I’ve been lifting weights for most of my life, and I’ve always liked that feeling after a good workout. Muscles are pumped, you’re tired, maybe you worked up a sweat, and you leave feeling like you did something.
The problem is I’m getting older, and my body is reminding me that being strong, fast, and explosive probably isn’t the only thing I should worry about anymore. I’m starting to make those weird grunting noises when I stand up from a chair that I feel like I’m still too young to be making.
And I know damn well what I need. More mobility, flexibility, yoga, soft tissue work, and all the body-maintenance stuff I’ve spent years telling patients they should be doing.
I’ve been trying to do more of it. I can spend 30 minutes doing exactly what my body needs, feel better afterward, and still think, “Did I even work out?”
Meanwhile, I can go for a run, come back sweaty and exhausted, and there’s no question. Hell yeah, that was a good workout.
Maybe mobility work isn’t really a “workout.” Maybe it’s maintenance, movement practice, whatever you want to call it. But I think that’s the point. What my body needs doesn’t always have to leave me exhausted.
And I think we can fall into that same trap with our patients.
A patient finishes a session sweaty, breathing hard, muscles fatigued, and says, “Damn, you really kicked my ass today.”
Come on. There’s a little part of all of us that likes hearing that. It feels like we did something.
But being tired doesn’t automatically mean the session was good.
There are absolutely times when I intentionally want to push a patient into fatigue. If we’re building strength, endurance, cardiovascular capacity, or walking tolerance, I may want their heart rate up and their muscles tired.
But that’s different from using fatigue as proof that the session was effective.
You can have someone walk lap after lap while reinforcing the same compensation or deviation. You can keep adding harder balance exercises, resistance, reps, and distance while they still won’t put full weight on the prosthesis.
That doesn’t necessarily mean you accomplished what they came to physical therapy for.
Sometimes the better session is slowing down and figuring out why they’re doing what they’re doing. Maybe you address a mobility restriction. Maybe you figure out why they don’t trust the prosthesis. Maybe you spend time working on motor control or priming their nervous system to get comfortable with something it’s been avoiding.
They might not leave drenched in sweat. That’s fine.
If your only goal is to make somebody tired, that’s easy. There are plenty of personal trainers with an online certification charging $50 an hour who can do that.
We’re supposed to bring more to the table than that.
Figuring out what that patient actually needs and getting them closer to it is the real skill set, and our job as physical therapists.
And I’ll keep trying to take my own advice when it comes to taking care of my own body.