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How I’d rethink it

What are you trying to understand about your pain?

I’m David Quenzer, a physical therapist in Clovis. Pick a question that sounds like yours. I’ll show you where I’d start, what I might try, and what we’d check again.

30 questions

Back and legMy back feels fine when I’m doing my exercises. Why does it still hurt when I get out of the car?

How I’d rethink it

Which part catches: turning in the seat, getting your feet under you, or standing up?

I’d recreate the stand from a low seat, then compare it after changing the support or checking a movement your hip or back needs. If the same seat still brings on the same catch, I’d look at a different part of the stand.

What we’d check afterward
How did it feel getting out after your next actual drive?

Read further George et al. Interventions for the Management of Acute and Chronic Low Back Pain. JOSPT, 2021. · Reddit discussion that inspired this question

Read the full guide →
Stiffness and coreI’ve always been flexible. How come I feel stiff all the time?

How I’d rethink it

Which movement feels stiff even though you can get all the way through it?

I’d compare an ordinary reach with your arm supported and unsupported. If support changes how much you have to grip, we can explore how to use that support and gradually practice the reach.

What we’d check afterward
Does reaching for the same shelf take less effort later in the day?

Read further Buryk-Iggers et al. Review of exercise and rehabilitation in Ehlers-Danlos syndrome · Reddit discussion that inspired this question

Read the full guide →
Foot and ankleWhy does my heel hurt when I get out of bed, then feel better once I’ve walked around a bit?

How I’d rethink it

Does it do the same thing when you get up after dinner?

I’d ask where you feel it, check the heel and ankle, and compare a few steps after a change in support or gentle hands-on work if it fits the exam.

What we’d check afterward
What do the first steps the next morning feel like?

Read further Koc et al. Heel Pain – Plantar Fasciitis clinical practice guideline. JOSPT, 2023. · Reddit discussion that inspired this question

Read the full guide →
Back and legWhy is my back so stiff in the morning?

How I’d rethink it

Is it worst when you roll over, sit up, or take your first steps?

I’d use the part of getting out of bed that bothers you as our starting movement. We can compare it with more support and see what changes the effort or discomfort.

What we’d check afterward
Does getting dressed take less time once you’re up?

Read further George et al. Interventions for the Management of Acute and Chronic Low Back Pain. JOSPT, 2021. · Reddit discussion that inspired this question

Read the full guide →
Back and legMy MRI only showed mild changes. Why does my back hurt this much?

How I’d rethink it

Which part of your day is hardest to get through right now?

I’d read the report with you and compare it with your symptoms and exam. We’d pick one task, such as standing to make dinner, and look at what changes how long you can do it comfortably.

What we’d check afterward
Can you cook a meal with fewer breaks?

Read further NICE. Low back pain and sciatica in over 16s, guideline NG59. · Reddit discussion that inspired this question

Read the full guide →
Back and legWhy does my back feel okay while I lift but hurt afterward?

How I’d rethink it

Does it start after the last set, when you sit down later, or the next morning?

I’d look at the lift, what happens as you get tired, and how much you did. We can compare one change in range, load, or setup and use the later response to choose what to build back.

What we’d check afterward
How do you feel the next morning after a comparable session?

Read further George et al. Interventions for the Management of Acute and Chronic Low Back Pain. JOSPT, 2021. · Reddit discussion that inspired this question

Read the full guide →
Back and legWhy does my leg feel better when I walk but hurt when I sit?

How I’d rethink it

How long can you sit before it starts, and how far down the leg does it go?

I’d check the symptom pattern, strength and sensation as appropriate, then compare sitting with a change in support. I’d use both where you feel it and how soon it starts to decide what to check next.

What we’d check afterward
Can you finish a meal sitting down more comfortably?

Get emergency care for new numbness around the genitals or anus, new trouble passing or controlling urine or stool, or severe or worsening weakness or numbness in both legs. NHS guidance

Read further Dove et al. Review of physiotherapy interventions for sciatica · Reddit discussion that inspired this question

Read the full guide →
Back and legWhy does my foot go tingly when I sit?

How I’d rethink it

Which toes or part of the foot tingle, and does it stop when you stand?

I’d map the sensation and check strength and sensation. Where it shows up and what changes it help me decide whether to look more closely at the back, leg, or foot, or whether you need another kind of assessment.

What we’d check afterward
Tell me if it starts sooner, spreads, or lingers after you get up.

