by Dr. Loni Rodriguez | Aug 13, 2018 | Back Pain
Where the heck is my back pain coming from?
What I was taught in PT school was that back pain was mechanical. It was coming from a muscle imbalance, tight hamstrings, tissue damage, a weak core, an unstable lumbar spine, etc. This directed treatment around a biomedical approach.
However, over the last 10 years there has been a significant shift in the way that low back pain is treated and approached. Additionally, this shift has been more profoundly researched in the study of low back pain, specifically. This is the biopsychosocial model of addressing this epidemic. There has been an immense amount of research on the connection between low back pain and psychological factors, social factors, beliefs about pain, pain catastophization, poor nutrition, lack of sleep, and co-morbid conditions. These factors are affecting patients therapeutic outcome AND their risk of long-term disability. Low back pain goes far beyond tissue damage!
For example, a patient has a higher risk of developing low back pain if they are dealing with depression. Patients whom are living with excess stress about finances, losing their job, or poor work satisfaction are more likely to experience low back pain. These are some examples of the social and psychological factors that must be addressed within a treatment plan.
Beliefs about pain and pain catastrophization also have been shown to play a role in persistent low back pain. It has been shown that the brain observes the world around us and makes predictions about how things are going to feel. It adapts to what we become used to and mimics the thoughts, feelings and beliefs beginning at early childhood with the observation of our parents. Similar coping styles are observed in children that resemble those of the adult.
So, if you witnessed your mother or father deal with debilitating, persistent low back pain for the greater part of your childhood, you may be more likely to experience this level of debilitating pain.
We also respond to others in pain with neuropsychological reactions, including anxiety and distress. If you are to watch someone experience a horrific bout of back pain, you will then begin to have negative thoughts during any back pain that you may experience in the future. Similarly, responding in dramatic fashion to a current bout of back pain can truly make it worse!
One thing that I am NOT eluding to is that back pain is “all in your head”. There are absolute circumstances when a tissue overuse condition can occur and may be CONTRIBUTING to the symptoms, but the CAUSE and EFFECT is not black and white. Back pain is complex and 110% multi-factorial. All factors discussed above SHOULD be talked about and addressed to truly get to the root of the issue.
by Dr. Loni Rodriguez | Aug 6, 2018 | Back Pain
Introduction:
Low back pain is one of the leading causes of work-related disability and activity limitations around the world, as well as one of the highest reasons for rising healthcare cost. Startling statistics also have been released in regards to the climbing incidence of chronic low back pain, or pain greater than 12 weeks. From 1996 to 2006, the incidence of people who experience this chronic low back pain climbed from 3.9% to 10.2%. Recent research has also shown that up to 33% of individuals whom have experienced low back pain, experience it again within one year(Delitto, et al).
How can this be? There have been advances in medical technology including improved surgical procedures, imaging techniques, and medications. We would assume the incidence would decrease with all the improvements we have made with regards to treatment. Well, it has not! So, what are we doing?!
Low back pain is widely under-understood and ineffectively managed by many healthcare professionals. I am not saying that people with low back pain are not being helped to a certain degree. What I am referring to is that there ARE effective means of treating low back pain that are WIDELY UNDERUTILIZED. Over the next few weeks, I will be writing about low back pain and explaining some of the most important aspects of the epidemic, talking about symptoms, and some effective treatments. This series is to not only help the general public understand a bit more about what has been proven effective, but also to help remind and / or educate fellow practitioners that a shift in our treatment styles NEEDS to happen. Let’s raise the awareness of the seriousness of this epidemic that is wasting the precious dollars of our healthcare system!
References
Delitto et al. “Clinical Practice Guidelines linked to the international classification of functioning, disability, and health from the orthopedic section of the American Physical Therapy Association”. J Orthop Phys Ther. 2012;42(4):A1-A57
ANATOMY
The back is made up of a web of intricate structures that include the five lumbar vertebrae and the sacrum, the various joints between each vertebrae, ligaments (bone to bone attachments) which serve as supporting structures, wide array of muscles that can span across many vertebrae, discs (everyone loves to talk about their discs) which help provide cushion and mobility, and an intricate weave of nerves and blood vessels.
