Winnipeg Free Press - PRINT EDITION

When injuries are the obstacles

Choosing the right practitioner is often the first step to recovery

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For the past week, as we sat huddled around fireplaces, heaters, or mugs of hot chocolate, we have mulled over how we will conquer our fitness goals for 2014. For most of us, the greatest obstacles are our motivation and frigid temperatures, but as we thaw out and head to the gym to better ourselves with a workout, there are people sitting at home wishing they could be in our shoes. This population has another obstacle hindering them from fitness, and that obstacle is injury.

Injuries can come in many different shapes and sizes. Perhaps the treacherous roads caused you to lose control of your vehicle, crash, and now you're experiencing some neck and upper back pain. Maybe you took your grandchildren out skating on Christmas Day (I don't think it was -50 C on that day), and sprained your knee trying to keep up with them. Most likely, you've had some sort of ache in your shoulder or hip for months or even years and you've hesitated to seek help.

If you start your fitness routine under these circumstances, you may be doing your body a disservice. The likelihood of you performing exercises correctly with significant pain and dysfunction is low, and you are most probably prolonging your current problem. Thankfully, in January, the insurance coffers are often topped up, and there are many different service providers that want to help -- but how do you choose the right one for you? Whether it is physiotherapy, athletic therapy, massage therapy, or chiropractic treatment, there is a therapist out there best suited to your needs.

Here are a few tips to help you choose a practitioner who is best suited to you.

INSURANCE COVERAGE: It is the unfortunate, yet ultimate deciding factor. If you're hurt and have extended health benefits, you want to use those funds as best you can, but beware; not all insurance policies are created equal. If you are planning on having your therapy covered by insurance, ensure you know the specific credentials of the person you are seeing. Often, policies cover each type of service to a different amount or have varying stipulations for documentation (you may need a doctor's note for massage but not for chiro, etc.). For instance, MPI only covers massage therapy when done by a physician, chiropractor, nurse practitioner, physiotherapist or athletic therapist. Know your specific plan amounts, and know who you're seeing, because a surprise $500 bill could give you a headache far worse than the fender-bender.

TYPE OF INJURY: I'm often taken aback by the course of action that people take after sustaining an injury, and the type of treatment they pursue. An acute injury with lots of bruising, swelling, and spasm requires much different care and treatment than chronic back pain. Be sure that your therapist is giving you the treatment warranted by your injury. Example: as an athletic therapist, I will sometimes refer a patient to a chiropractor if I feel a more aggressive manipulation will benefit their condition -- as long as that manipulation is accompanied by exercises to reinforce it.

YOUR DESIRED INVOLVEMENT: Certain services and/or service providers are more active or passive than others. At our clinic, the approach with both physiotherapy and athletic therapy is very exercise-based and every so often, it is evident a patient is not performing their exercises regularly. While it is not my approach, this patient would most likely benefit more working with a therapist that uses more modalities (machines that you're hooked up to), and hands-on treatments as opposed to home exercise. Everyone is different, and two people with similar injury will respond differently to the same treatment. Work with a therapist (or several) to find what works best for you.

Let's make sure that your injuries aren't limiting you from your New Year's resolutions. Get out there and find help! But if after reading this you have more questions than answers -- great! Next week we will continue this discussion on appropriate treatment, choosing a therapist, and dig deeper into the most common question I receive in the clinic; "What's the difference between athletic therapy and physiotherapy anyway?"

Tim Shantz is a certified athletic therapist and personal trainer

Republished from the Winnipeg Free Press print edition January 14, 2014 D16

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