Physical therapy frequency?

[hoyt66]

I competed in bodybuilding for three years (18-21 years old) and have lifted weights on and off since then (now 46). I know I would never work the same body part every day and in the "off"

season I would only train it once a week. So I was thinking how often should I do physical therapy. Is it the same principal? I should have asked my therapist yesterday but I was to occupied trying

to do my exercises with correct form and forgot. Thoughts?

[hernanu]

I'd rely on the physical therapist during this. I was doing it three times per week and pretty much the same routine for a couple of days, then increase the difficulty / number of reps / weight.

I was training pretty regularly before, so I was pretty damn sure of my routine, but one thing the PT found was that my core was pretty weak. I was offended, and she made it her goal in life during those few short weeks to strengthen my core. So I wound up doing unusual exercises for me (much more of a bench press, leg press, pull ups, hit the bag and stretch kind of guy), but these really addressed what would make my hips stronger.

After one month, we stepped it down to twice per week, but I also started doing upper body workouts from my old routine. We stopped at about three months, then I continued my PT exercises at the gym inserted into my regular routine.

[rubyred]

May I ask a question regarding PT?

Were you guys told to have PT or did you refer yourselves for it? I ask because I feel I need some yet was told on my follow up that there was no need for me to and that regular walking would suffice, yet my ROM is really suffering, my left side feels quite weak and just lately I'm feeling my level of pain increasing.

Sorry for the hijacking!

Ruby

[lycraman]

May I ask a question regarding PT?

Were you guys told to have PT or did you refer yourselves for it? I ask because I feel I need some yet was told on my follow up that there was no need for me to and that regular walking would suffice, yet my ROM is really suffering, my left side feels quite weak and just lately I'm feeling my level of pain increasing.

Sorry for the hijacking!

Ruby

Ruby, I know what you mean.  Mr Treacy told me to avoid going to see my own physio for the first 6 weeks and to just stick with the exercises given by the Birmingham physios.  I think he has had some bad results from people going off to see their own physios to quickly and pushing range of movement only to produce dislocations etc. Not sure if that is fact or just scare tactics on his part! I got the impression that after the ok at the 6 week follow up appointment you'd be able to crack on with normal physio, but from what you say, maybe I was wrong.  I'm desperate to see my physio to help with the inner thigh and IT band pain during the night and when I get up.

[rubyred]

May I ask a question regarding PT?

Were you guys told to have PT or did you refer yourselves for it? I ask because I feel I need some yet was told on my follow up that there was no need for me to and that regular walking would suffice, yet my ROM is really suffering, my left side feels quite weak and just lately I'm feeling my level of pain increasing.

Sorry for the hijacking!

Ruby

Ruby, I know what you mean.  Mr Treacy told me to avoid going to see my own physio for the first 6 weeks and to just stick with the exercises given by the Birmingham physios.  I think he has had some bad results from people going off to see their own physios to quickly and pushing range of movement only to produce dislocations etc. Not sure if that is fact or just scare tactics on his part! I got the impression that after the ok at the 6 week follow up appointment you'd be able to crack on with normal physio, but from what you say, maybe I was wrong.  I'm desperate to see my physio to help with the inner thigh and IT band pain during the night and when I get up.

Glad you were told the same! At my 6 wk follow up I was pretty much given the all clear to do as I wished, but when asked about physio I was told there was no need for it. At the moment I strongly disagree.

[hoyt66]

May I ask a question regarding PT?

Were you guys told to have PT or did you refer yourselves for it? I ask because I feel I need some yet was told on my follow up that there was no need for me to and that regular walking would suffice, yet my ROM is really suffering, my left side feels quite weak and just lately I'm feeling my level of pain increasing.

Sorry for the hijacking!

Ruby

Hey hijacker!! Just kidding. My surgeon wrote me script for a month of physio after two weeks of in home therapy. So a total of 6 weeks and then I will see him at twelve weeks for a follow up. My plan after all this is said and done is to concentrate on my core as well as my hips/buttocks as far as my workouts go. If you feel the need for more physio I would see if my surgeon/doctor would set it up. If that's not an option then start up your exercises from physio. I bet you could google " best hip exercises for hip patients" and get a ton of workouts. Good luck

[hoyt66]

I'd rely on the physical therapist during this. I was doing it three times per week and pretty much the same routine for a couple of days, then increase the difficulty / number of reps / weight.

