Physical Therapy or Chiropractic, how do you choose?

If you are in pain from a recent injury or chronic condition, how do you decide which healthcare professional will get you the best results and help you manage your symptoms independently. Below are vision and mission statements of both the American Chiropractic Association (ACA) and the American Physical Therapy Association (APTA). Both professions tout: collaborating with other health care practitioners; promoting change in public policy and legislature, giving the most value per health dollars spent on care; and access equity for the consumer.

The APTA Vision Statement however distinguishes itself by establishing what will be the primary guiding system used to achieve results (The Movement System) and focusing on Consumer-centricity (Patient/client/consumer values and goals will be central to all efforts in which the physical therapy profession will engage). The ACA’s mission statement as read below would seem to be more concerned with protecting the chiropractic profession, changing legislature and promoting the growth of chiropractic care. There is little mention of what type of system will be used to achieve optimal outcomes or mention of how a patient’s specific goals will be incorporated into an individualized plan of care.  

ACA’s Mission: The ACA is a professional organization representing Doctors of Chiropractic. Its mission is to preserve, protect, improve and promote the chiropractic profession and the services of Doctors of Chiropractic for the benefit of patients they serve. The purpose of the ACA is to provide leadership in health care and a positive vision for the chiropractic profession and its natural approach to health and wellness. On behalf of the chiropractic profession, we accomplish our mission and purpose by affecting public policy and legislation, by promoting high standards in professional ethics and quality of treatment and by carrying out a dynamic strategic plan to help ensure the professional growth and success of Doctors of Chiropractic. (please go to www.acatoday.org for a complete statement).

Vision Statement for the Physical Therapy Profession: Transforming society by optimizing movement to improve the human experience. Guiding Principles to Achieve the Vision: the following principles are condensed (please go to www.apta.org/Vision/ for a complete statement).

Identity. The physical therapy profession will define and promote the movement system as the foundation for optimizing movement to improve the health of society. Quality.  Collaboration.  Value. Innovation.  Consumer-centricity (as stated above). Access/Equity. Advocacy. 

Lastly, in my over fourteen year experience as a physical therapist I believe the defining difference in ‘Chiro’ and ‘PT’ is that physical therapist from day one of treatment give our patients self-management tools to assist in treating their own symptoms/pain to include extensive home exercise programs. Our primary goal as physical therapist is to assist a patient in restoring, maintaining and enhancing their own health.

For more information or education on physical therapy and rehabilitation please contact:

Greg Sterner, Board Certified Orthopedic Clinical Specialist in Physical Therapy, Owner

San Diego Sports Physical Therapy

2750 Dewey Rd. Ste 101

San Diego, CA 92106

How to Avoid Overtraining Injuries

Overtraining is a common concern, and something that we should all be aware of (both physical therapists and clients). Learn more about overtraining injuries, how to prevent them, and get the right guidance for training from this article published on MoveForwardPT.com, an informational site created by the American Physical Therapy Association. For more questions please call at 619-756-7500.

 

Overtraining is a concern for all people pursuing fitness – from recreational or elite athletes to people who exercise to lose weight and stay in shape. Overtraining injuries are musculoskeletal injuries that occur due to more activity or exercise than your body is used to, and may happen to anyone who increases intensity or changes type of activity. Overtraining syndrome includes overtraining injuries, but also encompasses general fatigue and other symptoms.

Signs and Symptoms

If you experience any of the following after working hard to meet advanced fitness goals, overtraining may be a cause.

  • Physiological: increased resting heart rate, increased blood pressure
  • Physical: decreased appetite, upset stomach, insatiable thirst, sleep disturbances, increased frequency of sickness and infections, general feeling of increased difficulty and fatigue throughout the day, abnormal muscle soreness, pain occurs that is different than typical muscle soreness
  • Behavioral: personality changes, decreased motivation, altered concentration, lowered self-esteem, decreased ability to cope with stress
  • Performance: Increased heart rate during activity, decreased strength or endurance, impaired movement and coordination, multiple technical errors.

Avoiding Overtraining Injuries

No matter the activity (running, swimming, weight lifting, etc), when working to improve your fitness you need to push yourself in order to see results. But pushing yourself too hard can result in injuries that are detrimental to your fitness goals. Here are some tips to avoid overtraining injuries:

Don’t increase exercise difficulty level too quickly. Exercise needs to be progressed steadily at a gradual pace. Following a structured plan that increases your activity incrementally and safely can help you stay healthy and pain free. For example:

  • For running, increasing difficulty may include increasing speed, running up or downhill, increasing duration, and use of intervals, where you alternate intensity over time.
  • For resistance training, increasing difficulty may include increased weight, repetitions, sets, and decreasing the amount of time to perform the same amount of exercise.

