The human body is an illustration of incredible design. Painful conditions are often like a complete puzzle with many pieces. For treatment to be effective, all pieces need to be addressed.
Listen in as Dan Elia, PT, MS, offers his advice for getting back to the activities you enjoy after an injury.
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Getting Back to Work and Hobbies After an Injury
Featured Speaker:
Dan Elia, PT, MS
Dan Elia is a physical therapist at Rochester Regional health specializing in dynamic stabilizing and orthopedic sports physical therapy. A Master’s graduate of Quinnipiac University, Elia has been specializing in physical therapy since 1994. Transcription:
Getting Back to Work and Hobbies After an Injury
Bill Klaproth (Host): The human body is an illustration of incredible design painful conditions are often like a complete puzzle with many pieces and for treatment to be effective all pieces need to be addressed. Dan Elia is a physical therapist at Rochester Regional Health specializing in orthopedics sports physical therapy and offers his advice for getting back to your activities after an injury. Dan, thanks for your time today. What’s most important to know when trying to get back to work or hobbies after an injury?
Dan Elia (Guest): I think that a foundational aspect is it exercise and rehabilitation and for that matter any form of treatment has to be harmonious with a person’s body and that means not forcing anything through pain. For me, personally, I loathe expressions like “no pain no gain” that really has nothing to do when a person is recovering from an injury.
Bill: So no pain no gain, not a good thing when you’re going through rehab after injury.
Dan: It is not. It is not. Exercise and rehab should be harmonious; it really should feel good.
Bill: Right. Well you’re probably going to feel some pain when the physical therapist is working with you, but that’s not the goal like as we hear in sports training and weight lifting, right. The old mantra of no pain no gain.
Dan: Ya, I think that that’s referring to muscle fatigue and the burning feeling when you work a muscle. That’s totally different from experiencing back pain or pain in a joint when you’re quite frankly overdoing it.
Bill: So tell us how you work with patients. So someone has an injury and they’re trying to get back to work or hobbies after that injury. How do you work with the patient? Can you kind of take us through the process?
Dan: When a person sees a physical therapist we would first evaluate them and try to see what I would describe as the big picture. We would look at their posture, we would look at their movement, we would look at their strength, we would look at the quality of their movement and then our program would be based on what we evaluate. Obviously that depends on the nature of the problem. A person with a lower back injury versus an athlete with an ankle sprain. Generally, we work on restoring mobility and movement when it’s limited and also regaining strength. Often times in that order- mobility first and then strength. And then doing things to try and keep the person well, usually that would be some form of a home program that they continue with when they’re done.
Bill: So restoring mobility and movement and then regaining strength.
Dan: A lot of my training personally and there’s a bit of variability between physical therapists, a form myself and many of my coworkers we’ve been trained quite of bit in various forms of manual therapy so that would involve putting our hands on the person to free up a muscle that’s restricted or to help restore normal movement at the joints. Physical therapy treatments that our clinic would usually consist of some form of hands on care in conjunction with the foundation of what we have as physical therapists and that is some form of exercise.
Bill: And Dan, how important is the mental aspect of staying positive during physical therapy? What if someone starts to get discouraged because physical therapy does take time?
Dan: That’s a great question. There’s an old saying that pertains to physical therapy that I sometimes quote to some of the people I’m working with and that is if it happens fast often times it won’t last. So sometimes things that are quick fixes that give short term relief don’t last and making changes in a person body by truly getting stronger and getting more flexible, those are very gradual things. Most research that has been done on strengthening shows that it takes about 4-6 weeks to truly make a measurable gain. So yeah it is gradual. Sometimes as a physical therapist in some ways I function almost like a cheerleader trying to encourage a person. You are right it can be discouraging sometimes when you have a significant injury that responds very slowly and you do have to try to stay positive, read positive things, not go home and draw the curtains and have a pity party. You know staying connected with friends and family members who care about you. Those things absolutely matter.
Bill: I like how you said that, if it happens fast it won’t last. That’s a good way to think about it.
Dan: In my experience that’s often times true.
Bill: So I know this is on a case by case basis, but you said that generally 4-6 weeks of therapy is generally the timeline?
