Dr. Joi Edwards Answers Your Physical Therapy Questions
Dr. Joi Edwards, PT, COMT, LMBT, has over a decade of experience in the health and physical therapy fields, maintaining a specific focus on massage and manual therapy. She’s the owner of Touch Therapy, treating physical therapy clients with an arsenal of knowledge and unique hands-on techniques. Here, she shares some serious wisdom in response to specific questions from the CGH community.
Mailande: Hey, Joi! So, you’re both a massage therapist and a physical therapist, specializing in injury management. How’d you get onto this path?
Joi: I have a bachelor’s degree in recreation, but I’ve always been asked if I ever wanted to do sports medicine when I grew up. I blew out my knee as a high school athlete, and I had to do physical therapy after my surgery. Being able to go from being injured badly to being able to go back and excel was amazing. The transformation was such an emotional and spiritual journey. I thought “Aha, wonderful!” I knew that I’d love to help other people make that transition, so I got my doctorate in physical therapy. I’ve always had a hands-on approach, and I have a specialization – which took me five years to obtain – in orthopedic manual therapy.
I compliment my PT sessions with exercise, but I think that, for the most part, people don’t drive 30 minutes, or however far they come in, to stand in a corner and perform exercises that they can do at home. Orthopedic manual therapy is joint mobilization, similar to what a chiropractor does. There’s a lot of pushing on body parts. So that wasn’t exactly a massage focus, but I did a little when my clients were hurting. Later, I went back to massage school, to compliment the hands-on work I was already doing. I just use all three things: the orthopedic work, the massage, and the classic PT.
Mailande: Very cool. Yeah, as someone who’s had a lot of physical therapy, you definitely don’t want to shot up and have someone be like “Okay, go do this over there” and that’s it. You’re like, “Why did I drive over here for this?” With that in mind, who can benefit from incorporating massage into their wellness or PT routine?
Joi: I think that the hands-on stuff, especially in physical therapy, is underutilized. I see some orthopedic patients that have balance or vertigo issues, and those folks are guarded because they don’t want to fall. They’re tense. So those people, too, can benefit from some massage therapy to relieve some stiffness that the guarding has caused. You can do other activities too, but I think 90% of people, if not more, could benefit from hands-on therapy.
Mailande: Gotcha. So, now, I’ve got some specific questions from the CGH community for you. First up: If someone is wanting to get back into shape but is pretty out of practice with different kinds of fitness and experiences that general-but-mysterious kind of knee pain, what should they do?
Joi: People have knee pain for different reasons. A lot of times, if you’re sedentary and you haven’t worked out for a while, it’s a lot of stress on your knees when you start back. And usually people don’t start slowly – they go hard with aerobics or P90X or whatever. So if your knees are hurting and you don’t know why, my advice is to back off, ice them for about a week, and then start back gradually. Start walking for 15 minutes, then 30. But don’t go right into running, right into squatting, right into the elliptical. Be gentle with your joints. It’s like a car – you’ve got to warm up before you ask yourself to go 100 miles in five seconds
Mailande: That makes sense. Okay, next question. Now, this happens to me: what does it mean when your knees make that weird creaking sound? What is going on?
Joi: There’s actually a term for that, called crepitus. It’s a horrible-sounding word. And it usually comes from simple wear and tear. After your teenager years, your joints just get worn down – I liken it to a train that’s just slightly off the track. Before that wear and tear, everything is nice and smooth and sits together. But as we gain weight or start to age, the puzzle pieces don’t fit as well. So when you hear that sound, it’s annoying, but it’s not necessarily doing any more damage than what’s already there. Unless you have pain with it, it’s nothing huge to worry about. And if it happens, say, while you’re doing squats, just don’t bend your knee past the point where they creak if it’s making you uncomfortable. You can always adjust your movements.
Mailande: Cool. So what about if you sit in front of the computer a lot for work and are experiencing some neck or shoulder pain, or headaches? Do you have any advice for avoiding those injuries?
Joi: The best approach is to keep your neck aligned. Usually when we sit in front of computers for long periods of time, we adopt terrible posture. And then your muscles get overworked and start to ache. That can lead to tension headaches, so one of the best things is to get up every 15-30 minutes if you can. There are stretches you can do, too: for example, take your left ear down to your left shoulder and stretch out the right side of your neck, hold for 10-15 seconds, and then do the opposite, making sure you’re not bringing your shoulder up to your ear by accident. It’s also important to make sure that your computer, keyboard, and monitor are all correctly aligned – there are a lot of helpful diagrams for this. And you can always get a massage to work the back of the neck and shoulders for tension headache relief.
