Ordinary Chaos

Tag: Therapist

  • Dear Therapist: Can I Get My Brother to Leave His Wife?

    Dear Therapist: Can I Get My Brother to Leave His Wife?

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    Dear Therapist,

    My younger brother and I are both in our 50s. He met his wife about 16 years ago, and they got married in 2014. This is her third marriage, my brother’s first. They have one child together, who’s 13, and his wife also has three other children, each from a different earlier relationship.

    From the beginning, their relationship has been beset with problems. She accuses him of cheating on her, wanting to cheat on her, looking at other women, and lusting after other women on television, in restaurants, and when out walking the dogs. Things will be fine for a while and then the whole thing starts back up again. Over the course of this relationship, he has given up his hobbies and fallen out of contact with his longtime friends, and seems allowed to do things only with her and her family. I have watched as my brother has changed from a healthy and happy man to a shell of his former self.

    Every time she gets upset, he has to jump through more hoops, make bigger gestures, and flagellate himself more until she relents and stops punishing him. He has come to my house twice in the past year and stayed, because she told him she wanted him to leave. I have continually emphasized to him the importance of seeking professional counseling but he says she refuses to consider it, because the problems all come down to him and his (alleged) wandering eye. My brother is a kind, gentle, considerate man, and this hurts him deeply.

    I fear that my brother is the victim in an abusive marriage, and I don’t know how best to support him. I have told him repeatedly that he always has a home here and he can move in and stay for as long as he wants. I have also reassured him that his daughter wouldn’t be the only one in her friend group with parents who have decided to split up.

    I care about him very much and want him to be healthy, safe, and happy. Our mom and I both worry that his wife will end up breaking him to the point that he would harm himself. How can I help him?

    Dear Reader,

    Your letter paints a troubling picture of your brother’s marriage, so I understand why you’re so concerned about his well-being. The situation you describe is indeed alarming, as it bears many hallmarks of emotional abuse: the constant accusations, the isolation from friends and family, the gradual erosion of your brother’s sense of self, and the cyclical nature of conflict and reconciliation, also known as “the cycle of abuse.”

    In this cycle, things are calm for a time, but never for long. The tension builds and builds until there’s an explosion, followed by another period of calm, of promises, of temporary peace. Each time, the price of peace becomes higher. Your brother must make bigger gestures, offer greater sacrifices, diminish himself even further. This is painful to witness, especially when it involves someone you love.

    Clearly you care deeply for your brother, and your desire to help him end this suffering comes from a loving and compassionate place. But I want to tell you something that might be hard to hear: You can’t save your brother from this relationship.

    This doesn’t mean, however, that you’re powerless to help—far from it. But it does mean that you need to reframe how you think about your role. Once you accept that no matter how much you want to rescue him, your brother is the only one who can decide to change his situation, you’ll be able to support him much more effectively.

    Read: The longest relationships of our lives

    So what is your role? First, you need to understand his situation better so you can appreciate what he’s up against. Start by educating yourself about his experience so that you can understand why he engages in behaviors that seem baffling to you—such as his tolerance of his wife’s behavior and repeated begging for forgiveness for crimes he didn’t commit. You might feel that what he should do here is obvious: He’s in an unhealthy relationship and should get out. But bear in mind that abusive relationships frequently create a warped reality for the person being abused. Your brother has likely internalized many of his wife’s criticisms and may believe he truly is to blame for the problems in their marriage. This warped view makes leaving incredibly difficult for victims.

    Think of it this way: Your brother and his wife are locked into a dance where the music of their relationship has become a monotonous dirge of accusation and defense. The steps go like this: His wife searches constantly for evidence of betrayal. Every glance becomes a crime; every interaction becomes a transgression. And your brother? He hears the music of confusion, self-doubt, shame. So he does his part of the dance: constantly attempting (and failing) to prove his innocence. Unfortunately for him, he’s trying to prove a negative—how do you show someone the absence of something? How do you demonstrate faithfulness to someone who has decided that you are unfaithful?

    What makes this dance hard for you to watch is that the qualities you admire in your brother and that could make him a wonderful partner to a different person—his kindness, consideration, gentleness—have become the very things that his partner is using to manipulate him. The more he accommodates, the more his wife demands of him.

