Observations from PT

imageAs I mentioned a few weeks ago, I’ve been dealing with a bout of neck and shoulder pain. This isn’t really a post about me, but since some of you have wished me well, I am making progress and I feel quite a bit better. The reason behind my relief is Physical Therapy. If you haven’t ever had PT, you might want to get a second opinion on some of the opinions expressed here. If you’ve had PT, I’d be interested to know if you agree with my observations.

PT starts with an evaluation. Before the physical evaluation, you fill out a form. One of the things they ask you to do on that form is to rate your pain from 0 to 10. Zero means you have no pain. That’s OK, you’re at PT, you will have pain soon enough. 10 stands for the most severe pain there is. They normally add little faces to help you assess your pain level.


I have a couple of thoughts and one minor change to this chart:

  • You don’t really go to PT if you don’t have some level of pain, so I’m not sure if 0 – 3 are really options. I suppose you could have range-of-motion issues without pain, but I’m guessing.
  • If your pain is severe enough to interfere with concentration, I hope you got a ride to PT.image
  • I would associate “bed rest required” with 9 on the scale. 10 is the kind of pain that requires prescription drugs or alcohol in order to achieve bed rest.
  • I would also add a level 11 for when the pain is bad enough that, if you were a dog you would gnaw off the body part involved with the pain.

Whatever your pain level is upon arrival, I’d leave a little bit of room for it to increase after the physical part of the evaluation. You’re going to need that.

During the physical evaluation, body parts, your body parts are twisted, bent, pushed and pulled and you are asked to apply force to the therapist and resist the force that he applies to you. This is the point where you start to realize that you have no idea how your body really works. You might think, for example, that if raising your arm up against the therapist’s hand doesn’t hurt, then holding it still while he pushes down on it won’t hurt either. You might be wrong. I was. The complete realization of how little I knew about my body, compared to the therapist occurred when he said:

I want you to put your arm behind your back and then I am going to press on this spot (near the end of my shoulder). If I’m right, this is going to be very painful.” I was glad that I had saved my 10.

Physical therapists aren’t mean, but they do get paid for doing things to you that hurt. On the other hand, they do tell you to stop doing most things if it hurts to do them. Still, in order to move you along your treatment path, they add more and more sinister elements to the routine. When your therapist says “we’re going to try something new today” you are in trouble. If you can lift a dumbbell, they give you a heavier one. If you can do 10 reps, they will have you do 20. If you can stretch without pain, they will add resistance. Weights, bands and even your own body can be used to make exercises harder.

The most painful thing I am doing these days is lying on a 6” diameter imagefoam tube with my arms in a ‘hands-up’ position. Just. Hanging. There.

Arms weigh a lot. I swear mine weigh 50lbs each.

The best part about Physical Therapy is the level of respect in the room. This isn’t you and your therapist in a small room with a door – this is you and your therapist in a big room with everyone else and their therapists. People are in pain, people are being evaluated, people are being told “let’s try something new” and, every now and then some fortunate soul is being “released” from the program. It’s just like being released from prison. OK, I’ve never been in prison, but that’s how I imagine the feeling. There’s an unwritten but well-understood protocol in the room. Nobody stares, nobody laughs, nobody makes “…suck it up” style comments and nobody whines.

Some of the other things that I’ve learned in PT include:

  • 3 pound dumbbells can be impossible to lift under the right (wrong) circumstances
  • The design of the human spine is way-too-complicated.
  • Doing 2 sets of 10 of anything is easier than doing 20. It’s so much easier to say “seven” twice than it is to say “Sev-en-teeeen” once.
  • Massage doesn’t always feel soooooo good.
  • Nobody likes co-pays or the insurance companies they rode in on.

Fortunately, my doctor let me refill the prescription for the NSAID gel that does provide relief. My Physical Therapist doesn’t like me to use the gel before my appointment saying:

Carry the pain in with you

But I can slather it on afterwards.

50 thoughts on “Observations from PT

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  1. That’s me in traction. It looks like a medieval torture device, it’s actually quite soothing. The illustrations are my attempt to stay within the boundaries of copyright law.


    1. Thank you Maggie! I did this before in 2010 (other shoulder) and the recovery was full (not so speedy). This time, I started earlier so I’m pretty optimistic. But, you have to laugh.


  2. Dan, I am glad you are feeling better. I’ve been laughing from the moment I got to paragraph 2:) Great piece of writing here.
    I know what you mean about those “pain levels”. I’ll add a 12. This is when you want to yell at and grab the therapist and cause him some pain. I’ve been in that room with people gritting their teeth and yelping in pain. I think the best part of PT is when they put the ice pack on your body part and you just lie still for a few minutes:)

    Have a pleasant balance of the week.


    1. Thanks Elaine, The ice pack is the best. I told the PT on Monday that I really like the fact that the timer for the ice pack is the last bell of the day. If I could draw an image of choking hands, I’d add level 12 – thanks again for your comment.