Dan: No. What I said was it takes 4-6 weeks to make a truly measurable gain in strength. The timeline for physical therapy, I mean that is true a generalization probably the average I see a typical person would be 4-8 weeks. But there’s quite a bit of variability there depending on the nature of the person’s injury. For a person who’s been severely traumatized and had extensive surgery that could take several months of therapy to really get that person going in the right direction.
Bill: And then you said that even homework after that, so there’s still time after that.
Dan: Always.
Bill: Always, right. So if someone is trying to get ready to return to work are there different evaluations you make before giving the ok?
Dan: Again, good question. So the profession of physical therapy has really become specialized; orthopedics is a specialty, pediatrics is a specialty. Return to work, work reconditioning, work hardening, is even another specialty area. So to answer your question it depends on how involved the problem is. For some people, especially people with significantly physical jobs, there is a specific type of evaluation called a functional capacity evaluation to really closely look at what a person’s capabilities are, how much they can lift, how much can they carry, can they crawl on the floor. And really looking at what they have to return to. One of my colleagues at one of our other offices in Irondequoit specializes in functional capacity evaluations and return to work. For someone who is very extensive. For a person with maybe a little mild of an injury I would orchestrate that my preference is to err on the side of underdoing it, to return just like an athlete you would have them return gradually, you wouldn’t just have them go back into the game first thing, you would first have them return to practice limited and then more significant. Sometimes returning to work is similar.
Bill: Right, so kind of work your way back into it, so that makes sense. Functional capacity evaluation.
Dan: Yeah that’s a specific test to closely look at what a person’s work capabilities are to see if there ready to go back, especially for a person with a physical job.
Bill: And Dan, if you could wrap it up for us, what else do we need to know about getting back to work or physical activity after an injury?
Dan: I’ll reiterate what I said to begin with. Work, exercise, activities, sports, should be harmonious with a person’s body, it should never be forcing it through significant pain. Pain is the body's warning system to ignore that is asking for trouble. I like the word moderation and I use that with my patients often. Moderation meaning returning to activities gradually, not trying to be aggressive and forcing it all at once. That would probably be my greatest advice.
Bill: And be patient as you said, it all takes time and if it happens fast it won’t last.
Dan: I do like that saying.
Bill: Well Dan thanks again. You’re listening to Rock Your Health Radio with Rochester Regional Health. For more information, you can go to RochesterRegional.org. I’m Bill Klaproth, thanks for listening.
Getting Back to Work and Hobbies After an Injury
Bill Klaproth (Host): The human body is an illustration of incredible design painful conditions are often like a complete puzzle with many pieces and for treatment to be effective all pieces need to be addressed. Dan Elia is a physical therapist at Rochester Regional Health specializing in orthopedics sports physical therapy and offers his advice for getting back to your activities after an injury. Dan, thanks for your time today. What’s most important to know when trying to get back to work or hobbies after an injury?
Dan Elia (Guest): I think that a foundational aspect is it exercise and rehabilitation and for that matter any form of treatment has to be harmonious with a person’s body and that means not forcing anything through pain. For me, personally, I loathe expressions like “no pain no gain” that really has nothing to do when a person is recovering from an injury.
Bill: So no pain no gain, not a good thing when you’re going through rehab after injury.
Dan: It is not. It is not. Exercise and rehab should be harmonious; it really should feel good.
Bill: Right. Well you’re probably going to feel some pain when the physical therapist is working with you, but that’s not the goal like as we hear in sports training and weight lifting, right. The old mantra of no pain no gain.
Dan: Ya, I think that that’s referring to muscle fatigue and the burning feeling when you work a muscle. That’s totally different from experiencing back pain or pain in a joint when you’re quite frankly overdoing it.
Bill: So tell us how you work with patients. So someone has an injury and they’re trying to get back to work or hobbies after that injury. How do you work with the patient? Can you kind of take us through the process?
Dan: When a person sees a physical therapist we would first evaluate them and try to see what I would describe as the big picture. We would look at their posture, we would look at their movement, we would look at their strength, we would look at the quality of their movement and then our program would be based on what we evaluate. Obviously that depends on the nature of the problem. A person with a lower back injury versus an athlete with an ankle sprain. Generally, we work on restoring mobility and movement when it’s limited and also regaining strength. Often times in that order- mobility first and then strength. And then doing things to try and keep the person well, usually that would be some form of a home program that they continue with when they’re done.
