The Merits of Physical Theraphy (are there any?)

[Dale Houser]

http://www.nytimes.com/2010/01/07/healt ... st.html?em

When I hurt my back last May, PT was prescribed, and paid for. The stretching was good for me and the TENS treatment felt really good but it didn't actually help my condition (herniated disk rubbing up against the sciatic nerve) or the pain (it always came back when I left).

I ended up getting an epidural steroid injection. It's keeping the pain away which is way better than what PT ever did. Surgery seems to be the only fix at this point. Anyway, what are your experiences with PT?

[Bill Glasheen]

what are your experiences with PT?

I've had access to good PT through the years. Since I was a varsity athlete in high school and college and I taught martial arts in college, they would bring me in the training room and I'd get first class treatment.

I'm a great believer in GOOD physical therapy. The goal however should be to bring your body back to a condition where you'll avoid the problem in question in the first place. That can mean making it stronger/better than it was before you hurt it. Often there is a reason for an injury happening.

You have neural issues in the spine. That is a whole other kettle of fish. The nerve issue has to be addressed or you're wasting your time. The herniation has to be managed and/or addressed.

That being a given, getting your entire trunk in better shape (better strength and flexibility in every degree of freedom of motion) is the goal. Even if you can't make your spine perfect again (as is the case with my knee that no longer has a lateral meniscus), you can overcompensate by having a better (stronger and more mobile) trunk. Muscles can make up for what the spine isn't doing. And in this case, poor trunk conditioning (or bad stretching technique) may have been the setting which made you vulnerable in the first place.

Good luck!

- Bill

[IJ]

PT is a broad thing. Lots of different people doing different things. It's difficult to compare them directly. You have to make sure you've got someone good and they're doing the right stuff. This varies by the condition.

I got sent to PT by a sports medicine person for my left rotator cuff. It took both of them commenting on my posture and relative fitness chest to back for me to realize that my posture and core strength and back workouts had a substantial impact on my low back pain and rotator cuff issues.

The PT person I met needed to be aggressively coached to treat me like an adult/physician/athlete--she suggested a few exercises and that I come back. I'm not a patient! What I needed was ALL her advice (written helps) and then I'll do it hardcore on my own (which I did); I had no interest in doing simple things under supervision at cost. A lot of PT is geared toward inactive unwell people who need instructors on stretching and basics.

I can say that this contributed to my level of current fitness, but really my advances were core exercises and back/pullup routines from p90x. Rotator cuff is fine and I do hundreds of pushups and dozens of pullups. Back pain esentially gone.

Discs can be a real pain though. I don't know of any PT that's gonna make you forget a nerve is compressed, but time, some injections, and supportive care often lead to results in a few weeks or months. Some people need surgery though. Regular ole back PAIN without nerve compression, on the other hand, I believe responds well to appropriate PT/ activity/posture/sleep habits/mental state.

[Dale Houser]

I've been doing exercises to strengthen my core and hamstring. I will be finally going back to the dojo this month. I am excited but will be taking it slowly. This has also helped: http://egwellness.com/, though it does not directly address my issue.

[Bill Glasheen]

The longer you survive in martial arts, the more you'll learn how to make much of PT part of your everyday life. If there's one thing good I've done to the thousands of University students who have come through my classes, it's to teach them how to live their lives productively and effectively. That's where karate jutsu and jujutsu evolves into karate do and judo.

I try anyway. It's like that old car commercial. Listen to me now, or listen to me later. Later isn't much fun, but the chronic owies you pick up in life remind you to pay better attention.

Be forgiving of and patient with yourself, and good luck.

- Bill

[IJ]

It's an interesting link you chose there... we discussed her work a while back on here, and I can say whenever I'm out in the garden or leaning over to listen to someone's lungs or picking something up, if I don't follow her advice (ducky butt, not tucky butt, essentially the opposite of sanchin) I feel a strain on my lower back and if I ignore it the strain becomes a pain.

I do feel solid and comfortable doing Uechi with a tucked pelvis, but that's as far as I'm taking it, and I found her mechanics discussion pretty convincing.

[Bill Glasheen]

I do feel solid and comfortable doing Uechi with a tucked pelvis, but that's as far as I'm taking it, and I found her mechanics discussion pretty convincing.

We need to spend some time together. There is no conflict. You're on the path to figuring that out, but I think I can scoot you along a bit faster.

BTW, I use "ducky butt" and "tucky butt" with my kid students now. It works...

- Bill

[IJ]

We're smart people, Bill, try me here. That's the magic of the internet, you don't have to fly out to ski country Colorado to talk spine

[Bill Glasheen]

It's too damned difficult to describe online, Ian. It took several years for me to pick it up from Nakamatsu's students. (Mostly thanks to Dana.) And since being taught the basic concept in Sanchin, I've expanded it to techniques in my other kata. I even employ it some now in my ukemi.

Some time back I did a picture analysis of it. But I'm not sure where that thread is. And the search engine kinda suks on this website.

This is best taught in a camp or with some one-on-one lessons.

- Bill

[Dale Houser]

FYI. From an email I received in case anyone is interested. I am not going. I hope to be on a nice sunny beach then.

We are happy to announce that Esther Gokhale will be coming to Washington, D.C. to
teach the Gokhale Method Foundations (GM 101) course from Friday evening, June 4,
2010 to Sunday, June 6, 2010.

The classes will begin on Friday evening and meet for parts of Saturday and Sunday.
Please see the link below to access course information and registration.

https://gokhalewellness.com/sites/all/m ... p?u=599&qi...

I have included a few links about Esther Gokhale and the Gokhale Method.

The SF Chronicle’s recent article about the Gokhale Method:
https://gokhalewellness.com/sites/all/m ... p?u=591&qi...

Esther Gokhale’s talk at authors@Google is a great introduction to the work:
https://gokhalewellness.com/sites/all/m ... p?u=592&qi...

Please forward to friends and family who would benefit from this course.

http://www.egwellness.com