  3. Oh wow. I really don’t want to go to PT, Dan. I was frightened that I may have injured my shoulder badly this last winter. I will not go to PT because I will always stretch before I shovel the driveway. UH HUH.
    I have a great pain chart meme…I’ll hafta hunt it down and blog about it sometime. For me, dry socket was 11. I would have removed my jaw if I could have. C-sections were a 9 and I don’t even know how bad labor would have been! Arthritis is a pretty constant 4.
    I shall count “NO PT” in my blessings tonight!


    1. The good news it that after the first few visits, you do feel a little better after going that you did walking in. It does work, and they really do know what they’re doing. I felt a little unqualified to talk about pain given that I’ve never had a baby (natural or c-section) and I’ve never had Kidney stones). I look forward to your descriptions. I stretch, I exercise and unfortunately, I work at a computer all day. This latest round is a result of the way I was sitting. I know. Sitting. It would be so much easier to write about if I had been taking down a big tree :)


  4. I appreciate this was a post ‘borne of suffering,’ but I really couldn’t help but laugh at much of it (sorry). Apart from the odd relatively mild twinge from a leg injury from many years ago in the army, I’ve yet to suffer any such pain, and have never needed any kind of physiotherapy. I guess I’ve been lucky, but at 55, I’m all too aware that one day I’m going to wake up with all the illnesses and aches and pains of middle age. Having said that, it was a very well written and funny post, and with a bit of editing could easily form the basis of a short story or a scene in a longer satire or comedy piece. Great post!


    1. Not to be the usher of doom, but I was 56 when I had my first round of PT. Don’t apologize for laughing, I tried to make this funny. Sometimes, laughter is all we have and sometimes it helps to laugh when the events aren’t funny. Thanks for your comment.


  5. On the flip side… I had a plate fitted in my ankle many years ago, and was a bit Lassez Faire about the PT in the recovery process after the injury. I accepted a constant level of annoying pain in my ankle for 8 years, particularly when driving. Eventually I got up the courage 3 years ago to go back to PT and have it looked at.
    My hesitation to return to PT was exactly as you have outlined, these people earn a living increasing your pain so you can get better! However in my case, the PT did some simple manipulations, and gave me exercises – no pain. Every week when I left him there was less pain in the ankle, after 8 weeks I was back to good as new. They really do know how to get your joints to work right, and pain is not a given during the process.
    I have to agree with you though that my understanding of how my body works from a mechanical standpoint is very poor.


    1. They are really good at what they do Les. They first time I had PT (2010) I was in terrible, constant pain. The stretches and exercises hurt, but the woman said “after 6-7 sessions you will start to feel a little better.” She was right. After those first three weeks, every visit brought progress and when I left after 3 months, I was pain free. Right now, the pain is associated with them trying to break up some scar tissue. They know that it hurts, but it’s hurting less each visit, so I’m still going.


  6. Laughing, laughing, laughing all the way through … wait … this is a post borne from pain, a lot of pain, traction level pain! And I still think its funny which sadly makes me the owner of a sick sense of humour. Seriously, I’m glad you are doing better!


    1. I filed this under ‘humor’ for a reason Jill. I’m glad it made you laugh. It was fun to write and it’s fun to think about it this way as opposed to dwelling on the downside. They are helping me to feel better, and that’s what really matters. I think you have to be able to laugh at stuff like this. Thanks for stopping by and commenting.


    1. Agreed, humor is a powerful remedy. That’s why I agreed that sharing some of the humor born of war would be good on your blog. It can’t be a long series of jokes, but it does help get you through the tough parts.


        1. True, but equally unrealistic to think that they never laughed and never joked around. I don’t know the stories from the war, but I know how my father acted after I was born, and I can’t imagine him not laughing for years on end.


  7. Oh Dan, on a scale of 1-12, I feel your pain!! LOL Humorous anecdote you wrote!

    I do hope the PT helps; it has been helpful treatment for me thru numerous sports injuries, however I’ve learned that what I eat factors into aches and pains as much as the injuries. Also … working on a computer in a seat at a desk is the worst. I used to sit on a fit ball instead of a chair (which reminded me to stretch while working) and had one at home which I used religiously at night (still do). Ask your Phys Therapist to show you how to stretch on one; Hub and I love ours.

    Sorry for such a long comment, but you will enjoy this anecdote having written about your father. Five years ago at 85, Dad was diagnosed with rectal cancer. He’d been in the hospital a whopping 1 time before that; wasn’t used to the indignities and probing questions and was his usual self commenting about all the “ridiculous” things he was being subject to. Every time the cheery, perky nurse would ask him “on a scale of 1-10, how’s your pain?”, he’d freeze for a minute then say “how the hell should I know. It hurts!” Then she’d leave the room and Mom & Dad would spend 15 minutes talking about how absurd that question was. “It hurts or it doesn’t” he’d say and Mom would nod in agreement. For me it encapsulated the simplicity and stoicism with which their generation lived their lives. My guess is “it doesn’t hurt” fit scale 1-9 and ” it hurts” fit scale 10 in his generation. My siblings and I now have a loving, but sarcastic, habit of asking “on a scale if 1-10” questions to each other.


