Q & A with a P.T. – Franklin Ortiz, D.P.T.
Most people think of P.T.’s (Physical Therapist’s) when they need rehab to heal from some sort of injury. Would it be fair to say that Physical Therapists are sought out just as often for prevention of an injury or to enhance their athletic performance?
“I don’t think that Physical Therapists are primarily sought out for prevention or enhancement, but we are certainly trying to move forward in that direction. I know the population is starting to be more proactive where they say, Look, I don’t want to get inured, I don’t want to get hurt, so before I get back to working out, or before I get back to cycling, let me go get myself checked out. We would hope that’s what they are trying to do. That would be ideal.”
“I work with a therapist, she explains it this way, It would be great if patients would come to see us every six months like they do with dentists, because usually by the time the patient comes to see us, all the bio-mechanical faults, all the injury, all the bad stuff has happened, now we’re doing rehab stuff. If we were in front of it, that would be great for everybody, there would be less injury, more time to do whatever you want to do in life.”
Is it true that accessing physical therapy is different from state to state? And as a patient, if I wanted to be a walk in and see a P.T. for prevention, could I, or must I contact my insurance company or be seen by an Orthopedist first?
“Yes, access is different from state to state. In California, we now have what’s called direct access, so you can go directly to see a P.T. for a short period, say for one month’s time, up to twelve visits without a prescription, without having to see a primary care provider. Different organizations, different businesses have a different set-up. The number of states offering direct access, is in the 40’s. At Torrance Orthopedic & Sports Medicine, we have different triages, so you would have to see the physician first. If I were a stand-alone P.T. there is a possibility you could see me directly. If you needed more than one month’s treatment, or more than twelve visits, we would probably refer you to a doctor to get a prescription to continue care. Going through your insurance, Medicare or on a cash basis, would be different, insurance and Medicare have their own rules.”
What would you say cyclists should look for in a physical therapist to prevent injury on the bike or enhance their performance?
“I would say certainly look for a P.T. with a specialty. For example, I’m specialized in computer and I’m completing a sports specialization as well. That’s one way to go about it. Look for someone who specializes in a particular demographic, like a women’s health specialist. Specialties can also include neurological rehab, pediatrics, oncology, wound care, cardio pulmonary rehab. There are some P.T.’s out there that may not have a specialty but are really good and have had years of experience. I’ve been asked about chiropractors many times and my opinion is usually to ask a number of people and see what your community says. If there is somebody that works for you or somebody you can recommend, even if someone has a recommendation that doesn’t mean that what’s right for them, is necessarily right for you.”
What types of injuries are typical for cyclists?
“Type of injuries can range from head trauma from a fall, mountain bikers – shoulder injuries, some of the repetitive stuff like patella tendinitis, patella Patellofemoral pain syndrome, wear and tear of arthritis, Achilles tendonitis, knee, ankle, maybe sometime even IT band issues.
How important is pre and post exercise stretching?
“Both pre and post exercise stretching are very important. The pre exercise is getting you ready to perform. For awhile there was some research, contradictory information about stretching activity that you would lose power, lose strength. They would say, just move around a little bit, kinda warm up a little bit and get going, because if you stretch too much you’ll just lose power and you may lose power immediately. Now there is a different consensus over time. A track star is stretching for an hour to run ten seconds, are they losing any power? Not necessarily. They are still stretching and getting ready to perform the sprint. It’s just preparing your body to perform at maximum, maximum length for muscles, maximum length for power. You want to get as much of it as possible. Mainly to move in the best way you can. The post exercise is really about, now that you’ve torn down tissue it’s then going to regenerate, and when it regenerates there are adhesion’s, there are calcium deposits, there’s tightness.”
That tightness then throws off your mechanics and it’s just a circle that can start wearing away at your body, at the parts that don’t necessarily regenerate as fast, like the cartilage between the bones. So if you start wearing that away, it regenerates as well, but it starts breaking down faster than it regenerates, then you’ve got injuries. It just changes the mechanics before and after. It changes the mechanics so you can perform at your best and changes the mechanics afterwards that starts wearing your body down.
Franklin Ortiz, D.P.T. (Doctor of Physical Therapy)
Torrance Orthopedic & Sports Medicine Group
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