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When to Rehab Yourself & When to See A Physical Therapist
Irina Whittlesey

The following may be a sensitive subject for some coaches, athletes, and physical therapists to discuss without getting into a heated argument. However, as both a physical therapist assistant and an athlete, I want to address the topic of athletes taking themselves through rehab.
 
As an athlete, I can confidently say that I am very aware of my body. I am aware of what feels normal and what feels like ‘okay’ pain. I also know what feels like odd or ‘sketchy’ pain. I can sense when my musculature is beyond than just sore and requires more rest. I can also tell when a certain sharp pain is just an odd angle in my shoulder. As an athlete, this insight allows me to recognize when my risk of injury is increased. Furthermore, this knowledge also allows me to do some general maintenance on my body to prevent damage.
 
Things that qualify as general maintenance:
  1. Stretching out external rotators of shoulders
  2. Involving yoga in my weekly routine for tight hips
  3. Laying off certain high repetition exercises to allow room for recovery on injury-susceptible joint
  4. Self-mobilization of spine, kneecaps, wrist, etc.
  5. Foam rolling out specific tightness areas of the body (IT band, adductors, hamstrings, thoracic spine)
These kinds of things are the type of general maintenance an athlete has the ability and responsibility to perform either on their own or with the help of their coach, in order to remain in optimal shape.
 
Due to this heightened awareness of their bodies, I have witnessed some athletes opt to perform rehabilitation on their own injuries by using Google search. These athletes may also opt to use the guidance of other athletes who claim that a certain technique “works.”
 
Although I cannot deny the fact that the internet has great resources for athletes, there are certain dangers in attempting to self-treat. Such dangers include risk of further injury and wrong self-diagnosis, as well as poor implementation of suggested techniques.
 
As a physical therapy professional, I can confidently say there are several issues an athlete may run into when they are trying to treat their own injury. Some injuries CrossFitters and weightlifters encounter can be detrimental not only to their athletic careers but also to their daily tasks and thus should be addressed properly. The difference between self-treatable issues and these more serious injuries is where I want to focus my attention.
 
There are certain signs that we as physical therapist professionals label as red flags, as they are likely symptomatic of a more serious underlining problem. Some of these signs are:

Tingling, “fuzziness” and numbness in the limbs and/or distal extremities lasting more than a few hours, going into days.
 
This may be a serious sign of a pinched nerve, damaged vertebrae and/or bulging discs in the spine and should be checked out by a professional as soon as possible.
 
New onset of swelling.
 
I say “new” because we all have some fluid buildup in some parts of our bodies at all times from general use. However, new swelling after a workout may be a potential sign of new strains, tears or dislocations. Unfortunately, just icing it won’t solve the root problem.
 
Repeated sharp pain with a certain movement, every time.
 
Occasionally I have had a sharp pain in my anterior shoulder with pressing movements, but when the issue became constant, I saw my physical therapist. He informed me that if I was to keep going on the same track, I would have had a cervical spine vertebrae fracture that would have ended in a neck fusion. This injury would have limited my working out and daily activities for the rest of my life. Pay attention to sharp, stabbing, repeated pains.
 
Dizziness with pain.
 
Some people have a hard time with pain, so dizziness may be their natural reaction. However, if this dizziness has never been an issue for you before, and one day occurs with a stabbing pain in the back, it may be a warning sign. Our bodies have an amazing mechanism to warn us of danger, and this new symptom may be that sign for you.
 
Pain, misalignment or dysfunction in the neck or back which causes difficulty to perform daily tasks of living.
 
If your spine or neck is too stiff, tight and/or painful after a training session to perform daily tasks, please see a medical specialist. At this point, if you are unable to drive a car, brush your teeth, or even turn without difficulty, it may be time to see a professional. The best-case scenario here would be that they can help you figure out what is causing this misalignment and proceed to prevent further damage. The worst-case scenario with this dysfunction could be as serious as surgery to the spine. Surgery to the spine requires long rehabilitation and recovery time but does not always guarantee a full solution to the problem. Because of the complexity of spinal issues, it is best to prevent such injuries, rather than fix them.
 
In general, any new pains, new sensations, and new issues should be addressed with your medical professional.
 
I will also suggest, in general, to not rely on someone at the gym who “had a friend who had that same issue and she used this lacrosse ball to work out this knot and she was cured.” You are your own athlete, with your own unique body, pain, goals, and history. Your body is a complicated creation, so it is important to keep all variables in mind when treating it. Unfortunately, as great as our gym friends can be, they are not trained in knowing your specific case. These numerous variables are best cared for by a professional who is trained in the area.
 
This is not to say you can never do your own injury prevention. Overall, the goal of a good physical therapist is to get their patient/client/athlete independent. This goal means educating patients about their injury, training self-mobilizations, and developing healthy habits. All of these techniques are established to prevent further injury. Once a patient can accomplish self-care, a PT should let them go. If a supposed professional claims to want to help you, but tells you to keep coming back, consider this a red flag. Instead, find yourself a physical therapist that cares for you and your goals.
 
Side note: This is where physical therapists and chiropractors differ dramatically. There are injuries and misalignments which require patients to return for a readjustment weekly, biweekly, monthly, etc. However, a good chiropractor should still be providing education and proper home exercise programs to maintain their patient’s health as long as possible.
 
So, when is a good time to do your own rehab? Once you have been properly trained by a professional who is aware of all your injuries, previous conditions, etc., then you may proceed to working on your own injury. After you are educated and well-aware of your injury, it will be safe to attempt to take yourself through maintenance rehab. Also, as soon as you know what your diagnosis is and have been educated on the mechanism of the injury, you will have the knowledge to tell which new Instagram sensation stretch will be beneficial to you, and which one will not. Educate yourself before your wreck yourself.
 
Please make sure to see a physical therapist when any of the aforementioned red flags show up in your training or daily program. If you have major goals in the sport you are involved in, you should be seeing a professional as often as a new injury occurs. If your goals are to lead a healthy lifestyle, then maybe your physical therapist visits can remain seldom. But no matter what your goals are, remember, if you cannot naturally perform your activities of daily living without pain, it is time to see a specialist.


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