Physical therapists can help injuries heal, even when the cause is unclear
By Lenny Bernstein,
My newest hero has vanished, as heroes are wont to do, perhaps down the dark streets of Gotham City or off to the Fortress of Solitude.
Okay, she’s in Cumberland, Md. But before she moved on to her new job, Carla Colella, my physical therapist, revived my exercise program by figuring out what to do about an injury that just wouldn’t go away.
And that’s no small thing. As I whined in a column in January, losing the ability to exercise when you’re accustomed to regular physical activity can be life-changing. Getting it back is just as earth-shaking.
Like my doctors, Colella never determined precisely what caused the ache in my right groin and hip whenever I went running, though she suspects I injured my abdominal fascia while working out with a trainer last year, then created more problems by continuing to run. But as experts in movement issues, physical therapists get right to work helping patients like me by teaching us strengthening, stabilizing and stretching exercises even as they look for the problem.
“Sometimes we have to get to that very root of it,” says Mary Ann Wilmarth, chief of physical therapy for Harvard University. “But we can always give the person something immediately to start with that can help them.”
No offense to my physicians. The care I’ve received over the past several months has been superb. Suspecting a hernia, I went to see a doctor at my HMO, Kaiser Permanente. He examined me and referred me to a surgeon, Brian M. Cantor.
Cantor is an earnest, amiable guy who had me lie on his exam table while he checked me out. We chatted casually about the Redskins until he sank his fingers deep enough in my groin to examine my tonsils. Even that was not enough to find my problem for sure, so he sent me for an ultrasound exam.
There, three women — two technicians and a physician — peered intently at a screen while one of them rolled the device over my exposed hip and groin, and I tried to pretend there was more between me and them than the flimsy “drape” I had tucked into the top of my drooping boxers. I think of “drapes” as long, flowing lengths of fabric used to cover windows. This one was the size of a couple of sheets of paper towel.
Just to make sure, Cantor also sent me for an MRI. It seems as if I read about athletes having these every day, but the sports pages never mention the quart of thick, nauseating barium I had to drink before the test to ensure that my insides would show up on the computer screen.
And when it was done, I was back where I started: unable to run, with no clue what was wrong. So I asked Cantor to refer me to a physical therapist.
The Kaiser office where I met Colella is in a nondescript building not far off Connecticut Avenue in Kensington, in a neighborhood of commercial structures. Colella, 28, is one of the 180,000 physical therapists in the United States and one of the 20 percent who hold doctor of physical therapy degrees, which she earned at George Washington University. Like a small percentage of her peers, she is a contract worker, and she is taking advantage of the severe shortage of physical therapists in the United States to move from city to city before deciding where to settle down.
(Note to college students: The shortage will continue, and physical therapists earn a median salary of as much as $90,000, depending on where they work. Earning a degree can be expensive, though.)
Colella knows the benefits of physical therapy from personal experience. “Similar to you, I did not have a major medical diagnosis,” she told me in a recent e-mail. In high school, “I caught an elbow to the back going up for a layup and a few months later decided to attempt to throw (shot & discus) in addition to sprint. The combination did a number on my thoracic (mid-back) area. I went though the typical medical management routine with no relief. I then went through physical therapy and after many months . . . I was able to compete in all recreational activities pain free. I thought it seemed like a good career — helping people, decent pay, tennis shoes & no cubicle, where do I sign up?”
On my first visit, Colella outlined a series of exercises, even drawing stick figure diagrams to make sure I did them correctly. After months of pain, I began to feel a difference in just a week or two. At two subsequent visits, she did deep tissue mobilization, or massage, on my hip.
Colella wanted to see me twice a week for three weeks, but with so many people seeking physical therapy at Kaiser, I was able to get only four appointments in four weeks (the last of which I missed).
In the end, it didn’t seem to matter. Colella’s treatment has put me back on the road and the treadmill. Although some pain and stiffness remain, I’m slowly overcoming a winter of sluggishness and weight gain. If all goes well, I’ll resume marathon training in a few weeks.
So thanks, Carla. And although I can’t flash a distress call against the night sky the next time I get hurt, I know where that Kaiser physical therapy center is now.
Do you need a physical therapist? In many cases, you can make an appointment without a doctor’s referral. Find one at at the American Physical Therapy Association’s site. The organization also hosts a Q and A at Ask a PT.
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