Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group What to expect from physical therapy?

My rheumy wants me to give physical therapy a whirl. I'm not expecting any miracles from it, unless the therapist has a magic Gumby wand he or she can wave and make my unbending joints as flexible as when I was... er, I was going to say "when I was a teenager," but I couldn't bend then, either.

From a previous thread I understand that the rigors of PT have sent one or two of you into near-murderous rages or crises of despair, but how many of you have found it helpful?

If you can find a PT that is also a trained and licensed massage therapist, your odds of being injured will go WAY down and you will likely regain some ROM and reduce inflammation. Quite frankly, this dual therapist type is the only type that has not injured my own clients.

I went to pt for frozen shoulder. It sucked and did 0.

Totally depends on the therapist.

Had 2 manual PTs in succession back in virginia and both were wonderful. They were gentle, did a lot of ultrasound which is very good for my tendons and ligaments, manual traction on my neck, joint mobilization, soft tissue work, strain-counterstrain. I mostly had to go for tendonitis, and neck, and SI.

When I was out of the critical stage, then and only then did they start with light strengthening exercises. Stretching was part of it too.

I had to run away from a few PTs who were too aggressive and then would argue with me.

Things that set me off / made me worse: massage, for a while, even very light massage made my muscles spasm more. trigger point therapy where they pressed on the trigger points; made them rebound worse. Ultrasound was awesome for the trigger points as was trigger point injections.

Physical therapy will not help with inflammation, and could make it worse if in a flare. But I find it is great to prevent mechanical damage.

I stretch every day and this helps me long term IMO.

Best,

Tim

I actually had a really good couple of sessions with a frozen shoulder that worked really well - clued up PT who first put heat on it, then did very very gentle mobilizations, that were enough to enable me to get back to stretching it properly. In contrast I have also had a really awful physio who wouldn't accept the AS diagnosis (I was just being lazy and not exercising, and needed to do core strengthening), and her exercises were just awful for me. Another one who focused on core stability had me on a wobble cushion that played h**l with my SI as well.

I think you need to make sure the PT really understands AS, and I'm guessing that PT will either be useful if you need someone to check the way you are doing your stretches, or have a specific joint that has seized up or specific problem area you want working on.

My pt tore my rotator cuff. Be careful. Go to someone experienced and start slow. It only takes a second to get injured and the damage can't easily be fixed. Also since many pts are very healthy and active physically, they do not understand how fragile some people can be even though that's their job. I don't blame them in a way, I couldn't really imagine I'd get hurt as easily as I do now, and it's hard to understand that when you're coming from a place of total health. I used to be able to just do whatever and my body would comply, now if I do too much I strain or tear things. Not good.

I did get some benefit from it, however, before my shoulder injury. The pt stopped the tingling that was going down my arms, and I was happy about that. But then I started trusting them too much, and that's when I got hurt. I think they felt confident too because of the success, and they got too aggressive when pushing on my shoulder. Overall, I think you can find out what exercises to do from the internet. Or just go to the consult. Get a print out of their exercises and go from there. Just work up to it all slowly even if it seems very easy and like it's not helping much. For me, I never feel the extent of the damage until the next morning, even when I tore my shoulder. So I have to give workouts 24 hours before I know if I went too far, I guess because that's how long it takes for the inflammation to really set in and hurt.

For me gentle exercise/stretching on my own and daily massage (I bought my own amazing massage table) has worked best and if I hurt myself at least I have no one to blame but myself which is how I prefer it.

I just started seeing a physical therapist that does manual PT. She does myofascial release as well as craniosacral therapy. She is extremely gentle. She has discovered a lot of issues with my fascia.

Thanks, all! I'm worried that more (accidental) harm might be done than good, and will heed the advice of proceeding slowly and cautiously. It's Smiletoday's point about active, healthy PTs not understanding our fragility that bothers me the most, because I'm young and look "fit" despite feeling anything but. But my desire to potentially regain some range of motion is greater than my fear.

I hope it helps you. I quit going. I went a lot for a long time but decided it really wasn't helping except for the nice massages and ice or heat.