The anatomy of the low back is important to understand for the sole reason of knowing that there are a TON of structures that are in there! It is impossible to assess these independently and determine if one specific structure is causing someone’s pain.
Next week’s post will focus on explaining the more recent understanding of a more effective treatment approach to low back pain.
Stay tuned folks, KNOWLEDGE IS POWER. EDUCATION IS THERAPEUTIC.
by Dr. Loni Rodriguez | Jul 16, 2018 | Uncategorized
When I tell people I have an assistant, their eyebrows raise and they look impressed. Not going to lie, It is pretty cool to say, “Oh, yes, my assistant will send that to you by the end of the week…”
When I first started the business, I needed to keep that overhead low! I wanted to do EVERYTHING. I was not going to give up the reins and pay anyone else but myself to do the work that needed to get done. I worked countless hours on projects unrelated to patient treatment. I was up late nights making flyers, creating social media posts, sending bills to patients, etc. Many of those things I was not efficient at and took much longer than it should have.
I met Lisa through my practice at Cynergy CrossFit. She was one of my first physical therapy patients. She kept talk all PT with an occasional, “…when you’re ready for help, let me know.” I kept this in mind, but mainly brushed it off because I was managing just fine without help… was I though?
One Thursday morning, as I began to start my session with my first patient at Cynergy, I looked down to find a small trash can. Now, this was not just an ordinary trash can. It was a grey one with my logo on it. I had been using a small Lululemon bag… I needed a trash can! However, it was not on the “C-list” of things to do. I immediately realized who had taken the time to make me a personalized trash can. It was Lisa, and she was hired.
I realized that I valued help like this from someone who cares about their job. She genuinely enjoys putting effort in to help small businesses grow, and help people live a bit more stress-free.. This screen printed trash can job does not amount to a measurable percentage of what she has done for me thus far. She has kept me afloat when life has been challenging, through bookkeeping, helping me find a new office, and teaching me the beginnings of entrepreneurship. She has been my go-to for all things business!
This blog post is not only to give a HUGE shout out to this SOLID assistant and plug Dargie Virtual Solutions, but to introduce all of you to the person you may receive a few emails from. Meet Lisa: support staff number 1.
If you are stressed out with the many things you are juggling in life, a small business, a side hustle? Check out the Services this lady provides. My level of stress has decreased tremendously and I would recommend her services to ANYONE.
by Dr. Loni Rodriguez | Jul 6, 2018 | Uncategorized
The importance of making the connection.
This post is not only directed towards my clients to help you understand my treatment style, but also my fellow providers. As providers, we can not forget WHY we do what we do…
I try to make connections with every client that I come in contact with. The connection I make with someone is one of the most important pieces that leads to a positive prognosis no matter what. When people are in pain, they are looking for answers. They are afraid, and in many cases, in a bit of a depression because of what they are dealing with. Calming that fear, lessening the worry, showing them that I understand and empathize can immediately allow them to open up.
Comfort at FIRST interaction looks like this:
“Hello, nice to meet you”
or on a phone call with, “Hello, what can I help you with? What can I do for you?”
Who are the first people you tell about something important or something of concern in your life? The people closest to you, right? Sometimes it is difficult to express your concerns to providers who do not act like they care or act as if you are just another person walking in their door. I’m not going to lie, personal issues and things I deal with on the day to day have impacted my time with patients. Yet, I try very hard to leave that outside the doors of my office.
The first impression and connection we, as providers, make with a client can push treatment immediately in a positive direction. This was not something that I learned right out of school, however. It took time to understand the power of body language, reactions, and responses. Beginning the initial interaction with getting to know the person as a PERSON can go a long way. Finding a common interest, mutual friend, or simply relating to them in any way can start things off on the right foot.
When it comes to talking about the reason why they are seeking treatment. LISTENING to them is the first step. Hear what they are saying, show them that you understand and can help them. A simple, “Okay, I have seen this before, let me explain to you what I feel you are dealing with…” can go a long way.
