The physical therapy way


3/3/2014

27 Comments

Until last year, I had never been acquainted with physical therapy. My only brush with it was when I would tell a passerby I was a therapist and they would ask "physical therapist?", or when people I knew would be going off to PT several times a week. Last spring, my daughter began having some hip/foot issues from her dancing and the pediatrician sent us marching to this "PT" thing. Once we got settled in at Bodies in Motion, she and I were both hooked. She for the individual attention and kindness of the therapists and me because it was so very fasciniating.

What was I fascinated by? First there is a big room of tables with multiple therapists and multiple patients doing all sorts of body work together. Bending, stretching, pushing, pulling, there are even people getting needles in their bodies right there in the middle of everything. Therapists and patients all chit chat amongst one another; be it type of injury, latest snow storm or lunch cravings - chatter and laughter abounds.

My mental health therapist head is thinking HIPAA? We operate under strict ethical codes highlighting all manners of confidentiality, conduct and boundaries; I get antsy when one of my clients happen to bump into another in the waiting room and here we have the PT patients being assessed, worked on and massaged in front of the entire patient population.

The other intriguing thing for me is the toys. Not only are there stationary bikes and treadmills, there are bands and balls and gadgets for every last muscle. My daughter was picking up marbles with her toes and placing them in a bucket. I was struck by the creativity of it all. I discussed it with her therapist and was amazed by all of the engineering technology involved in their "toys".

Now it's my turn. I've been having a shoulder/arm issue that just won't quit. It started with pain and over the duration of the winter has turned into a nerve thing with tingling up and down my arm. When I walked back into the 'toy' room for my first appointment, I was warmly greeted by the two PT's that had worked with my daughter. How is she, how is her dancing, let me see pictures etc.

One of these kind gentleman was assigned to my tingling. He took my history, asked about the initial injury and then began touching my arm, shoulder and hand. (Another bizarre thing for this mental health therapist, touching a client? If a client asks for a hug every clinical nerve in my brain is on "alert" due to our very rigid boundaries).

Push, pull, resist, stretch, turn, shrug - my PT is beginning to assess the tingle. He checked mobility, range of motion and who knows what? The good thing is HE knows what he is doing, I am just the body on which he does his work. And this is where my "aha" moment struck. He is looking for the cause of the tingle; by pushing and prodding at my muscles, assessing where I am tight and when I loosen up, subtleties of which I am barely aware, but he understands the body and can figure out what is going on with my nerve. He constantly asks me if I notice any difference, is the tingling more or less, rate it on a scale of 1-10. The tingle can't speak to him, thus he must rely on my evaluation.

The 'tingle' doesn't talk; I feel it, it is uncomfortable and irritating, but I'm not sure of its source. It is inconsistent; fingers, hand and arm depending on the moment or my movement. How is this similar or not to the mental health therapy that I do? Sometimes I see a client that knows exactly what is going on. "My mother died, I am heavily grieving and am having trouble getting my work done." PT patients can know the root cause; many of them are there for rehabilitation following surgery, have specific injuries or various medical needs.

Often I get the 'tingle' clients. "I've been feeling depressed", "my daughter is cutting herself ", "our teenager is self-medicating with drugs". These symptoms have less of a clear source. Sometimes they can be an offshoot of a trauma, root from a deeper depression or can be the beginnings of a chronic mental illness. These symptoms, as the 'tingle', can be a mystery. Like my PT, I begin to push and prod at the emotional muscles; I assess and ask and maneuver. Unlike my PT, who can push a muscle really hard (AND hurt my inner arm like nobody's business), I need to approach more gently. If I push too hard, I may cause my client to shut down or even worse, scare him away. (Of course the PT could push the limit, but based on my first two appointments, he has more wiggle room with the idea of gentle).

Over time, building rapport and trust, my clients and I dig together towards the source of their symptoms. Often, they too, find that their 'tingle' doesn't speak. Many of my clients struggle with identifying their emotions; they aren't familiar with them, can't discern between sadness or anger, or just can't find them. I slow things down and help them to build an emotional vocabulary and learn to identify emotional triggers via body sensations. Where do you feel it in your body? What does it feel like? Pressure/pain/shaky? All of these prompts help people to get in touch with their emotional temperature.

The word therapy, meaning curing or healing, comes in many forms. While I am doing talk therapy, there are so many ways to heal us humans. I am glad to know that both our bodies and our souls lend to pushing, prodding and healing so that we can all achieve the mental, physical and spiritual peace that enable our days to be filled with joy

Laurie Levine