    You say that this dynamic has been present since their relationship’s beginning, so instead of trying to convince your brother that his partner is mistreating him, you might get curious—and help him get curious—about what has drawn him to such a partnership in the first place. She seems to have come into this relationship with a history of relational instability—three children from three different relationships, prior to a fourth child with him. If she didn’t work through the issues that led to those relationships ending, she entered this current relationship with a suitcase full of previous betrayals (perceived or real), abandonment fears, and unhealthy communication patterns. But instead of unpacking this suitcase, she handed it to your brother and said, “You carry this. You are responsible for all of it.”

    Read: Couples therapy, but for siblings

    At the same time, your brother came into this relationship with his own suitcase. You say that he and his wife dated for six years before marrying, and even after having a child together they waited another three years to get married. I wonder if part of him had doubts about whether he wanted to be in this relationship, and another part of him preferred the certainty of misery to the misery of uncertainty. What in his own history led him to make that choice, to confuse controlling behavior with evidence of being needed, or to decide that the relationship he had—with all of its intense volatility—was “safer” to stay in than to leave so he could find something else?

    Another way to support him is to encourage his curiosity. Your instinct might be to focus on his wife’s behavior, but a more helpful role is to provide a safe space for him to explore his own. Instead of saying “Your wife is abusive and you need to leave,” you can try “I’ve noticed that you seem unhappy this week. How are you feeling about things at home?” You can also gently challenge the narrative that he has internalized. When he blames himself for their problems, you might say something like “That doesn’t sound like the brother I know. The person I know is kind and loyal. I wonder if there’s another way to look at this situation?”

    Whenever possible, you can float questions (not all at the same time) that help him reflect: “Do you ever feel lonely?” “Have you seen so-and-so lately?” “Do you miss doing (insert favorite activity)?” “What would be different if you weren’t worried about her reaction?” After another fight that ends with him at your house, rather than suggesting couples therapy, you might say, “Maybe you’d find it helpful to talk with a therapist on your own, even for just one session.” If he worries about his daughter, you might ask, again with gentle curiosity, “What do you imagine she’s learning about self-worth or loving relationships as she observes the two of you staying together?” He may not be able to answer these questions aloud, but you’d be helping him begin to consider an alternative narrative to the one he is carrying around. Just as important, you wouldn’t be trying to control him with what you want him to do and think, as his wife is—you’d be allowing him to go inside himself and access his own thoughts, feelings, and desires, which is a crucial step in a process that includes questioning, awareness, and finally, if he chooses, action.

    As you open up this space for him, remember that just as your brother is overly focused on his wife’s unhappiness, you don’t want to be overly focused on his. Supporting someone in an abusive relationship can be emotionally exhausting and shouldn’t come at the expense of seeking support (such as therapy) for yourself. Your brother is fortunate to have such a caring sibling, but if you want to model healthy boundaries in a relationship, make sure you’re taking good care of yourself too.

    Dear Therapist is for informational purposes only, does not constitute medical advice, and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, mental-health professional, or other qualified health provider with any questions you may have regarding a medical condition. By submitting a letter, you are agreeing to let The Atlantic use it—in part or in full—and we may edit it for length and/or clarity.

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  • The Best Balance Boards of 2024, According to a Physical Therapist

    The Best Balance Boards of 2024, According to a Physical Therapist

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    Balance boards come in all shapes and sizes, so it’s important to find one that fits your needs.

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    LIVESTRONG.com Creative

    The small stabilizing muscles in your body play a role in pretty much every action you do. But unlike your biceps or glutes, they’re pretty tricky to max out with standard strength-training exercises. Enter: the balance board.

    Balance and wobble boards can help build strength in these small muscles all over your body, improving your stability, balance and proprioception (your sense of body positioning), says Winnie Yu, DPT, CPT, a New York-based physical therapist. In the long run, that adds up to improved sports performance and a lower risk of injury.

    To help you start building balance and stability, we chatted with Yu and picked out the best balance boards you can buy, as well as what to look for. We chose our top picks based on her recommendations and the following criteria:

    • Price
    • Material
    • Size
    • Versatility

    Learn more about how we cover products here.

    The OG balance ball is ideal for all levels of athlete and all sorts of workouts.

