How preventative physical therapy can help you avoid injury and keep you pain free.
As I approached age 40, I prided myself on maintaining what I considered to be a high level of fitness. A lifelong runner, I had a handful of marathons and ultramarathons under my belt. With snowboard season approaching, I decided to hire a personal trainer to get my legs in prime riding shape. During our initial assessment, she had me walk across the gym, perform a few squats and walking lunges, and measured my ankle mobility by having me try to touch my knee to a wall while in a low lunge position.
My cardiovascular fitness was excellent, but I soon learned, my functional fitness was pitiful. My knees caved inwards when I squatted and my pelvis swayed excessively when I walked (both indications of weak hip abductor muscles). My ankle range of motion was poor. A lack of core stability made me wobble through my lunges. Even though I felt fine now, these little movement leaks and muscle imbalances would eventually catch up with me, my trainer warned. They could cause aches and pains, but they could also lead to injuries. Before I jumped into a strength routine, I needed to build a balanced foundation rooted in preventative physical therapy.
In the past, physical therapy, or PT, was used purely as a tool for recovering from something—a response to pain, surgery, or some unwanted physical sensation. Studies have shown that people who receive PT after an injury have significantly better outcomes in terms of function and range of motion in the long term. A mix of supervised exercises and hands-on bodywork, such as massage, can help facilitate healing, restore range of motion, and address the movement patterns that led to the initial injury, says Clyde Staley, a physical therapist and clinical director of Spear, a physical therapy center in New York City.
“It’s your long-term plan to stay strong, mobile, and pain free.”
— Jasper Kopreit, a Hamburg, Germany-based physiotherapist
Given the healing powers of physical therapy, many clinics and practitioners are using the practice to prevent future injuries by correcting poor movement patterns and minimizing the breakdown of structures in the body. “Think of it like brushing your teeth to prevent cavities,” says Jasper Kopreit, a Hamburg, Germany-based physiotherapist who works one-on-one with professional athletes. “It’s your long-term plan to stay strong, mobile, and pain free.”
More athletes, particularly those whose sport is based on repetitive, one-sided movements (golfers and tennis players) or relies on specific muscle groups (runners and cyclists), rely on preventative PT to address imbalances and nagging aches and pains from the demands of their sport. But you don’t need to be a pro athlete to benefit from preventative PT. It can help weekend warriors avoid pains that develop gradually, like runner’s knee, Achilles tendonitis, and plantar fasciitis, says Staley. It can also help people avoid postural-related low back or neck pain caused by long hours sitting at a desk, he says.
Declan Fischback, who recently completed his Doctorate of Physical Therapy at Touro University in Manhattan, has seen it help people who are hypermobile, meaning they have extra movement available in their ligaments. “This extra range of motion improves flexibility, but also means stability is sacrificed,” he says. “Preventative PT in this case focuses on strengthening muscles that aid in stabilization, such as the core and pelvis. It may not cure the condition, but it works to prevent injuries from occurring due to that instability.”
In its simplest form, preventative PT provides a personalized lesson on how your body moves, shares Malia Lauer, a Maui-based physical therapist. “We need to use our bodies and stress them in healthy ways to maintain a baseline of wellness,” she says. “Since consistent movement leads to healthy physical stress and some wear and tear, learning about our body’s tendencies and weak points as well as optimizing our movement to minimize overuse can create night-and-day differences in how we feel.” No matter your age, fitness level, or activity level, there’s value in working with a trained expert.
How big of a commitment does it involve?
In our time-crunched world, just fitting in a workout is a win. Squeezing in additional exercises, and even possibly a visit to the PT, may feel overwhelming. The time commitment is different for everyone based on their background, objectives, and level of motivation. Initially, it’s helpful to have a certified PT or someone trained in biomechanics and injuries dissect and train movement specific to a person’s tendencies and goals, says Lauer.
Staley recommends twice per week sessions for the first three to four weeks to establish a foundational exercise program. During this time the therapist can observe the patient’s response to the exercises and also ensure they are being performed correctly. “Most patients are given a home exercise program to follow outside of the structured, in-clinic sessions,” he says. “The home exercises are generally easy to do, don’t take much time, and help supplement the more advanced exercises that require supervision and cueing.” Once a foundation is built, patients can transition to once per week sessions or can maintain the routine at home. Consistency is key, and as little as five to 10 minutes of exercises a few days a week can make a huge difference.
“We need to use our bodies and stress them in healthy ways to maintain a baseline of wellness.”
— Malia Lauer, a Maui-based physical therapist
How do you know whether you still need supervision?
Lauer has her patients answer a few honest questions:
1. Do you actually do the exercises you were given on your own at home?
2. Do you do them correctly?
She recommends people come back for occasional check-ins or annual evaluations so their movement patterns can be reassessed with an expert pair of eyes. “The brain controls the musculoskeletal system and can be quite clever at finding ways to move that may be easier but less ideal,” she says. “It’s good to have a trained eye watching out for dysfunctional patterns the brain may come up with.”
