The way my physical therapy is set up, I see my actual physical therapist once per week, and then on second weekly appointment I see one of the physical therapy assistants. I HATE seeing the assistants, I feel like the sessions are never as helpful as the sessions with my PT. This past Monday I had a session with a physical therapy assistant that I'd never worked with before. After asking me a million odd questions, and wasting a good amount of time, she finally got started. Normally my PT session progresses something like this.... Ultrasound therapy, taping, then exercising the muscles to help with stabilizing patella (right now I have a million knee problems going on at once,) finally ice. She started the ultrasound therapy, but not with the correct gel, and not in the correct area. Then she moved onto taping.... now, because I have patella alta with a lateral tilt it has to be taped a certain way. Not only did she fail to tape it the way it needs to be taped, but she failed to tape my knee at all, and instead taped my thigh... UHHHH???? Then she decided to add another step... stretching.
Normally I'm a fan of stretching, but due to my hypermobility I generally don't let others stretch me (physical trainers at a gym, etc) because I don't really "feel the stretch" like normal people would, and its what everyone seems to be looking for when they stretch your limbs. I don't want to get pushed too far and then injured, where as I know my own limits and what I'm comfortable with when it comes to stretching.
I figured that a PTA in the healthcare setting would probably know how far they could and should stretch a patient though, so I allowed it. BIGGEST. MISTAKE. EVER. First, I'm guessing in attempt to stretch my calf muscle, while my leg was straight on the table she was flexing my ankle with my toes towards my shin. Now, I have hypermobile ankles apparently, and I think that shocked her, because it was almost like for a second she forgot about her "stretches" but it was like she was trying to see how far she could get my ankles to go. I remember thinking that while I was there and she was doing that, and it should have been a warning sign to me, I should have stopped it right then and there and said ok, I don't feel like doing the stretching today, can we just more on to exercises. Unfortunately, I remained silent. She then moved on to do some other odd stretches with my leg, that I have never seen or done before in my life, and I have been in and out of PT (never knowing what the real problem was) for 15 years now, so I've seen a lot of stretching. My leg was at an awkward angle, and she asked me if I felt the hamstring stretching, and I replied no, and also, that I have never felt stretches in the same way that most people do though. She then went on to push my leg even further into the awkward position and asked again if I could feel it. This AGAIN should have been a warning to me, that she thought she could force the response out of my body that just isn't natural for it. I replied no again, but didn't want to make a big deal out of this, because the Physical Therapy Center was busy and there were other patients there and other PT's and PTA's trying to do their jobs. I didn't want to disrupt them at all. I'm also not one to want to rock the boat at all with a health care provider.
After I said no, she pushed my leg a little further, for a moment, in a last minute effort to elicit the response she wanted, or maybe once again just to see how far she could bend me. She then let go of me, and stopped with the ridiculousness that she called stretching.
Nothing hurt, and I thought, "good, I managed to get out of that unscathed, but boy oh boy did I learn my lesson for good. Never again."
Finally it was time to do my exercises. Some of the exercises that I do stay consistent and I do them every time, and some of them change and I may do them every other time or every third time or so, but I know how to do them all, because my actual PT has trained me in the correct way to do them. Well, this PTA insisted that I do them the way that the PTA wanted them done. So now I'm being forced to do incorrect exercises, on my bad knee, that was taped incorrectly, and has been over stretched.... recipe for disaster? I think so.
Finally it was time for ice, and by now my knee was HURTING and not only my normal pain, but I had a whole new pain in my knee as well. While I was icing, I told my PTA exactly that, and her remark back to me was well "if you don't think physical therapy is helping you, you can always go back to your ortho." REALLY?!?!?! Are you kidding me? I didn't say I didn't think physical therapy wasn't helping me, or couldn't helping me, all I said was that right then and there I was having a ton of pain and along with my normal pain I had NEW pain. She didn't seem to understand that I fully believed and I still do believe that she is the reason for the increase in my pain and the reason for the new pain as well. Maybe she's relatively new and doesn't have as much experience. I'd rather believe this, than believe that she's just a bad PTA who shouldn't be in the field.
I'm obviously going to have to say something to my PT when I see her tomorrow, but I dont want to make it seem like I'm talking bad about one of her co-workers, and again, I'm really bad about speaking up and rocking the boat when it comes to a health care provider (oddly enough not with anything else though.)
What it all really boils down to though is that I'm really frustrated. I've been to enough Physical Therapy through out my life to know that a lot of people who go to physical therapy don't really want to do the work to fix whatever is wrong. They want a quick fix, and they're not happy that PT forces them to be active. Especially the older folks there. I'm incredibly frustrated because this is not the case with me. I'm young. I like active. I really think that with time PT can help. I feel like whatever little progress I might have made has been wiped away, and now I have a new injury on top of it. I was, and still am willing to do whatever it will take to get better, to make my knee better and to help better manage the pain in all of my joints. Once I finished up with PT and my knee is in better shape I'm planning to get started with training for a race for my own personal reasons. It was a commitment that I made to someone a long time ago, and I have to keep it, and I'm just feeling down in the dumps with this set back.