    1. I think you’re right about our parents’ generation. They were definitely more likely to work through most pain and only see a doctor when it was at or near 10. I don’t run to the doctor with every ache, but the first time I had this injury, I waited 8-10 weeks and by the time I got to PT, it hurt very bad and the pain was constant. I don’t like the scale because I feel like saying “I wouldn’t come here if I could ignore it” but I realize that they plan their course of action based on how much it hurts. I feel like saying “6.32 no, make that 6.27”

      I love the story about your dad, thanks for sharing that. My dad would have reacted the same way.


  8. Oh, Dan, how I feel for you. I’ve done the PT road and I KNOW how painful it is. You are in my prayers and I really hope for you, a very speedy recovery!!! Love and (((HUGS))) Amy


  9. One correction. PT doesn’t stand for Physical Therapy. That is a common misunderstanding. It stands for Pain and Torture. They only release you when they can no longer legally cause you pain.

    Other than that, great post.



  10. I’ve had PT…wish I could say I recovered full range of motion…but I can’t the damage was too severe. I couldn’t wait for the warm wax, and icing after the strenuous exercises the Therapist put me through. That to me was the best part of PT. :) I wish you a speedy and full recovery!


  11. Just LOL @ ‘I would also add a level 11 for when the pain is bad enough that, if you were a dog you would gnaw off the body part involved with the pain.’

    I recall doing PT during my rehabilitation process after I broke my pelvis in 5 places.

    I hated and loved my physio in equal amounts during my 1 hour sessions.

    Hope you are on the mend? I have to read through some more to catch up on what’s been happening!



    1. “Broke pelvis in 5 places” – That sounds awful. I simply have shoulder pain mainly due to the fact that I get tangled up in my work (at a computer) and forget that I am hunched over at my desk. Thanks fro stopping by.


      1. Was a bit painful… the ‘ole broken pelvis.

        I very much relate to aches and pains from being tied up in ones work on the computer.

        When i was working in a government contract they actually had a specialist come around every 12 weeks and measure everything respective to our bodies – in an effort to prevent sick days and compensation claims.

        Gel based mouse pads and ergonomic keyboards, correct chair heights.

        It did make a difference. There’s quite a market in it!

        Are you on the mend or lots more to do?


        1. I am on the mend, I normally work at a Windows laptop, connected to a large monitor and wireless mouse and keyboard. It allows me to stay in a good position. One of the development tasks that I am still involved with is creating a few iPad/iPhone aps. That requires me to work at a Macbook and I spent a few days bent over a small screen and the integrated keyboard. Stretching everything back into shape now.


  12. I’m proud of you for getting back into PT despite its difficulty. I find it interesting that rotator cuff and neck injuries run in our family. After 4 years of chronic levels 3-7 in my neck, I know PT is the best option for me, but I’m a little nervous to begin. I’m not sure I have the discipline to stick with it as rigorously as you have, but I imagine these types of injuries don’t get better on their own (and probably not at all if 4 years hasn’t helped.) Maybe your stories will inspire me to stop procrastinating what I should have pursued before it got to this point.


    1. Thanks! I’ve been lucky to have the support at home and at work for attending the sessions and continuing the exercises at home. I just bought my very own 6″ x 36″ round block of recycled plastic – OH, sorry, I mean my very own Foam Roller Exercise tube. Now I can hang my arms out to stretch more than twice a week :)


  13. “Nobody stares, nobody laughs, nobody makes “…suck it up” style comments and nobody whines.”
    That’s a very severe place, Dan. Because people are given to doing these things.
    I am glad you are making progress. All the best, man! Have a great weekend!


  14. Hey, something to look forward to then! Maybe I’ll hold off on the large tattoo I was planning on in lieu of this torture! Haha.
    How often did you go? And are you pain free yet? I see this is an old post relatively speaking.


    1. I was going 2-3 times a week for 6 weeks but I was pain free by week 4 1/2. I went the remaining 3 sessions so he could ramp me up on the weight of the dumbbells he has me use on that tube. I am still pain free. I pay more attention to how I sit and what I’m doing at my desk. That was the 2nd time I ended up i PT. The first time, it took 12 weeks and I was in agony for most of it. If you follow the Sarcastic Muse, Amanda just did a mini-series on how “your chair is killing you” and “how to sit” that is very good. I work at a laptop all day everyday and I swear, it is trying to kill me.


      1. Yep, I really notice it when I spend too much time on the laptop in a day. Great that the PT worked so well and so quickly for you. I have high hopes for myself… and so does my wallet. :P
        Thanks for the suggestion – I’ll look up the posts you mentioned. :)

        Liked by 1 person

  15. I sat up straighter and stretched while reading this. Sitting a lot is so not good. When I used to work in an office, sitting and typing a lot, I arranged things so that I could occasionally stand up and type. A few months later, the IT person got herself a stand up desk for her computer. It’s nice to have options. My PT experiences have been good though I quit going after a while cause copays add up.

    Liked by 1 person

    1. I do try to sit up at work, JoAnna, and I get up and walk around at least once an hour. If I don’t, my shoulders will scream at me.

      The copays for PT were basically 100% of the insured cost of PT :(


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