What Is Physical Therapy like with Jason Sweas?
Physical Therapy with me begins with a physical evaluation to examine your posture and how your body moves and how that movement relates to your pain. I will look for problems in the following general areas:
Flexibility / Mobility – whether a muscle is too long or too short or joints are too loose or too stiff
Strength – whether a muscle is strong enough to hold yourself in proper posture
Motor Control – whether your brain can use all your muscles adequately
To find this information, I will be incorporating tests from the SFMA (Selective Functional Movement Assessment), Shirley Sahrmann, and Mark Comerford.
After I assess these problems, we will work together to create an exercise program that should take no longer than 20 min / day (this may vary based on your diagnosis) to improve these problems.
How does flexibility affect my pain?
Pain frequently occurs because a body part moves too much in one area and not enough in others. In more severe situations, tears occur in tendons, ligaments, fascia, muscle, and other tissues. I will do different tests to try to figure out what areas of your body are moving too much and also tests to figure out if there are other tight areas that don’t move enough. I find that usually the painful areas move too much and we need to avoid stretching them. Rarely the tight or stiffer areas are pain producing, but they may be painful to the touch. Correcting these flexibility imbalances will help prevent the pain from coming back in the future.
How is strength related?
Strength is defined as muscle’s ability to move the body through space and control it in different positions. When you have pain, muscles frequently become weaker due to inhibition. Muscles also get weaker as we age (starting around age 25) and get weaker with not using them enough. I will use a variety of tests to measure your strength and then we will use exercises to try to improve that strength. I will also help teach you ways to move to make it easier and safer to use your muscles effectively. I like to work toward transitioning my patients to functional strengthening for long term management.
What is motor control? Is it different than strength?
Motor control is your brain’s ability to use all your muscles, from the big ones to the small ones. Physical Therapy research is beginning to better understand problems in this area. Recent research has determined that after someone gets injured, some small muscles called stabilizers stop working normally. I will use very specific techniques to check and see if all these muscles are working and if they are efficiently working. We will then move on to exercises to try to get these working normally. This is different than normal exercise in that we are trying to get these muscles working in a gentle manner. These contractions should not be too strong; they should be easy and efficient.
How long does physical therapy take?
Patients usually come to physical therapy 1-2 times per week for 6 weeks to start off. During these sessions, we will work on progressing your exercises appropriately and other techniques to address your problems. If we see progress, but you are not 100% improve, I will ask your doctor to continue therapy if you want to continue. I have had patients in therapy for as short a time frame as 1-2 visits and some for many months. In order to continue in therapy for a longer amount of time, we need to see functional improvements with continued deficits. If you are unsure of what functional improvements are, let me know and I’ll help you understand.
Is my insurance going to pay for physical therapy? Does my doctor know what’s going on?
Many insurance plans are different; you should call your insurance plan to find out about what services they will cover. Unfortunately, your doctor’s request for therapy may be ignored from your insurance company. Additionally, I may request more therapy and the insurance company may refuse. All of my notes are on our electronic medical record system and if your doctor ever works at NorthShore hospitals, he or she will have access to these notes. From a legal perspective, I am required to have your doctor’s approval of my plan of care and I will take care of that.
When will I be done with physical therapy?
There are 4 scenarios that will guide when you are done with physical therapy:
- The first one is you no longer have pain and have returned to your prior level of function prior to your injury. This is the ideal situation.
- The second situation is where you have improved most of the way (probably 90%) and may only have a little pain and you are going to continue working on your own to get back 100%. In this situation, you are confident in your exercise program and I have told you that you are doing the appropriate exercises.
- The third situation is where you have improved part of the way (50-85%) and you will continue with your home exercise program to try to get the rest of the way. This sometimes occurs with patients with more long lasting problems.
- The fourth situation is the worst case scenario: you have not made any improvement in pain or function. It is probably best to get further evaluation by your doctor or to consider other methods of treatment.
If you have any questions, please feel free to contact me via email, phone, fax, or mail:
Jason Sweas, PT, DPT
NorthShore University HealthSystem
Evanston, IL 60201