 Amy, completed an advanced certification in Orthopedic Manual Joint Manipulation from the University of St. Augustine. In addition to her clinical skills, Dr. McGorry is a freelance news reporter for Channel 12 and contributes medical articles, short videos and slideshows to health and wellness websites. (read more)

     

Who Are Physical Therapists, What Do We Do, and How Are We Unique in the Medical Landscape?

Posted on Posted in All Posts, Let's Get Technical

Hello out there, Thrive loyalists.  To those of you who spend much time inside our clinic, you might find this blog topic odd given your familiarity with physical therapy.  That said, I have many times been asked, by persons I’m in process of evaluating, what IS physical therapy?  I grew up with a physical therapist (PT) as a mom, so for me the idea that one doesn’t know what we do is foreign.  I suppose I’ve always had proximity to the profession.  It has come to my attention that, while I’ve been in and around PT gyms forever, that’s not true for many.  So, I’m writing this to give some clarity to those out there who wonder what exactly we are qualified to do and how we fit into the wellness and rehabilitation realm.

physical therapy cervicalWHO ARE PHYSICAL THERAPISTS?

PTs are, by and large, persons with a passion for PEOPLE, science, movement theory, rehabilitation, and often times exercise.  All PTs graduated in the past 10 years have clinical doctorates (DPTs), making them Doctors of Physical Therapy.  This means that, including clinical internships, PTs go to school for roughly 7 years.  Prior to making the DPT the entry-level degree, persons graduated with a Masters Degree or Bachelors Degree, depending on when they were educated.  All PTs are licensed by our governing body and have to maintain that license with continuing education requirements.  The reason I share this is to clarify that, while there is variety and art in the practice of PT, there is also a rigorous set of scientific standards required to get and maintain a license.  This is good for the patient!  In most states, persons can go directly to an outpatient PT without a physician’s referral.  All this credentialing and schooling is a safeguard for the patient so that you can trust your PT as the first line of defense when you have orthopedic pain, and also trust that they know enough to know when they need to refer you to a doctor.

WHAT DO WE DO?

Lots! In seriousness, you may interact with PTs in an outpatient clinic (like Thrive), a hospital, a cardiac rehab center, and a child’s school.  PTs can specialize in women’s and men’s pelvic floor dysfunction, hand rehabilitation, and lymphedema management, vestibular issues.  We’re everywhere.  At Thrive, you are interacting with orthopedic PTs, meaning we are specialists in the management of musculoskeletal and neuromuscular dysfunction.   What’s that, you ask?  It’s basically any injury or dysfunction that influences the muscles and bones and the creation of movement and/or the coordination of those muscles via the nervous system.  If you’re now thinking, “That seems to cover a lot,” you’d be correct!!  That broad umbrella includes orthopedic post surgical recovery, back and neck pain, muscle and ligament strains and sprains, jaw pain, balance and fall dysfunction, etc.  It’s our passion and goal to return our patients to function, get them back to work or sport or whatever moves them.  We want to see our patients doing what they love without fear of injury or pain.

kinesio taping in room at Thrive SoHoHOW ARE WE UNIQUE?

PTs, by and large, get in the field because we are interested in people.  We talk to our patients, put our hands on them as a means to stretch and manipulate tissue, and problem solve as a team to get them moving.  It is physical and highly interactive work!  It affords us the great privilege of truly knowing the patient and serving as a resource for them.   It is my humble opinion that PTs are expert in not only the management of pain and rehabilitation from injury but also in its prevention.  Rather than coming to Thrive when your back has been hurting for 6 months, imagine the scenario where you come prior to pain for the ergonomic evaluation, stretching program, and hands on re-education that allowed you to function at your best.   I know that, for many, that’s impossible due to time and financial constraints.  So, instead consider coming in when your pain starts…get an early lead on the healing process.  Ultimately, whether you’ve had chronic pain, recent surgery, or want to problem solve out how to return to running after baby, PTs are ready to help you move forward towards achieving your goals!


Elizabeth D'Annunzio Shah Physical Therapist New York CityElizabeth D’Annunzio Shah, PT, DPT, OCS, MTC works with patients of all ages and abilities including recreational athletes, professional dancers and performing artists. She has a special interest in vestibular and balance disorders, movement theory and creative solutions for both neurologically and musculoskeletally impaired persons. Elizabeth is passionate about exercise as a means to maintain health, manage stress and enjoy life! She practices yoga in the Iyengar tradition, is an avid surfer, and participates in distance running events whenever possible. (read more)