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Who do I need to see, PT or Physiologist

Joeyboy

Level 4 Valued Member
I want to see someone about my back, spine. I was diagnosed with lower back arthritis in 2008 and would like to get my exercises looked at and see if they are okay. I am particularly interested in my lumbar region. I also want someone to look at my back. What specialist is that? I'm in Phoenix AZ.
 
It’s worth a check in with a doctor to see how your symptoms are and if they can tell how the arthritis has progressed or changed since 2008. Once that is done, you will have more information for any physical therapists you work with.

Finding a physical therapist:

In my experience you will get a far superior experience paying out of pocket to one who isn’t working working out of a “big box” clinic. You might do well going that route, but the big box places will likely have more PTs who are paid through insurance, and this can mean you will get less time with them. Going to one who has their own practice gives you a higher chance of being able to spend a full hour or more at a time with them. That way they have time to learn your history better, and they can better tailor exercises to your specific needs.

When looking into physical therapists, I would ask things like:
-how long is a typical session?
-have they worked with athletes successfully?
-This one is tougher, but: you want to find one who will help you work towards your goals, instead of tell you not to do the things that make you happy. If the first one you try tells you not to use a kettlebell or whatever, you might look for a different one. It’s one thing for them to say, “let’s put that exercise on hold a bit and come back to it,” and it’s another thing to have them say, “no more weight training for you.”

Hope that helps.
 
bluejeff said:
It’s worth a check in with a doctor to see how your symptoms are and if they can tell how the arthritis has progressed or changed since 2008. Once that is done, you will have more information for any physical therapists you work with.

Finding a physical therapist:

In my experience you will get a far superior experience paying out of pocket to one who isn’t working working out of a “big box” clinic. You might do well going that route, but the big box places will likely have more PTs who are paid through insurance, and this can mean you will get less time with them. Going to one who has their own practice gives you a higher chance of being able to spend a full hour or more at a time with them. That way they have time to learn your history better, and they can better tailor exercises to your specific needs.

When looking into physical therapists, I would ask things like:
-how long is a typical session?
-have they worked with athletes successfully?
-This one is tougher, but: you want to find one who will help you work towards your goals, instead of tell you not to do the things that make you happy. If the first one you try tells you not to use a kettlebell or whatever, you might look for a different one. It’s one thing for them to say, “let’s put that exercise on hold a bit and come back to it,” and it’s another thing to have them say, “no more weight training for you.”

Hope that helps.
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I don't think I need a physical therapist. Movement isn't an issue. It's more creaking, having to realign my back with stretches and take nsaids and alleve. It also takes quite a long time before i can walk normal in the morning, sometimes, due to my lower back pain. I was looking more for an exercise physiologist that can maybe taylor something or tell me if I'm doing harm to myself with what I am currently doing.

I will start with my doc and talk to him. Xrays may be needed to see changes. Ever since I got my shoulder diagnosed I am a little worried that my spine may be running a close second. My shoulder is much better, as far as pressing. I can press again without pain, but i still know there are issues in there.

Edit: I wasn't downplaying your advice. I will take that. I thought there were different levels and a physical therapist was to get you back up after you were down, not for a training type thing. B
 
Joeyboy said:
I don't think I need a physical therapist. Movement isn't an issue. It's more creaking, having to realign my back with stretches and take nsaids and alleve. It also takes quite a long time before i can walk normal in the morning, sometimes, due to my lower back pain. I was looking more for an exercise physiologist that can maybe taylor something or tell me if I'm doing harm to myself with what I am currently doing.

I will start with my doc and talk to him. Xrays may be needed to see changes. Ever since I got my shoulder diagnosed I am a little worried that my spine may be running a close second. My shoulder is much better, as far as pressing. I can press again without pain, but i still know there are issues in there.

Edit: I wasn't downplaying your advice. I will take that. I thought there were different levels and a physical therapist was to get you back up after you were down, not for a training type thing. B
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How much time do you spend sitting during the day ?
Regular mobility work ? Any before bed ?
How old is your mattress ?
 
Joeyboy said:
I don't think I need a physical therapist. Movement isn't an issue. It's more creaking, having to realign my back with stretches and take nsaids and alleve. It also takes quite a long time before i can walk normal in the morning, sometimes, due to my lower back pain. I was looking more for an exercise physiologist that can maybe taylor something or tell me if I'm doing harm to myself with what I am currently doing.

I will start with my doc and talk to him. Xrays may be needed to see changes. Ever since I got my shoulder diagnosed I am a little worried that my spine may be running a close second. My shoulder is much better, as far as pressing. I can press again without pain, but i still know there are issues in there.

Edit: I wasn't downplaying your advice. I will take that. I thought there were different levels and a physical therapist was to get you back up after you were down, not for a training type thing. B
Click to expand...
I don't think an exercise physiologist is going to be much help. An ex phys is basically a glorified personal trainer that has a masters degree in exercise science/physiology.

In general -
1. A good doc (in your case, somebody who specializes with the spine and/or arthritis) to get your "left and right limits" - what you can and can't do, general recommendations, etc. as well as helping manage the condition and symptoms.
2. A good coach/personal trainer to make sure your movements, progressions, and programming is good.

