Listen in as Brandt discusses how a Yoga Therapist might work with a client who has already been to physical therapy, as well as some of the different approaches between the two therapies.
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Physical therapists, they go through a lot of school and they’re highly qualified and so often you’ll get clients who have been to PTs and what you see is like well I’ve done all these things and lets take a shoulder injury for instance or more specifically a shoulder problem like inflammation in the shoulder, maybe some impingement, arthritis, you know a minorly torn supraspinatis, things like this, and so you get this client and the client comes to you and they say oh yeah I did PT for this in fact I’ve been to two PTs but I thought I’d come to you because it’s not getting as better as much as I’d like so at first you might think okay you know what am I going to do that’s going to be so different than the PT I mean I guess I would strengthen up some muscles, maybe stretch some things, mobilize some things, so what is the PT job. So you look at the person’s sheets, a lot of time people walk in “oh this is what the PT said to do that seems reasonable, they had me doing an external rotation with the TheraBand, they had me doing these mobilization exercises. But it didn’t get better so what have you got for me”. The reason why I wanted to speak about it just for a moment today is because the first thing you might say “Oh you’ve already done that so let me do something completely different” which would be a completely reasonable you know sort of way to look at the universe. However, my experiences showed me that a lot of times when I end up doing the same thing, not the same maybe a different version of how we do these things, the shoulder gets better. So the question really is what’s been going with this person. So one, you have like it’s unclear what their compliance level was. But two, if you don’t ask the right questions, you wouldn’t get the lay of the land so often they go to PT twice a week and they basically go for half an hour but they’re being seen for fifteen minutes and they do some exercises and the PT’s like “do these things” and then sends them home. Sometimes PT will do some manual therapies like ultrasounds or something, really quick in there hoping to shake that up but you know sometimes all this works so I’m sort of talking about the ones where we see where it doesn’t work so keep bear that in mind that often all that works. But what I end up seeing is they go and do these things and no ones really paying attention to them so it’s like they’re kind of in a mill you know it’s not really the PT’s fault necessarily, I’m not a PT I’m sure it’s very challenging to manage lots of clients per day etc, however what I see is like they’re they told me to do these exercises and then you know my shoulder got worse but I kept doing them hoping I would sort of work through it, that’s like scenario one. So what I do is often our version of those, I mean I work off the PT sheet, reassess them, but it’s basically the same thing where I’m like okay we need to strengthen external rotation, we need to strengthen flexion in the shoulder, I see that this person needs to stretch their pecs and their facia in their chest, and they need to strengthen the muscles that draw the shoulder blades together so lets do all that and then the person starts to get better so the question is like what’s really different there and the difference is that I think that we are paying more attention so we have more time maybe to pay more attention is the positive view on that subject. The negative one would be the PT isn’t any good. So either of those things are possible. As a side note in any profession including ours some people are better than others so you know you’re going to get people coming out of PT school who aren’t great and then people see them so that’s possible. All of this is to say and this is what the questions are based around, I wouldn’t just jump into our deeper kosha model for instance or doshic model of let’s say a shoulder thing without fully investigating the physical stuff. So you know and then we have other things that we do which PTs don’t so we have strengthening and stretching and mobilizing things which we both do and then we have adding the breath you know using the breath as a guide for pain, using the breath as a way to affect the product body and maybe shift the person’s perception of their pain. So there’s not a lot of moving and breathing techniques and physical therapy so sometimes that stuff works better. And we also have a relatipnsho[ with the client where we’re very interested in their experience of doing those movements so maybe the PT again the generous version would be didn’t have time to do that or you know it just wasn’t in their training say so between those two things I would stick there and I wouldn’t get like too deep into it until you’ve explored all your options. And the final thing I’ll say is that a lot of times the exercises the PT and this is my personal experience has given the client are either way too easy in other words there is no way that flimsy TheraBand is going to fix the shoulder problem because it’s not enough resistance and it’s just not going to strengthen the muscles like you need a bunch of input to get bodies to change that’s on one side and then on the other side what you may discover is that they are way too hard for that client so the shoulder things especially I see it all the time it’s like they’re doing all these things and the shoulder is getting really inflamed and they need very subtle movements which is where perception of pain and breath in terms of us working with them changes things because you have to move very slowly and very mindfully and very consciously and work below their pain threshold and then their body begins to open up. So that’s what I see so I hope that helps those people that posted those questions and you know I hope that helps everybody actually. Because you’ll see a lot of this especially with I gotta say especially with shoulders. I’ve worked with a lot of shoulders. I actually enjoy working with frozen shoulder as both the Yoga Therapist and the manual therapist and a lot of times you just see like sort of a botched job you know so don’t make any assumptions and I would say just to be fair to everyone I wouldn’t make any assumptions if someone’s coming from another Yoga Therapist either. I would just start from scratch because you know that Yoga Therapist could be skilled or not and they could also have completely different training.
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