Can physical therapy be harmful??

[michelleric]

Hi all,

I saw a PT today. He is "unsure" as to what the "exact" problem was that is causing my abnormal gait. He knows for sure though that it is neurological and not my actual leg that is at fault. (I hope that made sense). It is bad, and my right foot is turning out more and more, and I am just totally lopsided most of the time.

I have MS and cervical myelopathy. I had 2 cervical discs replaced this past Jan. and have another that is now bulging, but it is not compressing the spinal cord. My gait has gotten MUCH worse since the surgery and he feels it should have improved if my gait was abnormal from the herniated discs to begin with.

Anyway, he gave me many exercises to do while there, and to do at home, but then he had me walk the treadmill. My foot started to burn while on the treadmill after about 2 minutes, I told him, he said "thats OK". I went for about another 3 minutes, and made myself get off. (It makes me VERY upset, it took only a few minutes until I was in this much trouble).  It is now about 8 hours later, and my right foot is on FIRE and I am in PAIN. I get this when I walk to much usually anyway, but if this is going to be the constant way from PT, I don't think I should be doing these exercises.

So, do I grit my teeth and hope it will get better?? What to do?  I do think I need to find a different PT, I cant imagine this is the normal route. How do you find a neuro PT versus an orthopedic PT?

I called the neuro today, left message with secretary. Trying to see if she can recommend one near me. She wanted me to go to the Cleveland Clinic, but realistically can not be driving there multiple times a week.

Thanks,
Michelle

[truelove47]

I was pulled from P T  by my neuro and ortho doctor because of spasms,

I had torn my rotator cuff frim a fall

When they worked on my right side, my left side would spasm and the same with the left,  Doctors agreed it was not helping me and was doing more harm than good.

My body would not cooperate,  They said to rest and it would take a good year to heal
and thankfully it did         .P T can take a toll on some.                    Linda

[Lulu54]

Michelle,
I am so proud of you for making that call and making the move.... we often stick it out with professionals who are harming us only because we're afraid to move on.  Good for you!!

Lu

[ashleyPT]

Ok my turn!

There absolutely is a difference between orthopedic and neurologic PTs.  There is even an extra certification for each of these for people who specialize.  The letters beside their name would include NCS or OCS (neuro or othro certified specialist).  Not all PTs qualified to treat neuro diagnoses will have these letters.  

The question can PT be harmful is tough.  For my patients that have any sort of chronic symptoms - they know themselves the best and I always emphasize that they are the boss.   For neuro symptoms I usually stress that muscle aches and slight fatigue for a day or so after are ok, but a sharp increase in actual pain is not ok. On the other hand, there are sometimes we have to cause some increase in symptoms to get to a certain end point (usually more orthopedic).  It's not a no pain no gain issue though.  Rarely can PT cause long term damage, but being in constant pain because of it is not ok.  

I would also encourage people to talk to their PTs before switching.  If you communicate your needs and concerns a PT should be receptive and the relationship will benefit both of you. If you still don't feel comfortable then find a new one.

[Quixotic1]

I echo everyone's comments.  Yes, Yes, and Yes, and untrained or ignorant PT can definitely harm you!  Yes, there are neuro PTs that work specifically with neuro departments.  They even can subspecialize in stroke, MS, etc.  I am so glad that you called someone who knows this stuff and pointed you in the best direction.

For others that need to go to PT try to get into a fairly large center where the range of experience will be greater.  Talk to the head person and get the most qualified person.  Find out who the local MS center uses preferentially.

I lucked into a fabulous neuro PT who knew how to analyze gait, down to the actual sequence of muscle movements.  She looked and obesrved and finally told me to "pop my knee flexion earlier in the stride forward with my right leg and all of a sudden a difficult, fatiguing stride became much easier.

A good PT is an amazement!

Quix

[michelleric]

I have taken everyone's advice here, and have a new PT scheduled next week.

I called my sons friends mother, who is a PT, and she gave me 2 good people to try. (Dont know why I didn't call her 1st! I am slapping me on the head right now!)

My insurance covered both, and she called them both and asked them about their experience with neurological PT.  One of them, her old boss, sees MANY patients with MS, and said I should go to her.

Best part about it, the "wellness" center this PT is in, has available free babysitting to any patient that needs it. That is WONDEFUL for me, since all the kids are now out for the summer. I will go and hope she can help me.

I have had an awful day. My "good" leg is SO weak today, I fell over in the grocery store getting my 6 year olds bday cake!

I am getting really frustrated with my body.

Thanks again,

Michelle

[Fluffysmom]

Great topic, thanks!

I've been going to a great physical therapy facility with gentle therapists, but my therapist is convinced I should work harder and I was ending up miserable.  I don't have a diagnosis, just a lot of orthopedic issues that confuse the issue.

Then there was the time that the paramedics came in for one of her patients...I'm sure she didn't mean to do anything wrong, and the person turned out to be OK, but I don't have a lot of confidence in her.

With the new MRI that shows spinal lesions (according to the neuroradiologist that read it) and a new neurologist I'll be seeing in September, I'll hopefully have a better idea of just what is going on with my body so that I can ask for someone that has experience working with my issues.

I already changed physical therapists there once, as the first one seemed to think that strain/counter-strain techniques could solve all my problems.  After talking to her about it a couple of times, and she kept hurting me, I just made an appointment to see someone else.

I'll speak with the owner and see if she thinks there is someone that is a good fit to my issues.

I wish you luck in finding the right PT for you.

hugs,

Kathy

[goofysmom1]

Listen to ess & lulu - see if you can have your doctor refer you to a PT who has treated someone with MS before.  You don't want to take the risk of injuring yourself or making the symptoms worse.

It has been my experience with PT that they tell you that you "just need to keep trying" and get through the pain...it will get better....I don't like that approach - when you are in pain, that is your body's signal that something isn't right...so don't keep doing it!!!!!  My last PT experience was different, she was very kind and gentle (she was working on my neck & upper back so she had to be), but it was her nature anyway.  

I hope you can find someone who is kind & gentle and can help you.

Hugs,
Chrisy
undx'd

[essdipity]

To answer the question in the title of your post: Yes.

Don't let this incompetent person experiment on you. If it hurts more than a little bit, don't do it. Years ago I had a PT who didn't know what he was doing, and only dragged out an already long and painful process, till I got smart and got better help.

I don't think there is such a thing as a neuro PT rather than an orthopedic one. They have to manipulate muscles regardless. In your place I'd investigate and find a good therapist in whom you can have confidence. That's not this person.

Good luck and let us know.

ess

[Lulu54]

Hi Michelle,
Your neuro should be able to refer you to someone who will help and not hurt your condition.  You want a PT who understands your condition and has worked with other MS patients.  Now is not the time to be some PT's guinea pig.

You probably should not be on the treadmill at all since you are there for gait problems.  The last thing you need is to get your feet tripped up and take a major fall.  If you do happen to see this same PT again, do not get on that treadmill/.  Refuse politely, but still refuse.

I would also be very cautious of any exercises you were given to do at home until you get a chance to make sure they are correct for your particular needs.

Its your body - you don't want it to get worse.

Lulu