Q & A with Dave Endres

1. Why did you pursue a career in physical therapy?

After graduating from Touro College, I worked for the Board of Education, treating children with severe physical disabilities, gaining extensive experience in an outpatient physical therapy setting. Helping children and adults eliminate or greatly reduce their level of pain is a true calling for me. Nothing feels better than being able to help a person regain mobility, reduce or eliminate pain and feel good about their life again. Today, the concentration of my practice is in orthopedics, musculoskeletal rehabilitation and the treatment of sports injuries.

2. 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.

3. 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.

The new Salonpas Deep Relieving Gel features three powerful pain relieving ingredients which go right to the site of 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. How much exercise each week can help reduce pain?

Exercising 30 minutes a day at least three or four days a week aids 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 ailments of inflammation, stiffness, and soreness with exercise, manipulation, and massage, but it also helps the body heal itself by encouraging the production of the body’s natural pain-relieving chemicals.

9. 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 external pain management over internal analgesics. It is also crucial that the physical therapist works in concert with a medical doctor who can prescribe any necessary prescription medications. All these components combined will allow the most effective pain treatment for each individual.

10. Tell me about the SPEAR Physical Therapy Center.

SPEAR Physical Therapy, www.spearcenter.com, is an established, experienced, physical therapy network with four convenient locations in Manhattan. Treatment focuses on individual potential for independence, recovery, and optimal life functioning and performance. The SPEAR Physical Therapy Center was co-founded in 1999 by Dave Endres and Dan Rootenberg.