An ex phys MIGHT be good at coaching movements and really know how to structure a good program. But maybe not. I mean the same can be said for personal trainers too though...
 
Joeyboy said:
I wasn't downplaying your advice. I will take that. I thought there were different levels and a physical therapist was to get you back up after you were down, not for a training type thing. B
Click to expand...
No worries. A good physical therapist is more than just a person to rehab injuries. I use mine for any chronic issues I’m having, especially if they don’t seem to be worsening with activity, and they are mostly uncomfortable/a nuisance. In most states in the US (as far as I know) you can see a physical therapist without a doctor’s referral. So, personally, I see mine when I have the money and I just can’t figure out what to do about something.

A good PT has a good understanding of biomechanics and injury/healing etc, and as such, they ought to be able to help you figure out if you could be moving differently in a way that could alleviate your symptoms. Sometimes we have restrictions in ways we aren’t aware of, and by addressing those restrictions we can alleviate uncomfortable symptoms we are having. Sometimes we aren’t using a muscle group in a way that might aid out symptoms, etc

John K said:
I don't think an exercise physiologist is going to be much help. An ex phys is basically a glorified personal trainer that has a masters degree in exercise science/physiology.
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I have to agree here. I briefly pursued an exercise science degree (similar to and ex-physiologist) and didn’t seem to be learning anything I couldn’t learn elsewhere. An exercise physiologist will learn stuff like anatomy, metabolic progresses and the like, and basic programming regarding training (most of which you could learn for free online with some effort). At least that was my impression.

A physical therapist will likely have a lot more knowledge with biomechanics, specifically, as well as the training to work with things like arthritis. Again, try and find one that has successfully worked with people with your specific issues if you can.


Edit:FYI many physical therapists have CSCS certifications as well (certified strength and conditioning specialist).
 
2008 is a long time ago and you now have further symptoms best to get an updated medical diagnosis - from a doctor who is used to working with athletes rather than sedentary people. Knowing the cause of the symptoms you experience will help to identify what measures are required to ameliorate them and allow you to work on your physical health and fitness.
 
Joeyboy said:
I want to see someone about my back, spine. I was diagnosed with lower back arthritis in 2008 and would like to get my exercises looked at and see if they are okay. I am particularly interested in my lumbar region. I also want someone to look at my back. What specialist is that? I'm in Phoenix AZ.
Click to expand...

Back up:

Why?

What's the actual issue?
 
oab said:
2008 is a long time ago and you now have further symptoms best to get an updated medical diagnosis - from a doctor who is used to working with athletes rather than sedentary people. Knowing the cause of the symptoms you experience will help to identify what measures are required to ameliorate them and allow you to work on your physical health and fitness.
Click to expand...
I strained my lower back in 92 lifting weights. I'm sure that's the cause.
 
bluejeff said:
No worries. A good physical therapist is more than just a person to rehab injuries. I use mine for any chronic issues I’m having, especially if they don’t seem to be worsening with activity, and they are mostly uncomfortable/a nuisance. In most states in the US (as far as I know) you can see a physical therapist without a doctor’s referral. So, personally, I see mine when I have the money and I just can’t figure out what to do about something.

A good PT has a good understanding of biomechanics and injury/healing etc, and as such, they ought to be able to help you figure out if you could be moving differently in a way that could alleviate your symptoms. Sometimes we have restrictions in ways we aren’t aware of, and by addressing those restrictions we can alleviate uncomfortable symptoms we are having. Sometimes we aren’t using a muscle group in a way that might aid out symptoms, etc


I have to agree here. I briefly pursued an exercise science degree (similar to and ex-physiologist) and didn’t seem to be learning anything I couldn’t learn elsewhere. An exercise physiologist will learn stuff like anatomy, metabolic progresses and the like, and basic programming regarding training (most of which you could learn for free online with some effort). At least that was my impression.

A physical therapist will likely have a lot more knowledge with biomechanics, specifically, as well as the training to work with things like arthritis. Again, try and find one that has successfully worked with people with your specific issues if you can.


Edit:FYI many physical therapists have CSCS certifications as well (certified strength and conditioning specialist).
Click to expand...
I'm starting this week. Going to see my doc to get radiology lined up and PT for if I'm harming myself.

I'm doing double 20 kg dead cleans and sets of 3. Double 16s are my normal day for these. I just don't want to damage anything. No, I don't have pain and I'm strong but I want to take precautions. My AC joint severe arthritis was a real surprise. It made me think. That's only part of my shoulder issues.
 
John K said:
By that do you mean you don't have symptoms?

Imaging only tells some of a story. Most people on imaging have herniated discs - and are symptom free.
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I do have symptoms in my shoulder. I apologize for not being clear. I have slight arthritis in the rotator cuff, plus the severe AC joint and a torn labrum. I have the common crunchy and sliding and soreness but crossover symmetry has basically brought my shoulder back. I don't need surgery. I take meds as needed and exercise to keep my strength.
 
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