    When you think of a balance board, the BOSU (short for BOth Sides Up) is probably what comes to mind first — and for good reason.

    “I love the BOSU, because it can be used in so many ways and to train so many different muscle groups,” Yu says.” It’s definitely one of my go-to choices of equipment for my patients at any stage of rehab.”

    You can use this trainer flat-side up or dome-side up for strength, stability, flexibility and agility training. And considering it weighs about 8 pounds, you can use it as a strength tool, too.

    2. EVERYMILE Wobble Board

    At less than 16 inches in diameter, this wobble board is space-friendly and has handles for easy carrying.

    Don’t have a ton of free space for a BOSU or two-piece balance board in your home gym? This board is an ideal alternative, according to Yu. It’s a smaller and lighter version at only about 3.5 pounds, so it’s easy to carry around the house.

    The textured flat top also helps you grip the surface, meaning you don’t need to worry about slipping off while you work on your balance.

    Strengthen your midsection with this unique balance board that utilizes phone games to improve core strength.

    Let’s face it: Planks, no matter how beneficial they are, aren’t the most exciting exercise. But this core-training board adds a little fun, according to Yu.

    You can place your phone in the cell-sized hole on the board and play games while training your core. Every purchase comes with four core-strengthening games to help keep you engaged (pun intended) and track your progress.

    4. ProsourceFit Core Balance Disc Trainer

    This beginner-friendly disc helps develop base-level balance.

    Yu recommends this balance trainer for anyone who’s trying balance board exercises for the first time. In her physical therapy practice, she uses this type of device for early stages of rehab.

    It offers a flat yet unstable surface for you to build foundational stability and strength, she says. And the cushion is safe for sensitive joints like knees and ankles.

    5. Revolution Balance 101 Board Trainer

    Skilled athletes can use this board to hone their balance and improve reactivity.

    This board is best for high-level athletes who want to challenge their core stability or reactive skills, Yu says. Less stable than other picks, this one provides a greater challenge for developing skills in sports like skateboarding or ice hockey.

    Unlike standard wooden balance boards, this one has a high-grip, cushioned surface, giving your feet a little extra comfort.

    6. Revbalance FIT 3-in-1 Exercise Board Training System

    This balance board is great for all fitness levels because you can make it easier or harder to use.

    This board includes a cushion, half-rocker base and roller, all of which add a different level of challenge to your balance exercises, according to Yu.

    So, instead of buying a new board as your stability improves, you can start with the cushion, move to the half-rocker as you get more comfortable and finally progress to the roller when you’re confident in your skills.

    “I like that this board gives users the option to vary their training to match their goals at different parts of rehabilitation and fitness levels,” Yu says.

    7. Huku Core Fit Balance Board

    Use this beautiful board to develop your balance, work on your core or practice surf skills.

    The Huku board is more than just a balance board — it’s a piece of multipurpose training equipment, Yu says. Sure, you can use this board for standard balance and stability exercises. But considering it’s made with soft cork, you can also use the roller for muscle recovery. Plus, the soft material keeps your floors scratch-free.

    8. URBNFit Wooden Trainer

    Practice your skateboarding skills with this balance board.

    Anyone looking to include a higher level of balance and coordination training in their workouts is sure to love the URBNFit, Yu says.

    Thanks to its high-grip tape, this skateboard-style board provides a safe surface to practice the skills and body control needed for sports like surfing, snowboarding and (of course) skateboarding, she says.

    9. Gentle Monster Wooden Wobble Balance Board

    This balance board is kid-friendly and stylish enough to leave out in the playroom.

    You don’t have to watch your kids run around the backyard or playground long to know they’re bound to fall down. A lot. But building balance and stability from a young age can help prevent injury. And this wooden wobble board is a great way to do so, Yu says.

    “This is a fun, versatile option for postural and sensory development that I would definitely use with a pediatric patient,” she says. After all, helping your kids build good posture at a young age has benefits for years to come.

    3 Factors to Consider When Buying a Balance or Wobble Board

    Your current balance and stability level is the first thing to consider before you buy a board, Yu says.

    For beginners looking to build foundational stability, a BOSU ball or rubber balance trainer are the safest options. They offer more stability than skateboard-style balance boards and are usually made with a softer material for extra joint protection.