Pay attention to your body.Your body is smart. If it feels like you are developing signs of overtraining, then take a break, lessen your activity, or rest.

Ease into it. Particularly if you are new to fitness or altering your exercise activities, take it slow. Don’t expect to make up for several months of inactivity with a few weeks of exercise. Aim for long-term consistency, not overnight success. People who try to do too much too soon often end up injured or frustrated and give up on their fitness goals altogether.

Avoiding Overtraining Syndrome

Overtraining syndrome occurs when an active individual or athlete increases activity faster than the body can adapt or is unable to recover from a sustained high level of activity. Your body then lets you know that you’ve done too much too fast through a variety of physical responses.

There are several signs and symptoms that may indicate overtraining syndrome but are also symptoms of other problems

Every active individual is unique. Your pain may be due to overtraining, but it also may be due to other health issues. For example, heart rate changes, general fatigue, and other systemic symptoms may be due to a more concerning condition. Physical therapists are educated to evaluate and treat a variety of conditions. If you have any of the above signs a physical therapist can help to determine the seriousness of the signs and what your next course of action for your health.

Here are some tips to avoid overtraining syndrome:

Take a break. If you have a scheduled rest day in your plan, use it, you’ve earned it!  Your bones, joints, and muscles need rest days to stay healthy.

Get rest. Recent studies are supporting the important role of sleep in the health of active people and athletes.  This is when our bodies’ build and repair and our immune system recovers.

Eat well. Proper nutrition is essential to the health of your body. Do not severely restrict calories when exercising. Make sure to eat proper nutrients, including plenty of lean meats, fruits and vegetables.

How will a physical therapist help me meet my fitness goals?

Physical therapists are movement experts, and work with people of all ages and levels of activity. During a visit, a physical therapist can:

  • Check your flexibility, strength, and endurance of muscles to support your desired level of activity.
  • Ensure that symptoms are due to overuse or overtraining and not something more serious.
  • Identify training errors to ensure a safe fitness plan, no matter your previous level of activity.
  • Correct biomechanical problems in form with your chosen activity to avoid overuse of a susceptible body part.
  • Provide appropriate training plan to minimize risk of injury and help you safely meet your fitness goals.

Heat vs. Ice

You have an injury, but you’ve heard to both heat and ice it? So which is better? Take a look at this article by Lindsey Balint, PT, DPT, featured on Sports Physical Therapy Institute to find out which will be more beneficial to you!

Ice and heat are common modalities used to help heal orthopedic injuries but how do you decide which is best to use? There are several things to take into consideration when deciding which modality will best help achieve your treatment goals.

Is the injury Acute or Chronic?

Acute: Recent onset of an injury (< 48 hours). During the acute phase of an injury the body's inflammatory response is active and ice is the preferred modality to prevent swelling that can cause pain. During the first 24-48 hours following an injury, the RICE principal should be followed and is described later in this article.
Chronic: Injuries that continue for a long period of time. During the chronic phase of an injury both ice and heat may be used depending on the treatment goals. Typically heat would be used prior to exercising to loosen tissues and prepare for activity. Ice is typically used after exercise to decrease inflammation following the activity.

What is RICE?

RICE is an acronym to help you remember what to do following an acute injury. RICE stands for Rest, Ice, Compression and Elevation.

REST: Immobilize to limit motion, and decrease the amount of weight you put through the injured body part.
ICE: Apply the cold modality of your choice to help reduce swelling, and decrease pain.
COMPRESSION: Apply a compressive bandage to reduce swelling to the area. When applying a compressive bandage it should be snug but not tight. Applying a compressive wrap too tightly can cut off blood supply and cause further damage.
ELEVATION: Raise the injured body part above the level of the heart. This will help the body decrease swelling to the area.

What are the goals of treatment?

Ice Heat

Decrease Swelling/Inflammation X
Decrease Pain X X
Increase Tissue Extensibility X
Decrease Stiffness X
Decrease Muscle Spasm X X
Increase Joint Range of Motion X

Are there any situations in which heat should not be applied?

Over an open wound
Over areas of skin where there is decreased sensation
Areas where circulation is impaired
Over tumors
Acute injuries

Are there any situations in which ice should not be applied?

Over an open wound
If you have hypersensitivity or intolerance to cold
Peripheral Vascular Disease
Over areas of skin where there is decreased sensation
Raynaud's disease

How long should heat or ice be applied to an injury?

Ice and heat can be very helpful in treating orthopedic injuries but overuse of these modalities can be too much of a good thing. Apply heat or ice for only 10-15 minutes at a time to prevent burning or frostbite. If you have any additional questions about when to use heat versus ice, feel free to contact the physical therapists at Sports Physical Therapy for additional information.