A PT question...what would you do?

[rocknrollgirl]

I started my PT on Wed. See my other post. In short, I like the therapist,we satrted nice and slow....

Yesterday was day two. Started easy, lots of stretching and then on the machines for leg strength. Light weight, two sets of 10.
My issue is this: There are two...

One of the leg machines is the seated leg extension. I have been told by several Sports Med docs and several trainers that this is a very bad exercise if you have knee issues.

1. Should I express my concerns? Just trust her judgement? Tell her I just don't like it?



2. They have me scheduled next week for back to back days, Wed and Thurs. I always thought you had to wait 48 hours between weight sessions.

Should I be doing those machines and exercises two days in a row?

What do think?

[VeloVT]

I'm sure the PTs here will have more helpful advice, but...

Don't some leg extension machines have an adjustment that allows you to limit range of motion? This could make it safer for your knees I think.

It seems odd that they have you doing weights on back to back days. Maybe the PTs can shed some light on this. Are the weights super light, so they almost mimic the stress of everyday activity more than creating a strong training-type stress???

[KnottedYet]

One of the leg machines is the seated leg extension. I have been told by several Sports Med docs and several trainers that this is a very bad exercise if you have knee issues.

1. Should I express my concerns? Just trust her judgement? Tell her I just don't like it?



2. They have me scheduled next week for back to back days, Wed and Thurs. I always thought you had to wait 48 hours between weight sessions.

Should I be doing those machines and exercises two days in a row?

What do think?

1. Express your concerns! If your gut instinct is that you don't want to do that machine, ask her to show you some "closed chain" exercises that will work the same muscles appropriately.

2. Back to back appointments aren't very cost effective from the patient's standpoint. A person generally gets more out of PT if they have a day or two between each visit. (did they book you back to back to squeeze a third visit into the week?)

Edit: the range of motion isn't so much the worry to me on leg extension machines, it's the shear force running across the joint line. Injured knees cope better with compressive force than with shear force.

[rocknrollgirl]

Knot..they did book me back to back to get the appointment in. My gut is telling me to cancel one of the appointments next week.

I am supposed to go M, W, Th. I think I might cancel either Wed or Thurs. I have some sore muscles today, I can't imagine doing the same session again today.

[KnottedYet]

If I see one of my patients has a M W Th schedule, I call them and ask them to cancel one.

While I am magical AND the high-light of their day , seeing me two days in a row is no better than just seeing me once.

[RoadRaven]

RnR
I immediately thought about training on the bike... you don't do two hard workouts two days running (unless you are gearing up for a multiday tour).
Usually you have an active recovery session or a day off...

If you have to do the 3 sessions a week, then that Thursday session should be really easy and light...

I'm no expert in this area (LOL, though I like to talk like I am) but you are trying to heal... and the way to heal something is to treat it firmly but gently... and also, while I am waffling on... after a hard workout our muscles have little tears, and our body has to have time to respond and repair so it is ready for the next workout we give it... again, the importance of recovery - whether active and gentle, or just a rest day...

I'm with the others, listen to you body and talk about it to the PT. Remember, these sessions are about making you feel better - you should be in control.

[Wahine]

I agree with Knott, tell her you're not keen on doing the leg extensions and that you'd be interested in learning some closed chain kinetic exercises that work the same muscles and are more functionally applicable for you.

Re to back to back days, I also agree. Unless they have a very good reason, ie treatment on the second day will be different that the other and is needed to get some sort of necessary treatment in... I'd cancel one of them and if it was me, I'd cancel Wed. I never have patient's on back to back days unless there is something that has to be done by the PT that can't be done on their own and is necessary for a good outcome. This is sometimes the case with very new injuries or post surgical patients. It doesn't seem to me like you fall into that category.

I hate to say this but... some PT clinics are all about the money and will push for the other appointment for that reason. They will also sometimes feel like they can make you dependent on treatment at the clinic by using machines that you don't have access to at home. If they only give you exercises you can do at home, how are they going to keep you coming in? This kind of behaviour ticks me off.

[HillSlugger]

I did my my PT either Monday/Thursday or Tuesday/Friday. I did those leg extensions, too.

[rocknrollgirl]

Thanks guys. I talked to my tri buddy from the pool today, he works at the clinic, but is out on leave. He said the same thing, that if the leg extensions concern me, just tell her to find a closed chain exercise.

I also asked him about the back to back days. He said he thought it would be ok because he said on the second consecutive day, that we could hit stretching really hard. He feels that my lack of flexibility, which is really bad is causing most of my trouble. Super tight ITB.


I think that I am going to go Mon and Thurs this week. Wed just makes for a really ugly day for me anyway.

We have almost a full gym in the basement of our house. Once I learn what to do, I can do a third day at home.

Thanks for your input..It is greatly appreciated. I am in incharted territory here.

Ruth

[han-grrl]

If you have concerns about the exercises, i agree, just ask. this is YOUR body. as for back to back days...ask why and what they planned on doing. If you are really that sore after one day, listen to your body. treatment can cause some flare ups, and going in too much can end up being a little painful on the body.

[HillSlugger]

I had to ask when we'd start adding in the stretching.