    Those looking to improve their balance for a sport are probably advanced enough to use a device with a rocker at the center. These are the least stable variety and require quite a bit of strength and stability to use, Yu says.

    Tip

    If you’re buying a wobble board as a part of an injury-rehab protocol, it’s best to ask your doctor or physical therapist to make a recommendation. That helps guarantee you stay safe and injury-free.

    There are tons of different balance boards out there, all with different surfaces and materials. Although there’s no one material that’s best for everyone, Yu prefers either plastic or rubber, rather than wood, because boards made of those materials last longer and offer a little more protection for your floors.

    But if the product you like happens to be made out of wood, you can put a towel or yoga mat under your board to protect scratch-prone surfaces.

    The best balance boards range anywhere from $15 to $200, so your available budget plays a part in which boards fit your needs.

    Tip

    A lot of gyms and physical therapy offices already have balance trainers. Play with them! Once you try them out, you’ll have a better idea how much money you want to invest.

    More Gear We Think You’ll Love



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  • Dear Therapist: My Relatives Don’t Believe My Parents Were Abusive

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    Dear Therapist,

    I was abused by my parents as a child and have limited contact with them now. I did try in my early 20s to have a relationship with them, but I saw no change in their behavior. In addition, they both flat-out deny the things they did, including dragging me by my hair from a dead sleep in the middle of the night down three flights of stairs, throwing me in the basement and locking the door, telling me repeatedly to do them a favor and kill myself, and beating me.

    I try to maintain a relationship with my aunts, uncles, and cousins—who themselves have some problematic behaviors—but I find doing so difficult because they, too, tell me that my childhood wasn’t that bad and that I should love my parents unconditionally. They will invite my parents to events I will be at without telling me. If I find out and say I will not attend because I do not want to see my parents, they will tell me I’m being difficult. They will also bring up my younger sister, who has always been and continues to be my parents’ favorite. While her childhood was by no means easy, she did not experience as much abuse as I did and was shown much more loving behavior. For example, my father would spend one-on-one time with her as a child, something I never got. Meanwhile I was sent to live with an aunt and uncle because my parents “needed space.” My relatives will claim that my childhood couldn’t have been that bad if my sister is able to have such a good relationship with my parents.

    I realize my parents will not change, and because I cannot accept their behavior, I have chosen to have limited contact with them. I would prefer to have no contact, but that is difficult while trying to maintain contact with my extended family. How do I maintain a relationship with my extended family without feeling so hurt or unheard?

    Dear Reader,

    I’m sorry for all you had to endure growing up, and for the repercussions you’re left to struggle with as a result of your parents’ behavior. I’m also sorry—but not surprised—that your family is minimizing, if not outright denying, your abuse. That must feel absolutely maddening to you.

    Unfortunately, your situation is all too common, for reasons inherent in the nature of child abuse. Although the U.S. Department of Health and Human Services says that more than 3 million cases of child abuse are reported each year, that is surely an undercount. If the abusers are family members, as tends to be the case, other adults in the picture aren’t likely to report their relatives to authorities; children, for obvious reasons, can be afraid to speak up. Complicating the situation further, perpetrators of child abuse might not even recognize their behavior as abuse. Because society is so poorly educated about what constitutes child abuse, physical and verbal abuse can, in some people’s minds, be mistaken for “discipline.”

    Because of all this, many children suffer alone, with nobody to turn to for help. Some children blame themselves (“If I were a better child, they would treat me well”) while others realize that their parents are damaged and hold out hope that once they reach adulthood, they will be free. Except, as you’ve seen, abuse leaves trauma behind, and the effects ripple throughout the family system for years—which explains the bind you’re in now.

    Read: Can children be persuaded to love a parent they hate?

    You say that you want to maintain a relationship with your extended family while also feeling seen and heard, but the truth is you might not be able to have both. More likely, you have a difficult choice to make. As we explore each option, let’s bear in mind that your goal is to hurt less. What actions might get you closer to a less painful situation?

