A Physical Therapist Can Help You Unlock
Some medical professions are straightforward — eye doctors help you with your vision; dentists concern themselves with oral health. With some professions, such as physical therapy, it’s not as obvious. A “movement specialist” like Fortino Gonzalez, who has practiced for over 29 years, can improve the quality of life of almost any person experiencing pain, discomfort, stiffness, or weakness by providing life-changing education about the human body’s natural movement. “The most valuable thing a physical therapist has to offer a patient is knowledge — expertise in movement and how to take care of yourself,” Gonzalez said. “It takes over seven years to become a licensed physical therapist. We are talking about a lot of movement science, not just some weekend certification with the latest greatest ticket.”
A physical therapist understands and explains to patients what a normal movement through full motion should feel like and shows them how they can resolve abnormal movement themselves. Gonzalez makes the analogy of the body being like a car — a technical machine that’s designed to work in a specific way. “You rotate the tires on your car because you want to prolong the life of your tires and make sure the car runs smoothly,” Gonzalez said. “Your body needs the same attention, and if you don’t know how to do that, you need to seek the people trained to help you.”
Learning Body Awareness
Every pain has a tissue of origin. “When people experience ‘sudden’ pain or discomfort, they were likely experiencing warning signs all along,” Gonzalez said. Whether they choose to heed them is a different story. Many people live in denial, pushing through their pain, or treating it with a temporary solution like massage, hot packs, shock therapy, etc., instead of addressing the root cause. “This mindset is common in our society because we like drive-thru, quick and easy. Patients go home feeling better, but the root issue isn’t resolved,” Gonzalez said. This will inevitably lead to bigger issues in the future. “The body is very forgiving, but if you continue to irritate and insult it, it will continue to create problems for you.” He explains that many issues can be episodic in nature and have a very high recurrence rate. With each recurrence the episode takes longer to resolve and is usually more debilitating with more intense and frequent symptoms. If you don’t get to the root of what’s happening, history repeats itself.
A highly trained physical therapist can help you find the root cause through a systematic mechanical assessment which entails moving the body through full motion. “Before sophisticated imaging machines such as MRIs and scans, we learned about orthopedic problems by taking a good history and moving the patient,” Gonzalez said. While medical imaging machines do help us see things we couldn’t before, Gonzalez says they sometimes reveal too much, like false-positives at rates as high as 32 percent that may be nothing more than an incidental finding. “The clinical presentation is much more reliable than a picture if done by a highly trained individual,” Gonzalez said. “Sometimes, after the assessment, I realize it’s not a mechanical problem and it’s due to something else entirely — and that’s when I refer patients back to their physician.” However, he believes a physical therapist should be the first stop that a patient makes if an orthopedic problem is suspected and cites a California-based pilot program doing just that. “Manual orthopedic therapists are on-call 24 hours a day in this hospital system,” he says. “They are the first healthcare practitioner to see the patient if an orthopedic problem is suspected by their physician. They quickly do their assessment and determine if it can be resolved through physical therapy or if further testing and referral to an orthopedic surgeon is warranted. What they are finding is that the issue is resolved quicker and that the cost per case is significantly decreased. They are identifying the issue quicker, the patient is healing faster, missing less work, and feeling more satisfied with their treatment.”
Taking Proper Action
The most common injuries Gonzalez sees are spine, neck, thoracic or lower back, shoulder, hips and knees, and ankles (in that order). He determines what can be done for that tissue at that stage of the episode. “Is it a tendon or cartilage? A joint capsule or muscular? They are all completely different and would require specific recommendations or advice,” Gonzalez said. Whenever he decides a patient needs a very specific movement or exercise, it’s a question of frequency, duration, and intensity.
However, Gonzalez says he sees all sorts of patients who are misinformed with an expectation that someone can “just fix it” for them. “We don’t like hearing that we have to change the way we sit or be aware of certain actions we’re performing that may be contributing to the problem,” he said. “Most of the time, if you move in the right direction, you’re creating the right environment for healing.” With the right instruction from a trained professional, the root cause of a long-standing problem could be unlocked and resolved on the patient’s terms with the power of motion.
Fortino Gonzalez is a physical therapist, Diplomat of the McKenzie Institute, Certified in Mechanical Diagnosis and Therapy (Dip. MDT), Fellow of The American Academy of Orthopedic Manual Physical Therapists (AAOMPT), and a Board Certified Orthopedic Clinical Specialist in Physical Therapy (OCS) serving the Rio Grande Valley from his practice, McAllen Physical Therapy. To learn more, visit www.fortinogonzalezpt.com or call (956) 661-1964.