Bill: So restoring mobility and movement and then regaining strength.
Dan: A lot of my training personally and there’s a bit of variability between physical therapists, a form myself and many of my coworkers we’ve been trained quite of bit in various forms of manual therapy so that would involve putting our hands on the person to free up a muscle that’s restricted or to help restore normal movement at the joints. Physical therapy treatments that our clinic would usually consist of some form of hands on care in conjunction with the foundation of what we have as physical therapists and that is some form of exercise.
Bill: And Dan, how important is the mental aspect of staying positive during physical therapy? What if someone starts to get discouraged because physical therapy does take time?
Dan: That’s a great question. There’s an old saying that pertains to physical therapy that I sometimes quote to some of the people I’m working with and that is if it happens fast often times it won’t last. So sometimes things that are quick fixes that give short term relief don’t last and making changes in a person body by truly getting stronger and getting more flexible, those are very gradual things. Most research that has been done on strengthening shows that it takes about 4-6 weeks to truly make a measurable gain. So yeah it is gradual. Sometimes as a physical therapist in some ways I function almost like a cheerleader trying to encourage a person. You are right it can be discouraging sometimes when you have a significant injury that responds very slowly and you do have to try to stay positive, read positive things, not go home and draw the curtains and have a pity party. You know staying connected with friends and family members who care about you. Those things absolutely matter.
Bill: I like how you said that, if it happens fast it won’t last. That’s a good way to think about it.
Dan: In my experience that’s often times true.
Bill: So I know this is on a case by case basis, but you said that generally 4-6 weeks of therapy is generally the timeline?
Dan: No. What I said was it takes 4-6 weeks to make a truly measurable gain in strength. The timeline for physical therapy, I mean that is true a generalization probably the average I see a typical person would be 4-8 weeks. But there’s quite a bit of variability there depending on the nature of the person’s injury. For a person who’s been severely traumatized and had extensive surgery that could take several months of therapy to really get that person going in the right direction.
Bill: And then you said that even homework after that, so there’s still time after that.
Dan: Always.
Bill: Always, right. So if someone is trying to get ready to return to work are there different evaluations you make before giving the ok?
Dan: Again, good question. So the profession of physical therapy has really become specialized; orthopedics is a specialty, pediatrics is a specialty. Return to work, work reconditioning, work hardening, is even another specialty area. So to answer your question it depends on how involved the problem is. For some people, especially people with significantly physical jobs, there is a specific type of evaluation called a functional capacity evaluation to really closely look at what a person’s capabilities are, how much they can lift, how much can they carry, can they crawl on the floor. And really looking at what they have to return to. One of my colleagues at one of our other offices in Irondequoit specializes in functional capacity evaluations and return to work. For someone who is very extensive. For a person with maybe a little mild of an injury I would orchestrate that my preference is to err on the side of underdoing it, to return just like an athlete you would have them return gradually, you wouldn’t just have them go back into the game first thing, you would first have them return to practice limited and then more significant. Sometimes returning to work is similar.
Bill: Right, so kind of work your way back into it, so that makes sense. Functional capacity evaluation.
Dan: Yeah that’s a specific test to closely look at what a person’s work capabilities are to see if there ready to go back, especially for a person with a physical job.
Bill: And Dan, if you could wrap it up for us, what else do we need to know about getting back to work or physical activity after an injury?
Dan: I’ll reiterate what I said to begin with. Work, exercise, activities, sports, should be harmonious with a person’s body, it should never be forcing it through significant pain. Pain is the body's warning system to ignore that is asking for trouble. I like the word moderation and I use that with my patients often. Moderation meaning returning to activities gradually, not trying to be aggressive and forcing it all at once. That would probably be my greatest advice.
Bill: And be patient as you said, it all takes time and if it happens fast it won’t last.
Dan: I do like that saying.
Bill: Well Dan thanks again. You’re listening to Rock Your Health Radio with Rochester Regional Health. For more information, you can go to RochesterRegional.org. I’m Bill Klaproth, thanks for listening.