    Your first option would be to try one last time to have a conversation with a relative who you think might be most receptive—perhaps a cousin your age, or the aunt or uncle who took you in when your parents “needed space,” considering they must have known something was amiss in your household. Given that you shared with your relatives the reasons for your parental estrangement and they’ve dismissed your experience as being “not that bad,” I don’t know how much hope there is that they’ll really hear you this time. They seem to have repeatedly ignored you and denied reality, which makes me think that—for their own reasons—they’re emotionally invested in believing the narrative that your childhood was different from what you experienced. Taking that into account, let’s think through how to talk with them in a way that validates that relative’s experience as well. You might say something like:

    There’s something I’d like to talk about with you, and I know this is delicate, but I really value our relationship and I feel that having an open discussion about this will bring us closer. I know that you want to maintain a relationship with my parents, and I don’t want to interfere with that in any way. But I also feel dismissed when I share the truth of what happened in my childhood. I believe that if you really imagine what it was like for a child to be dragged by her hair, locked in the basement, beaten, or told to kill herself, you would have empathy for that child’s experience. But because the people who did this are people you love, I understand that you might feel as if you’re stuck in a challenging position—that if you acknowledge my experience, you are somehow betraying them, or that believing me might even make you feel differently about them.

    Please know that I genuinely want you to have whatever relationship you’d like with my parents, and I’m not here to disrupt that at all. But for me to have a relationship with you, it’s important that you acknowledge what I experienced and respect my request to let me know in advance if my parents will be at an event so that I can make an informed choice about attending. You might believe that love is unconditional, but I believe that love is a verb—we act lovingly toward those we value. In that spirit, I hope that you hear my request with the loving intentions behind it, because I think having this understanding will make our relationship more meaningful and enjoyable for both of us.

    Acknowledging the awkward position your relatives might find themselves in as they try to navigate simultaneous relationships with your parents and you could help make them feel less defensive and also more heard and seen in the way you want to be. It can’t be easy for them to reconcile the people they want to believe your parents are with the reality of what you’re telling them. Giving their predicament some validation might make it easier for them to receive your request with more openness and understanding, and instigate a shift in their behavior.

    Read: Why don’t we teach people how to parent?

    If, however, they remain unreceptive, a very difficult choice awaits you. I appreciate that you might get some good things from being in a relationship with your extended family, and that you’d be reluctant to give those things up. Sometimes people make the calculation that having hurtful relatives is better than having none at all. You can, if that’s how you feel, accept that they won’t change but gain some benefit from maintaining these relationships in more successful ways—perhaps best done one-on-one instead of at family occasions where your parents might be, or by not engaging in conversations about what did or didn’t happen growing up and keeping things on a more superficial level. But a second option is available to you, and, given the depth of your ongoing pain, maybe it’s worth considering.

    Let me frame that choice this way: Your relatives are at best enablers and at worst accomplices to your parents’ abuse. By denying what actually happened and saying that you’re the difficult one, they are gaslighting you, and gaslighting is itself a form of abuse. They have made you seem like the problem instead of your abusive parents. You might have transferred your desires for support and validation from your parents onto your other relatives, but they have shown that they, too, refuse to acknowledge your parents’ actions. In fact, they insist that you love your parents unconditionally despite what they did to you and then disregard your wishes to keep yourself safe from their presence.

    Unless you can drastically alter your expectations of them, you will continue to feel hurt and unheard, which could be the compromise you settle on—but it might also be too much of an emotional price to pay. You distanced yourself from your parents after realizing that they wouldn’t change and you could no longer endure their behavior. Similarly, you may decide that the only way to take care of yourself is to apply the same standard to those relatives who are causing you ongoing pain.

    This won’t be easy. Breaking with your parents maybe seemed more warranted, because your parents’ abuse was more pronounced. But just because your relatives’ behavior is subtler doesn’t mean it’s less insidious or harmful in the long run. Most people who were abused carry a deep wish that someone in the family will “get it”—see them and acknowledge their experience. Yet sometimes that validation and support won’t ever come from the family and has to come from another source that you have the agency to create, often referred to as a surrogate family or family of choice—a family that understands that love does come with conditions, which makes it all the more precious.

    Of course, sometimes people who cut off ties with their parents can retain or even strengthen ties with extended family. But many also find they have to break up with the whole dysfunctional crew to save themselves. If you make that choice, you’ll have to grieve a series of tremendous losses: of the childhood you deserved, of the validation and support from other relatives who should be there for you, of the sense of safety and emotional security that comes from being part of a healthy family system. But you might ultimately gain an emotional freedom from the kind of pain the current situation repeatedly exposes you to—the benefits of which you may not even be able to imagine.

