Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Revisiting Tendons and Physical Terror-apy

While tendinosis/enthesis is NOT my major disabling condition, it seems to be cropping up and just adding to the "it's always something".
I've read stories here of people who have had repeated surgeries and tried all sorts of therapies.

What i am wondering.. and am asking both the group and the most "academic" PT i know: is there any EVIDENCE that PT is helpful?

Thanks.... will report what my academic PT says, altho' i know she is away at the moment..

p.s. my post should not minimize the disabling effects of the various tendinoisis i have fought including Plantar Fascitis and nearly every part of my body. It just isn't the NUMBER ONE Complaint that I would resolve if given a magic wand.

also, i have had PT on most of these body parts. And do love it, but it gets expensive and i wonder, if it is CHRONIC what is the POINT... i can heat and ice at home...
and so the question asking for EVIDENCE (meaning studies, etc)..

personally, i don't care what studies say, i only care, selfishly what helps me.

physical therapy has given me my life back on a number of occassions.

its not just ice and heat and exercises.

ultrasound for about 2 years got the trigger point band to a point where it could be injected over the next year to make it so i could once again sit (for some period of time), travel (to a limited extent), not have daily excruciating pain, etc.

that plus traction, gentle massage, counter strain, etc helped my upper back,

my neck had been so weak that i couldn't talk on the phone without it going into spasm.

the occipital muscle was so inflamed that i had daily chronic headaches for about a year.

the SI was so bad, every little movement seemed to misalign it.

my left wrist was so bad on two separate occassions about 8 years apart that i could not type with it, could not turn pages (in books, etc), could not push myself up from a bath with that hand, couldn't prep food in the kitchen, etc......

hand therapists used ultrasound and light weights (bolts and washers on rubber bands) the first time and ultrasound and ionophoresis the second time to give me my hands back.

for me, the disease causes damage and the physical therapy helps undo that damage. it's like taking your medicine, it doesn't cure you, but it keeps it all in check.

and i can tell you that there are reports that say that PT isn't really of much value, i've read them. i can tell you that insurance thinks things should be "fixed" at a much quicker rate than they are, PTs always having to justify the therapy when it takes longer than its "supposed to".

a good physical therapist is definitely an important person to have on my "medical team".

and the therapists have taught me so much over the years that i can do a lot of it on my own now, but there are still times when i can't do it alone.

sue

Hi Sue: thanks for your answer. i have had all of those PT treatments, and some, over the years ( ultrasound, massage, light traction, cranio-sacral treatments, trigger point, etc etc ) and when desperate, i.e. with neck stuff, it helps emotionally to feel like i am doing SOMETHING. But in the end, does it really speed or help healing?

I like your medicine analogy a lot!! doesn't cure but helps keeps it in check. Certainly building up the weaker muscles of a set i.e shoulders sounds logical.

No doubt it is an uphill (or going downhill? battle). i am wondering if the end result is any different.

Hi Swim - Well, go right along with Sue22 here. Don't know IF there are any 'studies' per se, but do know that many papers reference to physio therapy and to s-t-r-e-t-c-h-i-n-g as being important in 'managing' AS - and the other arthritic conditions. IF you don't move it you'll surely loose it, and that is a *known! (Old time ways of treating arthritic conditions was to immobilise almost, then findings were that patients *seized up*...) So, yes, PT. Which you can do on your own of course. But, would *strongly suggest starting with 'a' Physio Therapist, so that you have the groundwork knowledge of the 'hows' etc: all too easy to do the 'wrong' stretch? Also, Pilates is excellent, but, not unless you have a fully qualified instructor, who 'knows' your condition and will treat accordingly. Had a fantastic Pilates instructor in the UK. She knew my condition and really helped me. Terrific. Surely do miss her. (Have a friend who is spondy but not AS. She 'refused' to go to the classes, downright would NOT go, said she was 'too large' to be 'seen' in workout clothes! Anyways, she went out and bought herself a Pilates 'work out frame', almost damaged herself for life! Even then, could not take on board the basics of the theory of Pilates and that it was *necessary to start at the beginning, with a fully qualified instructor, and NOT try going it alone with a frame, a video and an instruction book...! Nuff said.)

Go for the PT, but under instruction first. OK?

Oh yes. Back to those papers. Many a mention: instructed by my erstwhile UK rheumy to 'keep active', go to dance classes, walk, do Pilates etc. Also, same admonition by by new rheumy here in France. Found a paper written by him the other day, speaking of the 'multi discipline approach' to treating AS, *including PT*. Interesting. (Reminder, now with James pointing me in the right direction, I can get the paper translated into English! Thanks again James.)

Molly C (France)

all i can say is that the end result is very different for me.
if i don't manage a problem, it snowballs into a huge problem,
but if it is managed, it can be brought under control.

i think its like any chronic illness, if you let it go, it becomes a big mess.
but if you constantly work at it, maybe it doesn't get as bad, or takes a lot longer to get as bad.

that's my opinion, anyways,

you say you've had all of this done in the past. how recently?
you said its been 20 years since your last rheumy visit,
has it been a long time for PT as well?

if so, give it all another try. with the right doctors and therapists,
maybe you'll have as good of results as i've had.

it is a constant daily battle, but the option of just letting things take there toll just isn't an option to me. i'm gonna keep fighting to stay as functional as possible. PT has definitely been a part of that plan.

sue

I started to answer this and wound up explaining mostly my entire history. Don't know if it was long winded or just long, but i cut that out (saved it, however, if you really want to know). One of these days i will post "my story",a s it is a bit different from the typical. If there IS such a thing as typical. IT helps me to see that other people are "complicated" with other conditions besides AS.. ( altho i am NOT a "misery loves company". I HATE hearing of other people suffering...)

Yes, i have been to PT for every body part for many years, but am losing faith, especially where my shoulders are concerned. Going feels great but is really hard for me to get out of the house reliably (wheelchair) until the weather breaks. And when i do i prefer to swim (which of course is really ADDING to the shoulder stress)

however, the words of wisdom here, which i knew but i guess needed to hear.. "might help keep it at bay", "might SLOW the progress" are helpful. VERY helpful.

i hope my words of encouragement are just that, and sound like they might be.
i do mean them as words of encouragement and not as a "lecture" on how to carry on. so much easier to give advice, to give a pep talk to others, than to face our own fears and frustrations.....i certainly have plenty of my own demons......and i'm probably in relatively good physical shape comparatively speaking.

but i think sometimes the most important thing we have is hope and a belief that things will get better, and so i try very hard not to lose that, and if i do lose that for a short time, i try very hard to get it back.

that's all i want for you,

but i understand how hard it can be sometimes; hopefully we can all help each other out in this regard,

sue

Swim - Shoulders. Yes, I have 'shoulders'. One is a Copeland Hemi-Arthrosplasty (semi replacement) and the other is exhibiting problems: rotator cuff tear + possibly needs an SAD/ACJ. Anyways, whatever 'smile' (shoulders can be a right 'pain'!)

Suggest you visit a very good website on upper limb, with emphasis on shoulders: www.shoulderdoc.co.uk One of *the best (best?) shoulder websites out. It also covers shoulder problems found in wheelchair users. So, might find a nugget or two there. The website is *enormous. Find the site menu and take it from there.

Please feel free to pm me if you want.

Molly C

Molly:

holy crap. You are the shoulder EXPERT. i am SORRY to hear that.. I look very forward to checking out the site.

THANK YOU