Tag: PT

You Say “OT,” I Say “PT,” Let’s Call the Whole Thing Off?

Over ten years ago, I was diagnosed with Tennis Elbow (lateral epicondylitis) even though I have never played a game of tennis in my life; it turns out that there are other causes. A few months ago, I began developing symptoms that reminded me of my Tennis Elbow; I saw a doctor in my primary care physician’s practice who suggest icing, wearing a brace, and treating the pain with acetamenophin (Tylenol). It did not improve much and then I took a tumble while traveling earlier this month; I landed on my knees, as well as (you guessed it) my elbow. The bruises were quite impressive.

After consultation with my PCP, I was able to get an appointment with a Physical Therapist (PT) for an evaluation. Imagine my surprise when she informed that she could only deal with my knee, since my elbow was considered to be in the realm of Occupational Therapy (OT)–at least that is how it works at the Cleveland Clinic. Instead of being able to have it all cared for at one time with one therapist, I now have two therapists and twice the number of appointments!

What is the difference between physcial therapy and occupational therapy? There is a lot of overlap, but some important distinctions as well.

Physical therapy focuses on improving a patient’s physical function, mobility, and strength. PTs treat patients of all ages with many different diagnoses, including neurological, cardiovascular, respiratory, and musculoskeletal conditions. They treat the whole body from head to toe (unless, apparently, it is your elbow!), and may focus on restoring range of motion.

Occupational therapy focuses on improving a patient’s ability to perform meaningful activities as independently as possible. OTs treat patients who have experienced birth injuries or defects, sensory processing disorders, traumatic brain or spinal cord injuries, autism, and other developmental disorders, or mental or behavioral health problems. OTs may work on the upper extremity, or the whole body, to help patients develop, recover, improve, and maintain the skills needed for day-to-day living. This could include helping a child with autism participate in classroom activities, a young adult with down syndrome develop job-related skills, or an older adult who had a stroke learn self-care tasks. OTs may adapt, modify, or change daily activities by altering the activity, the environment, or the patient’s skills. For example, they may teach stretches or exercises. 

In my case, PT is dealing with my knee to improve my function, mobility, and strength. My OT is dealing with my elbow because the problems I am having interfere with my ability to carry out certain task with my arm and hand that I need to do on a daily basis.

In the final analyis, I wish I could get one therapist who could do both of those things…but that is not the way it played out here. At the very least, it has helped me to understand the different roles that each kind of therapy plays. I am confident that my therapist will both work in concert to get me back to 100%. After all, I have to learn to play tennis before it is too late!

What I Hadn’t Counted on After Surgery

Scales

It has been 9 weeks since my surgeries on my leg and foot. The recovery has been more arduous and painful than I expected. And I have learned a lot.

It is only since I began physical therapy exercises a couple of weeks ago that i finally began to see progress in my mobility and levels of pain. As a personal trainer, I am on my feet a lot; after a month of putting no weight on my foot, the shock of doing that again was dramatic. After having been off pain medications, I went back on again for a short time. I’m still taking Ibuprofen and Tylenol–although a lot less now. It has only been in the last week that I finally have been able to go through a large part of the day without pain.

To those of you doing PT…listen to the instructions and do what you are told! It makes a difference. PTs are amazing skilled health professionals and I am really impressed with their ability to spot (diagnose) issues and recommend the appropriate exercises. I even “borrow” some of them for clients who have similar complaints.

Here is what I really did not expect. I put on quite a bit of weight–about a 5% gain. This is due to a number of issues. I was forced to be sedentary. Medications (especially pain meds) messed with my system. I did not eat as I normally did since I was sitting around with little to do but…snack. My exercise regimen was interrupted.

I have been trying for over 6 weeks to get back to my pre-surgery weight and really been finding it difficult. I finally turned to a subscription weight-loss app. Too soon to say if I am making progress, but the tracking of calories is scary as hell and definitely showing me where I am making mistakes. I will let you know if it works.

It is noteworthy that weight gain is quite common after many different kinds of surgery. It is also notable that few doctors warn their patients that this is a possibility and to prepare for it–physically and emotionally. I wish I had known; not that it would necessarily have made a difference, but I believe that knowledge is power.

My big takeaway? With regard to both the pain and weight gain after surgery, patience is required. Others who have had foot surgery have told me to not give up hope or get anxious; it takes a while for recovery. This is true of nearly any surgery. I now see a pain-free light at the end of the tunnel, but it took me longer to get here than I thought it would. With regard to the weight, I am also learning that what took 8 weeks to come on will not come off in 8 days. Slow and steady wins the race.

At some point, most of us will have to undergo some kind of surgery; in my experience, I never felt like I adequately understood what the recovery would be like (if we did, would we ever agree to the procedure?!?). If there is a next time, I will ask more questions, adjust my expectations, and remember that there is a reason why we are called patients!