Mailande: How often do you recommend that people get massages?
Joi: I think at least two per month is good maintenance. Every two weeks, about 60 minutes or so. I say that because a lot of people can’t afford to go weekly. And in between, take warm baths and showers, and stretch. I think stretching every day is key to keeping your muscles healthy.
Mailande: Gotcha. Next question – wow, I have literally no idea what this is. One question that we got was “What is cupping, and what’s the difference between that and a normal massage?”
Joi: Cupping is an ancient eastern medicinal method in which they put fire inside of glass cups and apply the cup to the body until the fire goes out, so there’s a suction that gets created. It’s really cool, and it targets the fascia, which exist alongside muscle and bone. Fascia is like a spiderweb, a very strong spiderweb, but it’s very thin, a kind of sheath, and it encapsulates every muscle, every organ. It’s what gives your muscles shape. Muscles can get tight from injury, from stiffness, from being sedentary, from a number of different reasons. And when the fascia gets tight alongside the muscle, it decreases blood flow and pulls on your nerves and muscles. With cupping, you can massage the area with that suction, and it’s wonderful. There are methods now that don’t actually involve fire, too. I think you should try it!
Mailande: That sounds awesome. I’m super interested. OK, next question: What should you do if you have pain on the bottom of your foot or heel?
Joi: A lot of the time, the source of that pain is called plantar fasciitis. A lot of time shoe inserts can decrease the stress that causes it, but the best bet is to actually go see a physical therapist. That fascia tissue that I was talking about before exists in a band on the bottom of your foot, and sometimes it gets pulled really tight by high arches, improper footwear, or excess weight. Sometimes changing shoes or massage can really help.
Mailande: Okay, great. So, next one: How do you know whether to use ice or heat when managing pain? I’m still fuzzy on this one, actually.
Joi: My general rule is this: for the first three days, if you’ve just injured yourself and it’s fresh, ice is your best bet. Ice helps to control swelling, inflammation, and pain. Thereafter, you can alternate ice and heat; everyone reacts differently. But those first few days are crucial: always ice.
Mailande: That’s really helpful. On that note, what are the most common mistakes that we make when we’re trying to self-manage injuries?
Joi: Doing nothing. A lot of people say “Oh I’ve had this pain for a week or a month,” and I say “Okay, what did you do?” And they say, “I didn’t do anything. I just thought it would work itself out.” Don’t do that! And don’t always take the experiences of others as fact; different people react to injuries differently. It’s always wise to seek medical advice for any kind of injury, rather than relying on your cousin or that person at the grocery store.
Mailande: Yeah, I’m making a note to myself, because sometimes I hope pain will just go away because I don’t want to deal with it. And you’re correct: it almost never works. Staying on the specific injury front, what is a rotator cuff injury, and how long does it take to heal? Does it always require surgery?
Joi: Rotator cuff injuries can occur for a lot of different reasons. If you have to repeatedly lift things overhead for work or something, for example if you’re a librarian or a shelver at a grocery store, that can cause a tear. If it’s a small or incomplete tear, a lot of times those will heal with rest, ice, anti-inflammatories, and specific exercises to strengthen the rotator cuff. And it just takes a little bit of time. Maybe four weeks for those.
On the other hand, you’ve got the seriously traumatic injuries, I had a close friend of mine that went up to dunk a basketball, and his arm got caught in the net; his body weight dropped, and his arm stayed in the net. He tore several of those rotator cuff muscles severely. He had surgery two days later, and rehabbed for 12-14 weeks. So, like many injuries, the healing depends on the severity.
Mailande: Okay. We’ve also had a lot of people ask about fitness apps. Do you have any recommendations for good ones?
Joi: I’m a yoga person, so I have the Daily Yoga app on my phone. There’s a Yoga for Runners class, a Yoga for Abs, all kinds of stuff. Each class ranges from 10-30 minutes, and I try to do that on a daily basis.
Mailande: Awesome, thanks! It’s been lovely talking with you. You have such a positive presence, even through the phone!
Joi: That’s so great to hear! I love what I do. Somebody asked me awhile back – this was before I became a massage therapist – and I thought, I don’t know, but at the time I was actually massaging somebody’s foot! And I looked down, and the light bulb went off, and I was like “This is what I’m going to do, it’s awesome!” When I was in massage school, I’d get home in the evenings and I couldn’t sleep – I was just so excited about what I was learning and what I’d be able to do in the future. It was like falling in love.
Mailande: That’s so cool. I love hearing about that about anyone in their chosen profession.
Joi: Yes. It makes me happy. It really does.