I was training pretty regularly before, so I was pretty damn sure of my routine, but one thing the PT found was that my core was pretty weak. I was offended, and she made it her goal in life during those few short weeks to strengthen my core. So I wound up doing unusual exercises for me (much more of a bench press, leg press, pull ups, hit the bag and stretch kind of guy), but these really addressed what would make my hips stronger.

After one month, we stepped it down to twice per week, but I also started doing upper body workouts from my old routine. We stopped at about three months, then I continued my PT exercises at the gym inserted into my regular routine.

Hernanu,

I'm not weight training on my own now. The therapist told me to do the exercises he gave me twice a day. So my question was "should I do these even on the off days from physio" ? Do we need to take a day off between physio or do it everyday? I know what you mean about the core too. Soooooo weak!

[imgetinold]

Hoyt:  I'm not sure of the real answer, but I would imagine that some things work with light, everyday workouts.  When I had PT for my tennis elbow, the exercises were every day, but very light weight.  I imagine that the same holds true for a good deal of the stabilizing musculature of our legs and hips:  They're used lightly every day, all day.  I would think the rehab would be similar.

Ruby: Dr. Gross basically says the same thing.  Walking is all you need, so he doesn't prescribe PT.  I also believe that he's had some bad outcomes with individuals pushing their recovery.  With that said, at 4 months I asked them for a PT referral, which they gave to me no problem.  They specified just strengthening, but no ROM (not sure why?).  It made a huge difference for me, and I was already doing 45 minutes of interval training on the exercise bike at a time.  Plus, my ROM improved even though we were not actively "stretching".

[hernanu]

I'd rely on the physical therapist during this. I was doing it three times per week and pretty much the same routine for a couple of days, then increase the difficulty / number of reps / weight.

I was training pretty regularly before, so I was pretty damn sure of my routine, but one thing the PT found was that my core was pretty weak. I was offended, and she made it her goal in life during those few short weeks to strengthen my core. So I wound up doing unusual exercises for me (much more of a bench press, leg press, pull ups, hit the bag and stretch kind of guy), but these really addressed what would make my hips stronger.

After one month, we stepped it down to twice per week, but I also started doing upper body workouts from my old routine. We stopped at about three months, then I continued my PT exercises at the gym inserted into my regular routine.

Hernanu,

I'm not weight training on my own now. The therapist told me to do the exercises he gave me twice a day. So my question was "should I do these even on the off days from physio" ? Do we need to take a day off between physio or do it everyday? I know what you mean about the core too. Soooooo weak!

I'd do these on the days off, twice a day like he/she suggested. I kept on with my exercises from the home PT even when doing outpatient PT, then added the new outpatient PT exercises to my regular workout.

I think you should let your body be your guide - don't push it, don't force it, let it happen naturally (repeated Hern disco wisdom), but only do them if you're not tired. It does you no good if you can't recuperate.

[rubyred]

Ruby: Dr. Gross basically says the same thing.  Walking is all you need, so he doesn't prescribe PT.  I also believe that he's had some bad outcomes with individuals pushing their recovery.  With that said, at 4 months I asked them for a PT referral, which they gave to me no problem.  They specified just strengthening, but no ROM (not sure why?).  It made a huge difference for me, and I was already doing 45 minutes of interval training on the exercise bike at a time.  Plus, my ROM improved even though we were not actively "stretching".

It's odd how some surgeon's prescribe it and some don't, it looks like Mr Treacy works along the same principals as Dr Gross. Right now I walk for about 20-30 minutes a day and I do gentle exercises in the pool twice a week, but if I'm wary of doing too much as my pain levels are rising and i'm beginning to up the pain meds again. I'm seeing my GP next week so I will take some advice from him.

[Dan L]

Hoyt;

My surgeon follows the McMinn/Treacy post op protocol (he was trained by them), essentially specific daily exercises 3x per day for at least first 6 weeks, and no PT other than that.  Walk and exercise after that, as much as can be tolerated  It has worked wonderfully for me, now almost 1 year out on one side, and 7+ months on the other side.

Hope it helps

Dan

[imgetinold]

Ruby.....you're still pretty early on in your recovery.  I was two months further out than you before I did my PT.  Keep your pain in check, and do what you can tolerate.  Your body will tell you when you're ready for more.  Then, go for it.

