The Body's Connections
by Justine Calderwood, MSPT
About a month ago I got a call from a gentleman who wanted to book a massage. He had gotten my number from a friend of his wife, who told him that I help people who are in pain. We talked a little while so I could determine what was going on that he was needing a massage. His lower back was really bothering him and he was desperate for some relief. I didn’t want to mislead him…I’m not a Massage Therapist. There is some overlap of what I do and what my massage therapist friends do, so perhaps I would be able to help him. The thing is, though, when I explained that I was a Physical Therapist and that I was confident that I could help him, even if what I provided wasn’t a typical “massage” like he was expecting, he stopped right there. “Oh, I’m already seeing a Physical Therapist for my shoulder”. He recently had shoulder surgery, so he was receiving physical therapy from a local provider. I was both embarrassed and dismayed when he said “I never thought about telling her that my back was bothering me. I didn’t know she could help with that, too”. Wow! What an eye-opener for the both of us.
For one, why and how has the physical therapy profession arrived at a point where we look at people as broken-up body parts? And two, how do we as physical therapists fail to take a thorough history and communicate with our patients on how we can help them? Isn’t the shoulder joint connected to the sternum, connected to the thoracic spine (mid-back), connected to the lumbar spine (lower back), connected to the hip joint, etc? If someone comes to us for shoulder pain how is it ok that we focus solely on that? Someone in a sling after surgery often-times gets referred pain to the upper back, neck, head, and even into the lower back, just from being immobilized in the sling. This can stem from guarding and protecting the shoulder.
Referred pain can happen even without a previous history of back or neck pain. Throw in the fact that back pain is the 1# reason for missed days of work in the United States, with 80% of people reporting back pain at some point in their life, you have a perfect storm of aggravating a pre-existing condition like lower back pain after surgery and immobilization, even if the surgery is not directly related to the back.
I was a little embarrassed to tell him that his current physical therapist should be able to evaluate his lower back and start treatment on it. It was unfortunate that he hadn’t communicated his lower back pain to her or that she hadn’t picked up on it. I was a little more embarrassed as I realized that I probably had previous patients in that same boat; patients searching for a massage therapist or other healthcare professional to complement their physical therapy treatment, because I wasn’t addressing them as a whole person. Feelings of being limited in what I could provide for treatment based on time or insurance. How was I going to justify treatment of the lower back for someone that just had shoulder surgery? How was I going to fit in treatment for both things in one short session? Should I split a 45 minute treatment in two and address the shoulder in the first half of the session and address the back in the second half? Was I giving this person enough hands-on treatment to benefit them and add in enough exercise to please the insurance provider? I certainly didn’t want my treatment note to look like I did only “passive” treatment, like manual therapy, at the risk that my employer wouldn’t get reimbursed at the maximum rate, or worse, that the claim would be denied. And I had to keep in mind that I could only charge a certain number of units of manual therapy, depending on the person’s insurance provider. So, I had to do some exercises, even though perhaps what the person really needed was the full 45 minutes of manual therapy, over several sessions.
The good news is that by saying goodbye to the insurance company and being able to coordinate care directly with the patient on what they need, I no longer have to limit treatment to a particular body part or to a certain number of billable units when someone is having pain in multiple areas. And my training in the John F. Barnes Myofascial Release Approach has prepared me to evaluate each person as a whole person, NOT broken-up body parts or diagnoses. It allows me to see an overall picture of where the body may be being pulled off-center or where fascial restrictions have developed due to surgery, poor posture, or holding and bracing patterns that have developed. Coupled with a thorough history and great communication with my patients, I feel confident that I’m better serving my patient’s needs.
Myofascial Release treats the whole fascial system, which is the soft tissue that connects everything in the body. It releases the collagenous barrier, not just the elastic and muscular components like other forms of therapy do, which leads to a more permanent change in structure. I do have patients that continue to complement their physical therapy treatment with chiropractic care or an occasional massage, but the majority of patients report that they are able to eliminate the need for other care when receiving Myofascial Release because of how well it addresses the whole body system. So, it turns out the back bone really is connected to the hip bone…is connected to the knee bone….is connected to the ankle bone, etc.
If you are experiencing pain in any part of your body, whether it's shoulder pain, lower back pain, or both, and you'd like to discover how Physical Therapy and Myofascial Release can help you, give us a call today. We offer free phone consultations and free, non-committal Discovery Sessions to help you decide if we are the best provider for you. We'd love to help you feel better and move easier so you can stay active and mobile!
Justine Calderwood is a physical therapist at The Healing Spot Physical Therapy, LLC in Woodland Park, CO. She has trained with John F. Barnes and is an Advanced Myofascial Release Therapist. The Healing Spot Physical Therapy, LLC serves the communities of Woodland Park, Divide, Florissant, Lake George, Green Mountain Falls, Cascade, and Manitou Springs, Colorado.
Justine Calderwood, PT, MSPT is the owner and physical therapist at The Healing Spot Physical Therapy, LLC in beautiful Woodland Park, CO. Since 2002 she has been helping people just like you feel better and move easier, by providing one-on-one hands-on therapy and educating people on what they can do at home to help themselves. She specializes in treating chronic and unresolved pain and conditions that haven't responded to other forms of treatment.
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