Bad PT experience
 

I had my 3rd appointment with a new physical therapist today and I am much worse now than before I went to see her, by the time she got done with my my hand was ice cold and had turned purple....this is the first time I've seen my hand change color like that. I'm just wondering if anybody else has the same problems when doing the same PT (hand bicycle for 8 minutes, elastic band stretches, and various exercises with my arms above my head.

I've had the hands change color before, but not as a result of PT.... my PT told me NO heavy lifting, and really no lifting above shoulder height at all. We did do the hand bike, some elastic bands, and then some light weights, but they were attentive to what hurt, what didn't, and what helped. I would recommend you tell the PT and doc about what happened, and make sure that they are communicating.

KLS,
You're still in pain correct??
What is your avg pain number for a day?
0= none up to 10 = passing out from pain more or less because there is no 11.

I hate to say it but that is not the right kind of PT for you, yet
- pain levels really need to be way down {0/2 maybe} before those kinds of activities will work {if at all}.

those did work for me later on - but first they did ultrasound, heat, massage, electronic stim, biofeedback stuff, isometrics {muscle tensing only}, chiro added IF stim and low level laser.

My average pain is about a 7-8....right now it's off the scale. I called the doctor's office and they told me to take some Ibuprofen and call them back tomorrow. The therapist that I had been seeing previously was just doing ultrasound, heat & electrical stimulation which at least brought the pain level down to maybe a 6 for an hour or so. The doctor decided last week that this wasn't enough therapy for me so he changed the therapist I go to.

yikes...
 

hand bike, therabands, overhead exercises (shudder)

Just hearing those words make me hurt:eek:

I had an excellent phys therapist tell me that as long as I was having pain I should not do any strengthening ( she meant off pain meds too)

Her reasoning was that you will not sense pain in the usual way and could cause injury and not know it.


This info was given to a Braintalk member Debra by Dr Sanders

Jo: maybe this could be made a sticky?This question is asked and I'm not always around to post Dr Sanders info
_______________________________________

"The initial treatment of TOS is certain types {or modalities} of physical therapy {PT}. Over the last few years, we have learned that a few modalities of PT are effective, while MANY OTHER modalities are ineffective or can make the symptoms WORSE. The recommendations below are based on the experience of OVER 1000 patients who have received therapy for TOS.
RECOMMENDED MODALITIES:

1.) Neck stretching exercises. Holding each stretch a minimum of 15-20 seconds, using your hands to help hold the head in the stretched position, and NOT trying to stretch through severe pain. If a stretch HURTS, reduce that range of stretch. Do NO MORE than 3 repetitions at one sitting; do this 2-4 times a day or more.

The 2 positions that are useful for TOS are:
1) Neck rotation and
2) Head tilting.

2.) Posture correction. Proper posture for people with TOS includes:
1) Head back,
2) Chin down and,
3) Shoulders relaxed in a neutral position, NOT STRETCHED BACK SO THAT THE SHOULDER BLADES APPROACH EACH OTHER, This position should be maintained as much of the time as possible when standing an sitting.

3.) Abdominal breathing: Practice this lying flat on your back on the floor.

4.) Nerve glides.

5.) Feldenkrais method. This is a total body approach of slow gentle movements of arms and spine with an emphasis on learning what motions bring on symptoms in your body and developing ways to avoid these motions. There is a national registry of Feldenkrais practitioners across the United States and practitioners in your area can be found on the Internet by looking up: www.feldenkrais.com

MODALITIES THAT OFTEN DON'T WORK AND CAN MAKE SYMPTOMS WORSE:
1. Strengthening exercises
2. Theraband use
3. Resistance exercises with machines
4. Neck traction
5. Exercises with weights
6. The concept of "No pain - No Gain"

The above are guidelines that have been effective in TOS patients. They will work for many people, but not everyone. Additional modalities of PT are indicated for other conditions that accompany TOS, such as fibromyalgia, shoulder tendinitis, cervical spine strain, and others.

Therapy must be individualized and it is best carried out with the guidance of a physical therapist plus additional training in the Feldenkrais method, usually with a different therapist.

Much more information about TOS can be found in the book, "Thoracic Outlet Syndrome - A Common Sequela of Neck Injuries", by Dr. Richard Sanders. The book describes the causes, symptoms, methods of diagnosis, treatment, results and complications of treatment, and other aspects of TOS.

__________________________________________________ _________________

It sounds as though your first therapist knew what she/he was doing.

The exercises you listed with PT #2 are all NO NO's!!!

If you have TOS, hand bicycle, elastic bands and overhead exercises are the WORST. It could be this is a test to determine the possibility of TOS. That would be rather harsh.

My PT prior to the TOS diagnosis included these typical PT exercises and I was certain to request that my negative reactions were noted in the records, (even though I did not know about TOS at that time). If I had known what I know now, I would have refused to do them...as in CAN NOT physically do it, not just opinion.

You really must find a TOS specialist, even if you have to be reimbursed at a later date.

The colors of your hand may indicate a secondary diagnosis of "Reynaud's Disease", not really a 'disease'. This can be inherited OR caused by TOS. That situation may or may not apply to you, but it is worth asking about.

Anyway, your Doc is either skeptical that you have TOS or is just plain ill-informed. I realize that WC is involved, but you really must protect yourself from further injury.

Anne

I did have a beginner PT person one time {he was reading out of a book for what to do!!}after 3 visits the dr decided, with my input, that i was not feeling any better with that person and changed PT places to a more advanced group.

In all I ended up going to 4 PT places and having 6 different PTs.
One place was my own independent evaluation choice- I only needed to go 1 time to him.

If you can you might do some calling or searching around your area for really good PT clinics.
even stop in if you can and talk with the staff- I was amazed at how helpful many places are - as long as they aren't really busy at the time.
or write a note asking for help and referrals and put your phone # on it and drop off copies at the front desks?

If you get some names and maybe drs names too - you'll have some to suggest to your dr.

NO!!!!
 

Don't do elastic bands!!!!!!!!!!! Oh, I have been there and done that and I know just what you are feeling.

You need to get on the phone immediately and find a PT that understands TOS and knows how to treat it. Best is to try to find someone who follows the Edgelow program.

Also, ask them if they have treated people with TOS before. I know the bad experience I had, the PT said she knew what it was, but has never seen anyone with it. NOT GOOD!!

PT's are only doing what the doctor recommends on the script, but if they don't know TOS........you can be doing more harm than good.

I used to leave the PT in tears for some of the thing they would have me do.

I feel for you! Hope you feel better soon!!

I added this thread to our drs & PT lists and changed the title to -DOCTORS & PTs List and saved PT info threads

as we get more PT threads or I come across some of our older ones I'll add them to it- so they'll all be in a easy to find place.

I want to join the others by saying, "omg, omg, omg!!!"

First rule of "overuse" injuries is that you can't / don't fix them by work hardening, strengthening, or otherwise repetitive moving (bad grammar) them!!!

What is WRONG with your PT and doctor????!!!

PLEASE get thee to a top TOS doc. Is there ANY way you can fly in for a day to Denver and see at least two docs there? You would be so refreshingly welcomed and loved and understood!!!!

omg!