Daniel O’Donnell got hurt several times as a high school athlete and became intrigued by how the physical therapists helped him heal.
“From that exposure the interest grew and grew,’' he said.
He specialized in the field at Florida International University, graduating in 1982. The longtime Clearwater practitioner is currently director of physical therapy at Therapy & Sports Center. His bio states that he’s one of 37 physical therapists in Florida who are certified in the McKenzie Method of Mechanical Diagnosis and Therapy.
O’Donnell, 64, talked with the Tampa Bay Times about getting muscles, bones, joints and tendons to function properly.
What is the McKenzie Method?
The McKenzie Method is a method of assessment. That’s basically what it is. What we’ve had problems with in physical therapy is our methods that we used, that we learned … to assess musculoskeletal problems. What we typically learn and get exposed to hasn’t had a good effect on outcomes because the assessment process has been relatively unreliable or essentially invalid. So what Robin McKenzie did was, he created an assessment process of repeated movements and positions by which a valid and reliable conclusion can be made by the assessment and therefore an appropriate treatment and a better outcome.
So, traditional methods of diagnosing a patient’s problems can result in using corrective measures that may be opposite of what should be done?
That’s exactly right. And it’s been proven that that’s what happens.
Are all physical therapists starting to adopt the McKenzie Method?
It is gradually becoming embraced, at least in the milieu that I work in, outpatient physical therapy, only because the outcomes are being proven and their statistics are showing that this is a more accurate and more expedient and cost-effective way.
What are the main problems you see that people have?
All of health care is 20 percent of our basic economy in the United States, and 20 percent of that 20 percent is musculoskeletal disorders, which is joint, muscle, bone and any dysfunction that envelopes those parts of the anatomy. ...
We see everything, from post-surgical rehabilitation to injury that doesn’t require surgery at various levels, to some of it is just prevention. Someone has a premonition that they’ve got something and not quite sure what they may be dealing with, they go to a physical therapist and that can be assessed and a preventative or even maintenance strategy can be applied.
You work with a lot of people who are recovering from hip and knee replacement surgery. What’s the harder one to recover from?
Knee replacement is the most significant time, discomfort and effort at recovery.
It would seem that hip replacement recovery would be more difficult.
It’s not. It’s a bigger, deeper joint that doesn’t require that much rehab and it is much less uncomfortable, and secondary problems are much less. The new hips … where they do the front approach to the new hips, and not every orthopedist does this, but the new approach is really sweet. It has a very low chance of dislocating after surgery. It is very low on the level of pain after surgery. People need much less recovery time and recovery effort.
Why is that?
It’s called a total hip arthroplasty, anterior approach. … That means instead of going from the back or from the side and having to cut some of the muscles of the hip, that isn’t done. More, it’s moving those structures to the side and being able to put the appliance in without too much soft tissue injury.
Why is recovering from knee replacement harder?
It’s difficult because the structure of the joint is such that you get the whole joint, the top of the joint, the bottom of the joint and behind your knee cap, all those things are replaced. And when they are replaced some of the ligaments have to be sacrificed. … They have to be removed just like the osteoarthritis is removed from the joint. … The appliance is attached to the bone on the top and bottom of the joint and behind the knee cap, and then the process of regaining motion, which is pretty difficult for most people, and then regaining strength so as to have a good functional outcome is time-consuming and can be uncomfortable.
Is jogging bad for your joints?
No, jogging is not bad for you. And we can look at this from a global view and say that, really, no exercise is bad for you if it’s done well and at a level that the individual is capable of receiving it.
But do joggers and runners have to warm up?
A sprinter needs a significant warm-up. A jogger doesn’t need that much warm-up. The first half mile can do as a warm-up. But where people get injured is when they try to do something they’re unfamiliar with or they do something with bad technique, or they increase what they can do well but their increases are too significant for the soft tissue, the connective tissue ... to be able to support it. And then that tissue can break down and become injured …
Obviously, the higher the level of the athlete, regardless of the sport, the more the warm-up becomes important.
Are there any exercises that are more risky than others?
Yes. … One of the high risks is weight-lifting and especially the faster lifts, which are the Olympic lifts, the clean and jerk. Those typically get a bad rap, and they are extremely effective and safe if done properly. You really need a good coach when you’re doing those things. And if that’s in place, then they’re completely safe. But if it’s not, people can hurt themselves. …
It’s the magnitude of weight and the speed at which they have to move it that requires them to be able to do that, and oftentimes when someone gets interested in that, they come in with not necessarily an injury but an inadequacy in motion, and then that throws the lift off and then they just can’t do it properly until they fix the motion problem.
Does slow-moving weight-lifting normally offer more benefit?
Yes, especially in acute injury, especially when you’re dealing with tendons. Initially, you’re going to move slowly, you’re going to try to eliminate momentum, and then the holding it at the apex of the maneuver for several seconds, that gives the soft tissue the stimulus it needs to get stronger.
Do you see a change in mood in people over the time they are in physical therapy?
One of the absolute best things about being involved in physical therapy is you get to see that evolution in mood from the initial day of fear, concern, some anxiety, and then it gets better and better and better until the day of discharge, when people feel very comfortable and are quite happy to have overcome their problem.