Recovery Physical Therapy

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Devising a Fitness Program Just for You! The Musculo-Skeletal Assessment.

Fitness Training at Recovery Physical TherapyJust as each of us has different facial features, we also are unique in our physical and fitness profiles and therefore our workout needs. We also have varying fitness goals. All of this should factor into devising an ideal workout. There is a vast menu of exercises out there but the approach should not be one-size-fits-all. Selections from this menu must not be made indiscriminately.

So, how can you identify the program that is best suited for you? How will you know how to progress that program as you improve? And, most importantly, how can you avoid injury? One answer is by undergoing a complete musculo-skeletal/structural assessment – something I’ve long advocated for anyone planning to initiate a fitness program or train for/compete aggressively in a sport. This is an exam that can be performed by a skilled physical therapist in one hour and is typically not made available to recreational athletes or gym members. A rudimentary version, one that is more dog-and-pony-show than substantive, is offered by some fitness centers in return for a mandatory initiation fee. In reality, even clients who undergo this abridged assessment begin their fitness

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programs with little understanding of their specific needs.

Many years ago I devised a one-hour structural exam and administered it to each new client at New York’s (sadly, now defunct) Sports Training Institute, the pioneer of one-to-one fitness. The purpose of this assessment was twofold: to identify existing injuries or vulnerabilities that may predispose an athlete (at any level) to injury, and to assist in the design

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of a safe, effective and individualized exercise program prioritized to address each client’s needs and goals.

This is a service currently offered at the Midtown East location of Recovery Physical Therapy (@ 51st Street). What exactly do we look for in this assessment? Most importantly we look for a balance between a client’s right and left as well as for any deficits that either side might exhibit with respect to normative values. Let me explain further… We look first and posture and alignment. Next, all the major joints in the extremities are tested for range of motion and for pain with certain positions or stresses. Core muscles are tested for strength and those of the extremities for strength as well as flexibility. Special tests are performed to assess the integrity of the shoulders, hips, knees and ankles in order to identify any laxity (looseness) of the ligaments, tears in the cartilage at the knee, the labrum at the hip or shoulder, and arthritic changes (wearing of the joint surfaces), etc. We also test for other common overuse injuries – the “itis” conditions, which are inflammatory processes or tears (generally due to overuse compounded by each individual’s unique predisposition to injury). When a red flag is raised and further diagnostic testing is warranted, the evaluating therapist can make recommendations and refer to the appropriate specialist in a client’s insurance

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plan. In these cases physician or physical therapy intervention may prove to be beneficial before an all out fitness program is initiated. However, most clients with simple strength or flexibility limitations, require guidance rather than rehab.

Armed with all of this information, it is possible to devise a tailored fitness program. By drawing selectively from a vast menu of exercises and prioritizing effectively, each client can shore up areas of deficiency, minimize the risk for (further) injury and even rehabilitate or conservatively manage existing musculoskeletal complaints. The evaluating therapist can also interface with a client’s personal trainer or schedule one or more joint sessions to provide an educational foundation for the safe progression of the fitness program. Clients who benefit from this service stand out in stark contrast to those whose workouts may lead them to pain, injury and ultimately the need for medical attention.

So, as summer rapidly approaches and bathing suit weather looms, you may be thinking about gearing up your fitness program. We salute you! Think about visiting us before you embark on your program so as not to need us because the going gets rough down the road!