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I Have Pain, But I’m Already Active and Don’t Need Physical Therapy

Have you thought this to yourself when a doctor, friend, or other medical professional tells you that physical therapy can help your situation? I have heard this from doctor’s and family of prospective patients. So, I will do my best to explain why an ‘active’ person still may need the help of a physical therapist.

I have found that being ‘active’ has many definitions for many different people. One of the most common situations I see in my older adult population is someone who is occasionally doing tasks around their home (i.e. laundry, dishes, cleaning, or making a bed), but this would hardly be enough to overcome what is, most likely, the underlying cause of the pain. Oftentimes, I can find significant weakness or mobility deficits that can directly be correlated with a client’s pain. If you would just continue with your normal ‘active’ lifestyle, you would most likely not correct any of these deficits. A therapist would be able to provide specific exercises, diet modifications (very basic suggestions, but not a complete diet plan like a dietician would do), and manual treatments to help resolve the weakness or mobility issue.

Here is the caveat; these treatments are only the beginning of solving the deficits. I always get asked, “How long will I have to do these exercises or diet suggestions?” The answer may be different for each person, but if someone is looking for a temporary fix, they can be diligent with their exercises and diet modification for the duration of therapy, but they will most likely end up in the same situation down the road if they go back to the same lifestyle they used to live. I am a huge proponent of getting clients to go from ‘active’ to ‘physically fit.’ These two adjectives are completely different and something that a good physical therapist should be able to help a patient achieve if they are willing to make the necessary changes.

American College of Sports Medicine

The American College of Sports Medicine (ACSM) recommends that adults 18 and older get at least 150 minutes of moderate intensity exercise (per week) or 75 minutes of vigorous activity (per week). The difference in these activities is how fast your heart is beating during these activities. Moderate intensity exercise is defined as a heart rate that is between 50-70% of your maximum heart rate. Vigorous activity is defined as 70-85% of your maximum heart rate. Your maximum heart rate is calculated by subtracting your age from 220. For example, a 65 year old’s maximum heart rate would be 155 beats per minute (bpm). That would mean that moderate intensity exercises would be between 78bpm and 108.5bpm, and vigorous intensity exercises would be between 109bpm and 132bpm. There are so many fitness watches or wearables that can easily track your heart rate if you are curious how intense your activity level is.

Now that you know the MINIMUM recommendations for activity level, you can start tracking your daily activities to see if you are meeting, exceeding, or not meeting these recommendations. If you are in a situation where you have multiple comorbidities (diseases or medical conditions), it is recommended that you see a licensed healthcare professional (such as a physical therapist) to help you get on the right plan to improve your overall health.

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