Of course, I want to fix every ailment that walks in my door, however, I know that is not possible and fixing is not what I do. My job is to give answers, debunk misconceptions, inform clients about their concerns and empower patients to take control over their symptoms. There is no quick fix… I put the power in the client’s hands.
Providers! These people are looking to YOU as the experts. Make sure that you are giving them your 110% and make them feel comfortable. Listen, pay attention, and respond thoroughly. Ease their fears, don’t heighten them.
Are you looking for someone who will listen to your concerns about pain? Not sure if what you are dealing with is something that can be helped with PT? Find a PT and ask!
Want something answered right NOW?! Click HERE to book your complimentary consult.
by Dr. Loni Rodriguez | Jun 29, 2018 | Uncategorized
As year one comes to a close, I have had time to look back and reflect. What a year it has been! If you had asked me 2 years ago if I thought I would ever want to open my own clinic, I would have laughed and said, “…absolutely not”. I was convinced that I would be working under someone else for the rest of my life versus becoming a small business owner. Little did I know, my future would look very different.
Here is my story…
Many of my patients and friends ask me, “How did you do it?”, or “What made you want to go out on your own?” The answer is easy! I love my career and I felt as though I could be more successful doing things MY way over working under someone else.
The business story is fun to tell… It all started with sticking strangers with needles in my basement… true story. No, but really… I began treating friends, and friends of friends, etc.. at my house. Yes, people who didn’t know me, would come to my house because their friend and trainer, “Meg”, said that I worked miracles. Thanks, Meg
Meg is the well-known and loved head coach at OrangeTheory Fitness in Quincy. Poor Meg had a nagging knee injury that plagued her 2017 Boston Marathon. I met her one day after taking one of her classes and she was interested in this dry needling treatment. I told her that I would love to help her and she adamantly made an appointment. Sure enough, Meg showed up to my house, we went into my newly redone basement and that was it. I was fortunate enough to find a way to help her and she was sold. She told me that I could make a business out of this… the rest is history.
I began receiving calls from people who would say, “I was referred to you by Meg at OTF, I have this issue with my [ENTER PAINFUL AREA] and she said you can help me…” I thank Meg daily for being my first referral source!
Not only was I treating people in my basement, I began helping out the members of Cynergy Crossfit in Hanson. I was fortunate enough to be given the opportunity to come down to their gym on a Sunday morning and give a small talk on dry needling. I did a demonstration and every person wanted me to come back the next week to be treated. I left that day with a sign-up sheet packed with 6 hours of patients to be seen the following weekend.
As patients continued to call and inquire about my services, I started going through the motions of starting a business. I began a ton of research about starting an out-of-network practice. The business model was exactly what I had been looking for. It gave me the opportunity to treat people as people and not numbers. It allowed me a flexible schedule, higher income, and I could bring my dogs to work!
July 1, 2017 I opened the door to my office out of CrossFit 781 in Weymouth. I continued to be part-time at my job in Cambridge, while treating people outside those hours at this new office. My schedule soon filled as I was receiving referrals from other CrossFit gyms in the area including Crossfit Prosperity, CrossFit Fit Factory Kingston and Quincy City CrossFit. Additionally, referrals from OrangeTheory Fitness gyms in Kingston, Quincy, Dedham, and Hingham poured in and the word of mouth referrals increased. Before I knew it, I was faced with going full-time and I made the leap mid-August 2017.
Being a business owner has its pros and cons. There is definitely a huge element of stress! If I don’t work, I don’t make money. If I don’t get things done that need to be done, no one else will (that is unless you have a killer Virtual Assistant that takes care of you). I also had zero business experience prior to this – it has been a learning experience to say the least. I have made some mistakes along the way, but have learned from each one of them. I plan to continue to grow and not give up on my dream of creating a killer PT clinic. I want to continue to serve people in pain the way they deserve to be treated!
Thank you to all my friends and family, patients who have become great friends, multiple CrossFit gyms and OrangeTheory Studios who have welcomed me with open arms and have spread the good word. I could not have done this without you – on to year TWO!
