A conversation with MTI's Robin Schoenfeld

Robin Schoenfeld is a gregarious outdoorswoman. She has an easy laugh and photos on her office desk of herself and friends rock climbing. Schoenfeld likes to keep active. That’s at least partly because, as a physical therapist, she believes that agility, coordination and other physical skills can fade without practice.

“Use it or lose it,” she recently told Queen Anne & Magnolia News. “For instance: balance. Sometimes you ask someone to stand on one foot for a little while, and their immediate response is, ‘Oh, no. I don’t have good balance.’ You should practice and keep doing things that maybe feel a little daunting to you.”

Schoenfeld spoke with us recently about physical therapy and how people can help keep themselves fit and healthy.


OK, tell me about what physical therapists do.

Schoenfeld: It varies greatly. What I do is work with folks in an outpatient, orthopedic setting. So basically people are coming in to do assessments and treatments, which include sometimes hands-on work and exercise -- generally always exercise -- to improve function or restore a level of function.


Restore might involve an injury?

Schoenfeld: Yes. It could be they sprained an ankle playing racquetball. So they need to work on balance and coordination. We also work across the ages and in more than one scope -- we have therapists who work in pediatrics. In and out of the schools. There are specialties in geriatrics. Issues with balance and falling. Some PTs who work only with wounds, with rehabilitation, so they’re in the hospitals.


According to the Oxford Dictionary, physical therapy is “the treatment of disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise rather than by drugs or surgery.”

Schoenfeld: Physical therapy started as a branch off of medicine to treat folks who had war wounds and amputations from World War I. And then it became more rehabilitation, working with folks who had polio. Those were kind of the setting starters.


You have different specialists here at MTI?

Schoenfeld: All of us here have been trained in manual therapy -- which is talking about hands-on work and your specific manual skills. But we also have a very heavy, heavy emphasis on exercise, and doing it in a certain way that’s based on the mechanics of the body.


Why an emphasis on exercise?

Schoenfeld: To reinforce the change. So any kind of change you make, unless you practice it and have a lot of repetitions, you won’t necessarily make changes for the long term.


Is this where we get into a mind-body connection?

Schoenfeld: Yes, to retrain the motor patterning. So, it’s like, you look at kids and they have a variety of ways of doing something, like getting up off the floor. Kids will get off the floor in twenty different ways. But adults typically have one way. You just happen to get into a habit of doing something this one way.


So do adults think they can change their habits?

Schoenfeld: Some do, some don’t. Some think, “This is the way it’s always been.” Some think, “I’m free to change, but I fell once, so I can’t do that.” So you help them work through that.


That’s interesting. When I think of physical therapy, I think muscles and tendons and bones, and not my mind at all.

Schoenfeld: There’s always a connection. So there is a major learning process. That’s why we make people do home exercise programs. We want to reinforce that. So compliance with that is importance.


So what are your five things people can do in the course of everyday life to make their lives better?

Schoenfeld: First, not to sit so much. Not to be so sedentary.

Simple movement is OK, like walking up and down stairs instead of taking the elevator?

Even walking a flight, if you’re able to do that instead of four flights. If you can do some things, you’re best to continue doing those things -- unless the reason you’re stopping is pain or taxing your cardiovascular system.


Ok, what else?

Schoenfeld: If you have regular workouts, try to vary your workout. So that it’s not always running. You’re not always doing one pattern of movement. And learn to recognize recovery from muscle soreness -- a normal process -- versus pain from damage. As long as your soreness takes a week or two, that’s OK. But if it take six to eight weeks, or it’s worsening, don’t ignore it.

Third, change mechanics. Simple education on form and function can help you function for the long term So, trying to really improve your mechanics -- simple things, like your computer set-up at work.


Where could one learn about that?

Schoenfeld: You can look online or talk to a specialist about that. If you’re sitting at your computer and you always get a crick in your neck, that’s obvious and it can be changed. It doesn’t have to be a long-term treatment, it’s just a consultation. There are specialists who do office consultations. There are bike-fit specialists. There are running specialists.

Fourth, stretching does not have to hurt. So, just do a good warm-up before the activity, like walking or doing the activity a little more slowly at first.


So, I could warm up for racquetball by walking to the gym?

Schoenfeld: Yes. Some people really want to feel pain when they’re stretching. They think harder is better. They want to work through the pain. But some things don’t like to be stretched -- nerves don’t like to be stretched. You keep stretching a nerve, and you’ll compress it. It’s easy to know when you’ve compressed your nerve — you feel numbness or pins and needles.


What’s your fifth way people can improve their own lives?

Schoenfeld: Balance. I keep coming back to this. We’re all guilty of avoiding things we don’t like. Like, some people don’t feel they can stand up from sitting without holding onto something. Or, moving quickly. The thing is: Can you do something safely? Can you practice it? Well, you have to be safe, but (some people say) “I’ll never walk down a hill because it looks scary.” Well, good luck with that in Seattle.


Finally, what’s a good online information source about physical therapy?

Schoenfeld: Go to the American Physical Therapy Association, or the Physical Therapy Association of Washington. There are also great links on patient education at moveforwardpt.com.