When filling out a to-do list of things to do as we age, few people are likely to add “live without pain” to their list. Pain comes with aging, right? It doesn’t have to. If pain really were an inevitable part of aging, how are many older people staying active and pain-free? Many people feel like they’ve tried everything — including surgery, injections, ablations, chiropractic, acupuncture, yoga, Pilates and traditional physical therapy — for relief of chronic pain that impacts the ability to enjoy life and favorite activities and sports. The truth is that aging has very little to do with stiffness, soreness, and “bad” joints. Problems like that are usually the result of years of unhealthy habits, such as poor posture. To get rid of bad habits, it’s best to replace them with good ones. To do this, you must know what the good habits are and how they feel within your body. That’s where manual physical therapy comes in. Manual physical therapy involves evaluating, then effectively treating the dysfunction with specialized hands-on techniques to improve joint motion, decrease scar tissue, and reduce pain and inflammation. The only way to cure pain permanently is to treat the root cause, not the symptoms. If you go to your primary doctor with knee pain, the doctor is only going to look at your knee. You can do anything
you want to that knee — massage it, inject it with steroids, apply electric stim to it, burn off the nerve endings, have surgery on it — but if the true root cause of the pain lies outside of the knee, those techniques will never be able to eliminate the pain. Manual therapy techniques take pressure off overtightened muscles, mobilize joints, loosen fascial restrictions, which are all responsible for pain. The philosophy of a whole-body approach behind manual therapy is what separates it from other treatments. We run diagnostics on the full body, not just on the place that hurts. Motion testing allows us to determine if something is too loose or too tight, which could be the cause of your pain. Manual therapy uses hands-on techniques to examine the entire body, not just the area that’s in pain — because pain can be tricky. Sometimes the area that hurts is not the area we should really be focusing on. For example, I once treated someone with wrist pain that was being caused by a pinched nerve in her neck. She had no neck pain at all, so her doctors never thought to look there. They zoomed in on her wrist, but because they couldn’t find anything wrong with it, there was nothing they could do. When she came for manual therapy, we looked at her entire body and tracked down the true cause of the pain. Within minutes of working on her neck, I was able to eliminate the pain in her wrist. Another patient came in with intense knee pain that no one had been able to resolve. Within a half hour, we discovered that his knee was in pain because his hip was weak. His hip couldn’t support his torso, so all the weight of his upper body came crashing down on his knee every time he took a step. There was nothing wrong with the knee at all! It was the hip that was causing all the trouble. We worked on strengthening his hip for a few sessions, and within a month, the knee pain had completely disappeared. I treat a lot of people who have back pain. The most common causes of back pain are poor posture, improper workout techniques and core instability. Back pain sufferers might also have nerve entrapments, diaphragm issues or strained ligaments. None of those things will show up on MRIs, X-rays or bloodwork. You need motion tests to figure them out. Some patients see improvement immediately. I once treated a man who was told he needed hip surgery, and we solved his problem in 45 minutes. As soon as we found the true root cause, the relief was instantaneous. I believe it’s always better to try solving the problem naturally. Surgery should be a last resort. Conditions that can be treated and improved with manual physical therapy include: Achilles tendonitis, arthritis, bunions, “bone on bone,” carpal tunnel, chronic pain, degenerative joint disorders, disc herniations/bulges, golfer’s elbow, hamstring injuries, headaches, hip bursitis, meniscus tears/injuries, nerve impingements/pinched nerves, Parkinson’s disease, plantar fasciitis; postsurgical rehabilitation; strokes; sports injuries, rotator cuff tears, runner’s knee, scar tissue/scar injuries, sciatica, scoliosis, stenosis, tendonitis, tennis elbow, TMJ/jaw pain and vertigo, among others. The goal is to eliminate pain and give patients the tools they need to remain pain-free. It’s a short-term option with long-term effects. Once we’ve fixed the dysfunction, we give patients simple strength, mobility or posture exercises to do at home so they can maintain their progress. Patients who are eager to get back on the golf course or the tennis court are usually the hardest workers, because they are motivated to feel better. A lot of times, pain can cause apprehension or compensation in movement for sports, leading to not using the body to its fullest capabilities. Pain interferes with technique and performance and can even result in injury. It’s possible to live without pain and even improve your golf and tennis game!
Dr. David Lee, PT, DPT, founder of Bridging the Gap Physical Therapy in Bonita Springs, has a Doctor of Physical Therapy with eight manual therapy certifications. He is an orthopedic expert
with concentrated experiences in musculoskeletal conditions of the ankle, knee, hip, spine neck, shoulder, elbow and wrist.