Get the right solution only if you know the right question

Written by: Paul Kochoa, PT, DPT, OCS, CKTP, CGFI

Being a medical professional, I always seem to run into people asking me questions about what to do about a certain problem they have.  For example, “Can you give me a couple core exercises? I have some back pain.”  The problem is that I can’t give the right answer without knowing the right question, which means, your back pain may be from something else.

This was inspired by my experiences with the Titleist Performance Institute (TPI), movement screens and analysis, and by physical therapist Gray Cook.  His great quote goes something like, “Never bring a fitness solution to a medical question.”  It’s a premise also used by the instructors of TPI and pretty much dictates what and how to fix someone, especially when they have movement deficits.

When it comes to exercise prescription, this goes out to all my fitness instructors out there too, you can’t prescribe a set of exercises to someone without knowing what exactly the problem is or if they have movement deficits.  Giving every patient or client with low back pain some core strengthening exercises may not be the best or right thing to do.  If the patient has inherent movement deficits and cannot perform the simplest abdominal curl, then why give them sit ups or physioball work to do?  Or what if they have pain with the movement, what then?

According to Cook, it starts with a movement screen like the Functional Movement Screen (FMS) or a similar tool used by medical professionals, my tool of choice is the Golf Movement Screen, developed by TPI for specific use with golf athletes.  Unless you can find the deficits in just how a person moves, then you can’t prescribe the correct exercise.  This comes from personal experience as well.  There have been many times I’ve caught myself in a rut and giving out generic programs, but then I’d run into times when those generic programs and protocols didn’t work.  So then I’d have to start from the beginning and look deeper into a person’s movement patterns, coordination, mobility, or stability issues.  Believe me, it’s easier to always move forward and progress than try and go back and start over.

The bottom line is always make sure that you’re asking the right question when you’re looking for the right answer.  If it’s truly a medical problem, don’t try and solve it with plain exercise.  Consult a physiotherapist to find out if you’re asking the right questions.

If you would like more information, please call Professional Physical Therapy and Training at 973-270-7417.  Our offices are located within the YMCA locations in Madison and Summit, NJ.  You do not need to be a member of the YMCA to visit with us.