Get emergency care for new numbness around the genitals or anus, new trouble passing or controlling urine or stool, or severe or worsening weakness or numbness in both legs. NHS guidance

Read further Dove et al. Review of physiotherapy interventions for sciatica · Reddit discussion that inspired this question

Read the full guide →
Back and legIs it normal to feel worse the day after my PT exercises?

How I’d rethink it

What got worse, and how long did it take to settle?

I’d review the specific movement and dose with you. If appropriate, I’d change one thing, such as how far you move or how many repetitions you do, and reassess your response before deciding how to progress.

What we’d check afterward
Can you do your usual activities the next day?

Read further George et al. Interventions for the Management of Acute and Chronic Low Back Pain. JOSPT, 2021. · Reddit discussion that inspired this question

Read the full guide →
Neck and headachesWhy does my neck get tight again by lunch even though I stretch it?

How I’d rethink it

What are you doing when you first notice it creeping back?

I’d have you show me how you sit and work. We can compare the same reach or turn with your forearm supported, then see whether that changes how much work you feel around your neck.

What we’d check afterward
On a normal workday, when do you first feel like you need to stretch?

Read further Blanpied et al. Neck Pain clinical practice guideline. JOSPT, 2017. · Reddit discussion that inspired this question

Read the full guide →
Neck and headachesWhy is it so hard to turn my head when I’m driving?

How I’d rethink it

Does it feel stiff turning both ways or only toward one blind spot?

I’d compare a comfortable turn in a chair with one where your upper back has more room to move. Then we’d see if any change makes the same turn easier.

What we’d check afterward
Does turning to look over your shoulder feel easier when the car is parked?

Read further Blanpied et al. Neck Pain clinical practice guideline. JOSPT, 2017. · Reddit discussion that inspired this question

Read the full guide →
Neck and headachesWhy do I get a headache after a few hours at my computer?

How I’d rethink it

Does the headache start while you’re reading, when you look up, or after you stop working?

I’d ask about the headache pattern and other symptoms first. If a movement exam fits, we can compare what happens when you change the screen setup or how your upper back and neck move together.

What we’d check afterward
Track when the headache starts, how long it lasts, and what else you notice with it.

A sudden, severe headache or new trouble speaking or moving one side of your body needs emergency care. Urgent headache guidance

Read further Blanpied et al. Neck Pain clinical practice guideline. JOSPT, 2017. · Reddit discussion that inspired this question

Read the full guide →
Neck and headachesWhy do my shoulders feel like they’re up by my ears when I work?

How I’d rethink it

Does it happen while you type, use the mouse, or hold the phone?

I’d watch one task you do all day and see whether a change in arm support or reach affects how much effort you feel. Then we’d try it in a setup you can use at your actual desk.

What we’d check afterward
Can you get through a work block before you feel the need to shrug or stretch?

Read further Blanpied et al. Neck Pain clinical practice guideline. JOSPT, 2017. · Reddit discussion that inspired this question

Read the full guide →
ShoulderWhy does my shoulder hurt when I sleep on that side?

How I’d rethink it

Does it hurt as soon as you lie down, or wake you up later?

I’d compare how the shoulder feels with the arm supported in a few positions, then check an everyday reach that also bothers you. That can guide what to practice and what support might make sleep more comfortable.

What we’d check afterward
Are you waking less often, and how does the shoulder feel when you get dressed?

Read further Rotator cuff rehabilitation guideline · Reddit discussion that inspired this question

ShoulderWhy does my shoulder hurt when I reach up for something?

How I’d rethink it

Does it hurt on the way up, at the top, or when you bring the arm down?

I’d compare the same reach with a different arm path and check how your shoulder and upper back move. If a change helps, we can practice reaching at the height you actually need.

What we’d check afterward
Can you put something in the cupboard with less hesitation?

Read further Rotator cuff rehabilitation guideline · Reddit discussion that inspired this question

ShoulderWhy does bench pressing hurt my shoulder when other lifts feel fine?

How I’d rethink it

Is it the bottom of the rep, the push back up, or the next day that bothers you?

I’d compare a lighter press and change one part of the setup, such as depth or grip. We’d use the response to find a starting point you can build from.

What we’d check afterward
How does the shoulder feel later that day and on your next push day?

Read further Rotator cuff rehabilitation guideline · Reddit discussion that inspired this question

ShoulderWhy does my shoulder hurt when I reach across my body?

How I’d rethink it

Do you notice it more putting on a seat belt or reaching across a table?

I’d compare the reach with and without a little room for your upper body to turn. I’d also check shoulder movement itself and repeat the exact reach after any relevant change.

