Whole Person Approach

Physical therapy: an integral component of the recovery process.

One day in 2004, Nadine*, an assistant customer service manager, was bringing in carts from her store parking lot. The front entrance didn’t have a straight curb; it curved. To get into the store, employees had to make a turn. When Nadine, a Maryland native living in Florida, turned that day, she heard a “pop.”

Photo by Jordan Pysz.

Dr. Peavler (left) and Dr. Boyle believe physical therapy helps in the recovery process.

“I ended up having a tear and bulging discs in my lower back,” she describes. “That year, I had my first surgery. The doctors scraped off the discs and sealed up the tear. Because my discs were bone-on-bone, they also put some caulking between the bones. That repair lasted a long time.” Unfortunately, she was left with some pain, despite the effectiveness of the repair.
Ten years later, Nadine was again at work, this time helping to stock shelves. She was on her knees placing items on the bottom shelf. When she went to stand up, she heard another popping sound.
“I said, No way, not again,” she relates. “This time, the injury affected my nerves. The doctors once again got my back all cleaned up and put more caulking between the bones. They also unwrapped the nerves, but I had severe nerve damage on my left side.
“After that surgery, I had intense, sharp pain in my back. It was often a nine or ten on a scale of one to ten.”
Because her pain was so severe, Nadine’s doctor recommended a third surgery to fuse the discs in her lower back. Nadine, however, did not want to go through another surgery. The doctor then suggested a pain management specialist who prescribed opioid pain medication.
Like many others taking these powerful drugs, Nadine slipped into addiction. From there, her life went into a downward spiral. Nothing mattered but the drugs. And for her, access to them was easy.
“I would get the pain pills every month,” she reports. “I didn’t even have to go to the doctor’s office. My pharmacy would just send me a text telling me my prescription was ready. I went downhill fast.”
Nadine’s family was concerned for her and sought options for help. After a particularly bad episode with the pain pills, Nadine found her way to Riverside Recovery of Tampa.
“I don’t have much memory of how I got there,” she admits. “I was told I passed out on our porch and was taken to the hospital. Apparently, after the hospital, I was admitted to Riverside Recovery.
“I stayed to myself pretty much the first week I was there because I was in a lot of pain and wasn’t walking very well. Then the doctor asked me if I’d be willing to start physical therapy, and I said, Okay, I’ll try it. That’s when I met Dr. Peavler and everything changed.”

Total Health

At Riverside Recovery, the staff views recovery as embodying total health. That consists of mental, spiritual and physical health. The staff includes qualified clinicians who help clients achieve mental and spiritual health. Physical therapists help clients achieve the third component, physical health.
“Physical therapy is a profession grounded in the use of exercise, education, manual therapy and other modalities to improve people’s physical health,” explains Leighton Peavler, DPT, doctor of physical therapy at Riverside Recovery. “They are the gatekeepers, so to speak, from a physical health standpoint.
“The beautiful thing at Riverside Recovery is there are experts in mental health, medicine, nursing, clinical services and behavioral health. When you add physical therapists, there’s a nice harmony under one roof. It makes the facility more well-rounded and comprehensive in its ability to help clients recover.”
Dr. Peavler notes that physical health is an integral component of the recovery process because being physically unhealthy is often a barrier to recovery. He points to the current opioid crisis and how many people who are addicted to the drugs started out in physical pain.
“People need to be physically strong to be mentally strong,” he asserts. “A physical impairment, such as pain or difficulty performing a functional task such as sitting, walking or reaching overhead, interferes with recovery. More than half of my clients are here for opioid addiction due to a physical health problem.
“The biggest part of our treatment is education about pain, what it is and why the clients feel it. Teaching them why they have pain has been shown to reduce their pain levels.”
At the same time, manual therapy and exercises are being taught and administered. Manual therapy includes massage therapy, myofascial release techniques and joint mobilization. Exercise includes stretching and exercise to music. Eventually, the therapists wean the clients off manual therapy and into techniques to manage their pain on their own.
“At that point, we spend more time working through their internal controls with exercise that mirrors what they’ve been doing in treatment,” confirms Dr. Peavler. “So, when they have pain, they don’t reach for a pill. They take internal control. It’s more powerful that way.”
“During my second week at Riverside Recovery, I was allowed to go outside for a while,” states Nadine. “I had to go down some steps, and I ran down them. I thought, Wow, I couldn’t do that before I started physical therapy.”

“Thanks to the physical therapy, I didn’t have any pain when I left Riverside Recovery. Best of all, I’m five months clean.” – Nadine

Shannon Martin, LCSW, director of clinical services at Riverside Recovery, is impressed by Dr. Peavler’s physical therapy program. She likes that he gives clients with opioid addictions drug-free strategies for managing their pain. She’s worked at other recovery centers, and only Riverside Recovery offers the physical therapy component. They take a whole person approach to recovery.
“When people are in recovery, they’re going through a lot. It’s often the worst time in their lives,” says Shannon. “They go to therapy and process trauma and their life decisions. When they’re done with that, they’re given an opportunity to focus on their bodies. This also allows them to disconnect from those really intense feelings they’ve just shared.
“At Riverside Recovery, we’re seeing clients get healthy – mentally, spiritually and physically – right before our eyes. That wouldn’t happen without Dr. Peavler’s physical therapy program and his staff. What’s happening here is absolutely miraculous.”

Relieved and Clean

When Nadine entered the physical therapy program at Riverside Recovery, her pain level was severe. She was skeptical the program would give her the pain relief two surgeries had failed to provide. By the time she was done, she was converted into a believer.
“The amazing part is that Dr. Peavler listened to my problems,” marvels Nadine. “First, he massaged all the knots out of my lower back. I didn’t have any strength to lift my left leg, and I didn’t have normal range of movement with it.
“By the time I left physical therapy, I could lift my leg normally and had full range of movement. I could also stand up straight and bend down, which was painful before. Toward the end of my treatment with him, we were doing exercises to music, and I kept up with him and even passed him once.
“I still have all the materials he gave me, including the two exercise routines. I love those because it’s a lot more fun for me to exercise with the music.”
For Nadine, the total person approach at Riverside Recovery was effective at reducing her pain and eliminating her addiction to the opioid pain medication. She credits the staff and the entire process for improving her life.
“Thanks to the physical therapy, I didn’t have any pain when I left Riverside Recovery,” she enthuses. “Right now, my pain level is good. It’s very low. The pain goes up to about a one or two now and then, but that depends on the day, what I do and the weather.
“Best of all, I’m five months clean. I feel great.
“I rate Riverside Recovery an A-plus,” she adds. “Everybody there is awesome!”

*Patient name withheld at their request.
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