    Dear Therapist is for informational purposes only, does not constitute medical advice, and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, mental-health professional, or other qualified health provider with any questions you may have regarding a medical condition. By submitting a letter, you are agreeing to let The Atlantic use it—in part or in full—and we may edit it for length and/or clarity.

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  • When to See a Physical Therapist: 7 Signs Something’s Off

    When to See a Physical Therapist: 7 Signs Something’s Off

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    Don’t let these common reasons for physical therapy keep you from staying healthy and active.

    Image Credit:
    Daniel de la Hoz/Moment/GettyImages

    Physical therapy isn’t just for after surgery, and it’s not just for rehabilitation — those are some of the most common reasons for physical therapy, but in fact, a physical therapist can help you maintain (and improve) whole-body health.

    “Everybody should have a physical therapist on hand, and treat it more like going to the dentist. Everybody has a dentist. You do your checkup every six months, get things cleaned up, and it’s preventative care,” says Renato Sanchez, DPT, CSCS, physical therapist at Bespoke Treatments in San Diego. “It’s the same thing for physical therapy.”

    Instead of checking for cavities, though, physical therapists can make sure your movement is clean, he says. That will keep you up and at ’em, and away from injury. (And away from the PT office for non-preventative reasons.)

    And with changes in insurance coverage that address wellness more than just sickness and injury, physical therapy is easier to access, with these types of visits often covered, says Scott Cheatham, PhD, DPT, a professor of kinesiology at California State University, Dominguez Hills, and a NASM-certified personal trainer.

    “Traditionally in the U.S. healthcare system, physical therapy has always been looked at as post-surgical or post-injury rehabilitation,” he says. “As we start getting more knowledge about the importance of regular exercise and lifestyle modification, the physical therapist has become a key healthcare provider, and a direct access provider for active individuals.”

    The term “direct access” means that patients can see a PT directly, without a referral, Cheatham says. Because of this, their offices are prepared for patients to call for reasons that aren’t rehab.

    When making an appointment for a movement checkup, some lingering pain or any of the other reasons below, Cheatham says, communicate your goals for seeing a PT, whether it’s a pre-exercise screening, to address lingering injury, or one of the other reasons listed below.

    Clear communication and goal setting will help the physical therapist be ready to assess your movement and provide corrective movements, exercises and strategies that can help.

    Here are seven situations where a physical therapist (really, a movement specialist) can help improve your health and wellbeing.

    1. Before Starting a New Exercise Program

    Many workout programs and classes have a disclaimer that you should see a doctor before starting a new exercise program. A physician can help determine if you’re healthy enough for that activity — if you’re at risk for heart or lung problems as a result, for example.

    But visiting a physical therapist before you start can help make sure you’re ready from a movement perspective, Cheatham says.

    “The physical therapist can screen for potential injuries. They can screen for flexibility, proper strength and the proper endurance to be able to work out,” he says. “And then they can make recommendations for safe exercise.”

    Some patients, Sanchez says, fear that this kind of screen or visit will result in the PT telling the patient not to participate in the exercise, or that they need a long rehab process before they can. That’s rarely the case.

    “The worst thing I can tell someone is that they can’t do the thing they want to do,” he says. Instead, the PT may provide you with a few moves to do ‌before‌ your new activity — a short warmup or other movements that can help you participate with more confidence and a lower risk of injury.

    2. You Have Pain From Exercise

    When many people experience joint or muscle pain from a workout at the gym, a run or another type of workout, they have the same reaction, Sanchez says.

    “They tend to just take a week or two off and think, ‘I’ll try again in a week or so,’” he says. “They’ll completely stop whatever they were doing, whether it was a single movement, or training in general, and expect it will just get better.”

    Sometimes, this works. But the time off can also make you weaker in the surrounding muscles due to a lack of use, or the pain may not go away.

    If you experience acute pain from an exercise, stop doing that exercise during that session, Renato says. If your back hurts from a deadlift, for example, don’t keep deadlifting and make the injury worse. But instead of just laying off it for a week or two, consider seeing a PT right away.