[Tin Soldier]

I was prescribed PT at 2 weeks and I let the therapist suggest how much PT I should do during the week.  He recommended 2 sessions per week with homework (3 times per days doing the usual "floor exercises").  I think the difference with surgeons prescribing PT vs not prescribing, might have a little to do with the age-old differences between PTs and orthopedic surgeons.  Some, actually a lot of PT's have more knowledge about the intricasies of soft tissue, bone, and how it all works together and some are really good at applying that knowledge.  Some orthopedic surgeons are really good carpenters, but might not have the interest and maybe not even the knowledge to apply PT after surgery.

Also, the amount and magnitude of PT should be pretty minimal early on in recovery and that's probably more the reason why some surgeons recommend it vs not.  The example of Gross suggesting that walking with some of the "floor exercises" is really all I did even with PT during the first 4 to 5 weeks.  My therapist took it real easy early on and it was really just me doing a lot of the same exercises we all do, I just had a PT session that I was committed to.  I think that is another good reason for having PT.  You are more committed to actually doing some of those exercises.  All in all, it probably doesn't matter too much if you do formal PT or if you just do some good walking with a few of the regular "floor exercises" thrown in.  Although, I'd recommend finding a PT that is knowledgeable about HR or THR and the posterier surgical approach. 

[imgetinold]

Tin, that was a really the best way of explaining it I've heard.  I agree.

The first several weeks typically consist of those same, basic exercises that many surgeons, including Dr. Gross, show you.  If you're more likely to do the exercises with a PT looking over you, then do PT early.  Otherwise, you may be okay to do it yourself until you can do more involved strengthening work.

[Woodstock Hippy]

At the Rusk Rehab Hospital I had PT three times a day starting on my third day.  I got home on Thanksgiving, my ninth day.  I went to outpatient PT the next day and kept going three times a week for the next ten weeks when I started going to the gym and working on my own three times a week.  In the beginning I did the Mcminn exercises on my off days and walked every day.  I've dealt with my PT for quite a few years and I worked out the schedule with him.  I think good PT is just as important as good surgery.  I really don't understand the idea that you should just walk.  I've pushed it pretty hard and I've had the most miraculous recovery I could have imagined.

Ruby, get yourself to a good therapist and start working your body back into shape and Hoyt, I don't think you should be working so had at the physical therapist that you need a full recovery day afterwords.  You should be able to do alternate exercises on the off day and walk every day.

Also, get to a swimming pool as soon as you can even if it's only walk in the shallow end........it feels so goooooooooood!

[hoyt66]

At the Rusk Rehab Hospital I had PT three times a day starting on my third day.  I got home on Thanksgiving, my ninth day.  I went to outpatient PT the next day and kept going three times a week for the next ten weeks when I started going to the gym and working on my own three times a week.  In the beginning I did the Mcminn exercises on my off days and walked every day.  I've dealt with my PT for quite a few years and I worked out the schedule with him.  I think good PT is just as important as good surgery.  I really don't understand the idea that you should just walk.  I've pushed it pretty hard and I've had the most miraculous recovery I could have imagined.

Ruby, get yourself to a good therapist and start working your body back into shape and Hoyt, I don't think you should be working so had at the physical therapist that you need a full recovery day afterwords.  You should be able to do alternate exercises on the off day and walk every day.

Also, get to a swimming pool as soon as you can even if it's only walk in the shallow end........it feels so goooooooooood!

This makes sense. I'm not working that hard at pt to warrant a day off. I went yesterday and today I have done the exercise program twice today. I do need to find a pool too! Sounds good. thanks everyone

[Baby Barista]

I started PT at week three and went twice a week for 5 months. For me, the greatest benefit of the therapy was various kinds of massage I got that took up at least half of every session. I do think for hip #2, I'm not going to start formal PT until about the 6 week mark. Those first few weeks I think were a bit of a waste.

[lyn]

Im a Gross hippy and his intructions were to walk 2 x daily and some isometrics, thats it, I wasn't even told to do clamshells like some people.I'm going into my 5th week . Lee said at my 6week follow up they would add excersizes.lyn

[imgetinold]

Lyn...I stuck with Dr. Gross' protocol for a long time, and the new exercises at six weeks definitely helped.  If you're not an athlete, and you want to get back to walking, gardening, yardwork, etc., then walking and those exercises will probably suffice completely.  After 4 months I wanted to accelerate my abilities, and for that the PT definitely made a big difference.