I had the pleasure to ask physical therapist Joel Verzosa a few questions about rehabilitation. Joel is the owner of Optimized Physical Therapy and been working in physical therapy for 5 plus years.
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What are some of the biggest mistakes people make when they are rehabilitating from a lower-body injury?
It could be an injury of the lower body, upper body, or the spine the biggest mistakes that you can make are doing too little or doing too much. There is this space in between that I refer to as the “Goldilocks Zone” with the upper limit being any activity that causes UNREASONABLE discomfort and the lower limit being only performing activities that cause NO discomfort. I would describe unreasonable discomfort as around a 5 out of 10 on a 0 to 10 scale where 10 represents you need to go to the emergency room. I wouldn’t be doing my job if I didn’t further explain why we believe it is ok to move through some reasonable amounts of pain but, in short, it is because pain is a protective mechanism that our nervous system uses as it is trying to do its job, protecting us from harm and not an indicator, in most cases, of true physical damage or harm. In fact, physical harm and pain can both exist separate from each other (think of a time where you’ve found a bruise and have no idea where it came from).
Is there anything special you should do to your diet while rehabilitating?
I don’t claim to be a dietician but I tend to recommend a diet low in processed foods, sugars and carbohydrates for general health but it is more important with those who are recovering from injury.
The reason behind this has a lot more explanation but put simply think of your system as a bucket where all stressors equal liquid that goes into that bucket. If you overflow the bucket then the result is a pain. Processed foods and those foods mentioned above have a detrimental effect on your gastrointestinal health, therefore, causing stress. Most times this isn’t an issue but when a person also has the physical stress of healing an injury, the mental stress of pain and personal beliefs about pain, and the stresses of normal daily life (kids, family, traffic, and relationships tonnage a few) all filling the bucket to some extent the stress of dealing with pro-inflammatory foods could cause overflow.
What are some of the recommended exercises?
This is a very broad question that I also give a very broad answer to which is anything that doesn’t cause discomfort above a 5 out of 10 on that 0 to 10 scale of pain (UNREASONABLE discomfort). What I suggest goes for those who haven’t had recent surgery and/or those who are following specific instructions from their MD or orthopedic specialist.
Most times it is as easy as finding the exercises or activities that decrease our discomfort or only cause discomfort that is REASONABLE and progressing gradually back to your normal. For example, if bending down to touch your toes results in 6 out of 10 pain when your hands get to your knee caps then my suggestion is that you perform as much of bending down to just above that point as possible that day and do any other activities that don’t produce pain above a 5/10 and repeat that process the following day trying to bend further down making sure not to try to push into discomfort above a 5 out of 10.
Measure your progress by how much further you’ve been able to increase in your activity not simply by if you have pain or not.
What Condition have you treated the most?
As with most physical therapists, back pain is our number one most treated condition. As a bonus, my favorite condition to treat is prolonged back pain with or without symptoms (numbness/tingling/burning/pain) into either leg.