    “If you go to a PT right away, you’ll end up with strategies [for overcoming the pain and moving better], instead of just guesswork,” he says. You may actually need to take less time away from the exercise than you would by simply resting.

    And if there’s more to the injury than can just be fixed with PT, Cheatham says, the physical therapist will know, and will be able to refer you to a doctor for further examination.

    3. You Can’t Perform a Movement You Used to Be Able To

    If there’s a movement you used to be able to do — at home or in your workouts — but you can’t anymore, don’t just chalk it up to aging, Sanchez says. And don’t just “work around it.”

    “Any time there’s a movement you used to do, and you feel like you have to modify it, or you’re restricted in certain situations, you should go to PT,” he says. “Physical therapists are movement specialists for a reason. So we would do an in-depth assessment to see what is going on, and then tell you to continue doing what it is you’re doing, but with some tweaks.”

    For example, if a patient who loves to surf is having trouble with shoulder pain while paddling and has had to change their stroke, Sanchez says, he doesn’t tell them to stop the activity they love. Instead, he might provide a short warmup routine that helps them move their shoulder in the way that it used to, as well as a daily five-minute routine that can help strengthen that movement pattern.

    4. You Have Numbness or Tingling

    Numbness or tingling can point to an injury at a nerve root, Sanchez says.

    “If someone goes for a deadlift, and they wrench their back, they might have shooting, sharp pain down their leg, and they might lose some function of standing on their toes on one side,” he says. “More than likely, there is an injury at a specific nerve root as it exits the spine.”

    This doesn’t just happen with back injuries. Neck injuries can result in numbness in the arms and nerve pain in the shoulder, for example.

    If you’re feeling numbness or tingling in your extremities, consult a physical therapist and your doctor. The PT may be able to help improve movement patterns that are causing this nerve impingement.

    5. You’re Losing Mobility and Flexibility

    Spending lots of time in a chair can stiffen you up. This type of mobility and flexibility loss is in the scope of what a personal trainer can do, says Sanchez, who’s both a physical therapist and a strength coach, working as a personal trainer.

    But if you work with a personal trainer for a while, and nothing is really improving, you should seek out a physical therapist (and your trainer is likely to want to refer you to one).

    That’s because personal trainers and physical therapists are part of your personal healthcare ecosystem. In this universe of care, Cheatham says, different practitioners care for different parts of your health, and can help refer you to others for other portions. For example, your physical therapist may have a close relationship with a nutritionist or acupuncturist, if you need these types of services.

    And a personal trainer most likely has a close relationship with a physical therapist they trust. So if you need a new part of your health ecosystem, don’t just Google: Ask health practitioners you already trust for a recommendation.

    6. Before and After Surgery

    Physical therapy is often prescribed for after surgery to help patients recover faster and get back to moving in a normal way. If your surgery doesn’t include PT, you can still consider it, Sanchez says. But he also suggests heading to a physical therapist ‌before‌ going under the knife.

    “If someone tears their ACL [anterior cruciate ligament, one of the ligaments in the knee], they’ll just stop completely. They’ll say, ‘I’ll just start rehab after the surgery,’” he says. As a result, they stop moving all together. “All these things you’ve been training and training for, you’re losing them. You don’t have to.”

    Pre-surgery PT, he says, can also help strengthen and prepare your body in such a way that you’ll recover faster when you do begin post-surgery rehab. Because the other movements and muscles that you can use before surgery stay strong, you won’t have to re-strengthen them while you’re rehabbing the repaired portion of your body.

    7. Before and After Having a Baby

    “If you’ve had a baby, you should definitely go see a PT,” he says, to assess the function of your pelvic floor.

    Post-natal incontinence, where women experience bladder issues when doing something strenuous, has become normalized, he says. But it doesn’t have to be permanent. These troubles are often due to issues in the pelvic floor and the surrounding muscles, and a PT who specializes in post-natal or pelvic floor care can help.

    Sanchez also suggests seeing a physical therapist who specializes in these areas before giving birth. As with surgery, seeing a physical therapist during the pre-natal period can help make mothers stronger for the process of giving birth.

    “You’re going to know how to move all your pelvic floor muscles, your diaphragm, your rectus abdominis, all of it,” he says. You’ll be able to breathe stronger and feel stronger through the process.

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