Interview with Dave Endres, Physical Therapist and Co-Founder of SPEAR in New York City
After graduating from Touro College, Dave worked for the Board of Education where he treated children with severe physical disabilities and gained extensive experience in an outpatient physical therapy setting. Dave realized that helping children and adults eliminate or greatly reduce their level of pain is a true calling for him. Nothing feels better to him than being able to help a person regain mobility, reduce or eliminate pain and feel good about their life again. Today, the concentration of his practice is in orthopedics, musculoskeletal rehabilitation and the treatment of sports injuries.
Q. Why do people seek out physical therapists?
People turn to physical therapists when they have pain issues that they cannot resolve on their own. In most initial visits with a personal licensed physical therapist, the patient will explain when they began feeling pain and how the pain may have arose (either due to a injury, past surgeries or other health concerns). The therapist will then conduct an evaluation to identify any postural faults and musculoskeletal imbalances, including tests for muscle length and strength, joint mobility, and soft tissue integrity.
Based on the diagnosis and the patient’s personal goals, the therapist will create a personalized treatment plan. Most therapists will also recommend a home exercise program to speed the recovery process. The physical therapist will explain each exercise and make sure there is an understanding of the proper technique. Subsequent patient visits feature a full treatment session. Most prescriptions and treatments typically span 6-12 weeks, last and hour, and are scheduled for 2-3 visits per week, but this will vary based on a person’s condition and physical ability.
Q, What role does topical pain relief in the form of cream, gel, and patches play in reducing pain in your practice?
We work closely with a patient’s doctor to ensure that their pain management is safely managed through drug therapy when necessary. However, if there is a choice between oral or topical pain therapies we encourage the transdermal route every time. Transdermal pain therapy ensures a control-released delivery of pain medication.
One of the main causes, whether suffering from acute or chronic, is strains to your back. Because nerves stretch out from the spinal cord throughout the entire body, back strain can also cause pain in areas other than your back.
The Salonpas® products including Salonpas Pain Relieving Patch Large, Lidocaine Pain-Relieving Gel Patch, Salonpas Pain Relieving Patch and Salonpas-HOT, can temporarily relieve your lower back pain. In my business, keeping pain at bay for as long as possible, and ultimately eliminating it from one’s life is a key imperative.
Q. What lessons have you learned from other areas of the world that you use in your practice?
Stretching and exercise are always the first things that come to mind when I think about the rest of the world, especially in Asia. Practices like yoga improve flexibility, help build lean muscle and improve circulation. However, the use of topical pain relievers also comes to mind. Asian countries use topical pain relievers as often as they use pills. Both of these practices have been going on for hundreds of years, so you know that they are tried and true.
Q. Is exercise important in reducing mild, moderate and chronic pain?
Yes, while pain may leave a person wanting to curl up in bed with a heating pad and a bottle of medication to ease their aches, exercise is one of the best pain management options for mild, moderate and even chronic pain. Physical therapy can be highly effective for all types of musculoskeletal and neuropathic types of pain. A primary goal of physical therapy is to help chronic pain patients become stronger, because they’re usually weaker from not moving.
Physical therapy can teach people how to move safely and functionally in ways that they haven’t been able to in some time.
Q. What types of pain does physical therapy help alleviate?
Physical therapy is used to alleviate many sources of pain, including muscle cramps, osteoarthritis, fibromyalgia, chronic headaches, rheumatoid arthritis, hamstring pain, neuropathic pain (pain caused by injury to tissues or nerves) and back, shoulder and neck pain, to name just a few.
Q. Besides exercises, what different types of pain management methods do physical therapists employ?
Physical therapy can feature many different types of pain management methods, including manipulation of joints and bones, massage therapy, movement therapy and exercise and even micro-current stimulation to increase serotonin and dopamine to alleviate pain naturally.
Within each of these categories, there’s a variety of treatments that a physical therapist can offer. Exercise may involve walking or running on a treadmill or using various weight-bearing machines, depending on the person’s pain and physical abilities.
A physical therapist works with each patient to understand his or her particular pain — what causes it and what can be done to manage it. This is the kind of attention that a regular doctor often doesn’t have the time to give, but a physical therapist can provide; they can ask questions and talk about pain issues as the patient is going through their exercise routine.
Q. How much exercise each week can help reduce pain?
Exercising for just 30 minutes a day on at least three or four days a week will help with chronic pain management by increasing endurance, muscle strength, joint stability and flexibility in the muscles and joints. A consistent exercise routine helps control pain. Regular exercise helps a person maintain the ability to move and function physically, rather than becoming disabled by pain.
Physical therapy addresses the physical side of the inflammation, stiffness, and soreness with exercise, manipulation, and massage, but it also works to help the body heal itself by encouraging the production of the body’s natural pain-relieving chemicals.
Q. In your world, what role does topical gel, cream and patches and other forms of therapy play in concert with physical therapy and exercise?
I am a proponent of heat and cold therapy. It is also crucial that the physical therapist works in concert with a medical doctor who can prescribe any necessary prescription medications. Put all these components together to find the most effective chronic pain treatment for you.
Q. Tell me about SPEAR.
SPEAR is more than just a Physical Therapy clinic…it’s a championship team. Our team members act with a shared mission and a shared gratitude for the positive impact we’re able to make on patients’ lives. Each of us has a contagious “I can do anything” attitude. It’s a feeling you get when you work with the SPEAR team or meet one of us at a community event, or become the newest member of our team. It’s our SPEAR-IT culture in action. And this feeling is realized every day in every area of the SPEAR organization.