physio pt. I

Last Friday I was involved in a fender bender in which I was sandwiched between two cars. As a result, I've been feeling some lumbar and cervical spine stiffness, and booked in for physiotherapy today.

I have to say it's weird being on the other side. I had remembered how annoying MVAs were what with all the paperwork, so I made sure to fill out my AB-1 and AB-2 forms as best as I could. When I got there, the receptionists were confused: "You're literally the first person I've seen that's filled everything out." I told them I used to work behind the desk. It's weird and almost a little bit ironic - I never thought I'd need physio or be filling out my own informed consent form, but there I was doing what I'd told so many other people to do.

My physiotherapist, K. actually graduated last year from the U of A program, so we had a chat about all the profs and their approaches to therapy. It was kind of refreshing to speak to someone who had already finished the program and was practicing - it was kind of the light at the end of this endless scholastic tunnel, that there really is a career waiting for us. We discussed the merits of challenging Level 1s quickly and obtaining acupuncture in second year - apparently the benefits of knowing trigger points and basic techniques facilitates the education process greatly. Tips and tricks and words of wisdom from the ex-student.

Physios hate it when physios are their patients because it becomes immediately obvious when they're doing something wrong. It becomes quickly apparent that in the real world, we are forced to skip many steps - whether it's out of time constraints or just because they're more focused and know what they're looking for is beyond me (likely a bit of both). K. was extremely nervous throughout the entire process, giving the disclaimer "I should probably do it this way..." the entire time. Regardless, it was interesting to see how proficient you get at the whole process, even though some things get left out.

During the observation, K. noted bilateral muscle wasting in my lumbar spine, which took me by surprise. Atrophy happens pretty quickly after injury (case in point) but I didn't think it would be so obvious in me. Unfortunately, I can't really see my back on a regular basis so it never became apparent to me. During the scan she found right-sided C5 myotome weakness, but I'm not sure what she recorded with regards to AROM/PROM/RI. I received the straight leg raise for the special test, and the majority of the time was spent on joint play in both C-spine and L-spine as well as with palpation for trigger points. In the end, I was diagnosed with L1/2 hypomobility and L3/4/5 hypermobility, likely due to ligamentous strain, with quadratus lumborum tightness due to overcompensation. I also had unilateral levator scapula tightness trying to stabilize for upper C-spine hypomobility.

I was placed on heat and given TENS, but for some reason - my guess is nerve irritability - the TENS would cause tingling down my L4/L5 dermatomal distribution. During this period K. performed myofascial release at different trigger points to loosen up some of the suboccipital muscles preventing me from full side flexion and rotation, the actions that were most limited for me during AROM. I was prescribed with stretches for lev. scap and upper trapezius (side flexion, side flexion /w flexion), as well as stretches for my paraspinal muscles (tucking knees into chest in full hip flexion) and my quadratus lumborum (L-spine rotation essentially). We remarked that the levator scapula and the quadratus lumborum have a tendency to be extremely tight following injury, but that we never learn much about them in class, which makes treating it kind of a guessing game. At the end, I was given a hot pack to take home and throw in the microwave, but I don't really believe in superficial heating so I just warmed it up for Mag's feet which are perpetually cold.

I think it's really interesting to receive physio. Everything seems so simple in classroom, but in application to injury everything is surprisingly helpful. My neck is incredibly limber, and even that little bit of release makes a crazy difference. Even though my back hasn't changed much, I greatly look forward to the next few weeks of treatment. I think it changes your perspective on your profession when you actually experience what you do, and despite having a mangled car and some soft tissue injuries, I'm really glad for this opportunity. I don't like how I got there, but I'll take it for what it is - an exercise (pun!) in enlightenment.