What we’d check afterward
Is buckling your seat belt easier without having to use the other hand?

Read further Rotator cuff rehabilitation guideline · Reddit discussion that inspired this question

HipWhy does the front of my hip pinch when I squat?

How I’d rethink it

Does the pinch show up at a certain depth, or only when you add weight?

I’d compare a squat to a higher target and check what changes with stance or support. I’d also check hip motion so we have something more specific than guessing from squat form.

What we’d check afterward
Can you reach your usual depth with less pinching at a manageable load?

Read further The Warwick Agreement on femoroacetabular impingement syndrome · Reddit discussion that inspired this question

HipWhy does the outside of my hip hurt when I lie on my side?

How I’d rethink it

Is it pressure on the hip against the bed, or does the top leg bother you too?

I’d ask about sleep and compare a task like standing on one leg or stepping up. Then we can see whether support at night and a manageable starting load during the day help with the things that bother you.

What we’d check afterward
Are you waking less, and does getting up the stairs feel any different?

Read further Mellor et al. Education and exercise for gluteal tendinopathy · Reddit discussion that inspired this question

HipWhy does my hip start hurting a mile into my run?

How I’d rethink it

Does it happen around the same distance, on hills, or after you speed up?

I’d look at what changed in your running and assess a movement that loads one leg. We can pick a change to pace, distance, or terrain and see if it shifts when the symptoms start.

What we’d check afterward
How far can you go before you first notice it, and how does it feel the next day?

Read further The Warwick Agreement on femoroacetabular impingement syndrome · Reddit discussion that inspired this question

KneeWhy does my knee hurt going downstairs but feel fine going up?

How I’d rethink it

Does it hurt when you lower yourself or when the other foot lands?

I’d compare a step down with a lower step or some rail support and look at how the knee, hip, and ankle move as you lower. Then I’d check the same step again after one change.

What we’d check afterward
Can you go down your own stairs with less effort or less reliance on the rail?

Read further Best practice guide for patellofemoral pain · Reddit discussion that inspired this question

KneeWhy does my knee only hurt when I squat deep?

How I’d rethink it

Does it start at the same depth with and without weight?

I’d find a depth you can repeat comfortably, check how your ankle and knee move, and change one part of the squat at a time. That gives us a starting point for building back toward the range you want.

What we’d check afterward
Can you squat a little deeper at the same load without a flare later?

Read further Best practice guide for patellofemoral pain · Reddit discussion that inspired this question

KneeMy knee feels fine walking. Why does it hurt when I run?

How I’d rethink it

When does it start on a flat run, and is downhill any different?

I’d ask about recent mileage and compare a step down or short run if it fits the exam. We’d see whether a change in the task or running dose gives you a more comfortable starting point.

What we’d check afterward
Does it start later on a similar route, and how do stairs feel afterward?

Read further Best practice guide for patellofemoral pain · Reddit discussion that inspired this question

Foot and ankleWhy does my heel hurt barefoot but feel okay in shoes?

How I’d rethink it

Is it the hard floor, the first few steps, or being on your feet longer?

I’d compare the same short walk with and without the support you usually wear, then assess the foot and ankle. That helps us decide what support buys you and what you want to build tolerance for.

What we’d check afterward
Can you spend a little more time on your feet without paying for it the next morning?

Read further Koc et al. Heel Pain – Plantar Fasciitis clinical practice guideline. JOSPT, 2023. · Reddit discussion that inspired this question

Read the full guide →
Foot and ankleI rolled my ankle months ago. Why does it still feel stiff?

How I’d rethink it

Do you notice it most stepping down, squatting, or pushing off?

I’d check how far your shin can move over your foot and how steady you feel taking weight. If appropriate, we’d compare the same step after hands-on work or guided practice.

What we’d check afterward
Do curbs or stairs feel less awkward outside the clinic?

Read further Lateral ankle sprain rehabilitation guideline · Reddit discussion that inspired this question

Foot and ankleWhy does one heel come up when I squat?

How I’d rethink it

Does it happen on the same side every time, even in a shallow squat?

I’d compare ankle movement side to side, then change the squat depth or stance to see whether that affects when the heel lifts. If an old ankle injury is relevant, I’d assess how it’s moving and taking weight now.

What we’d check afterward
At the same depth, can you stay more evenly supported through both feet?

Read further Lateral ankle sprain rehabilitation guideline · Reddit discussion that inspired this question

Stiffness and coreI stretch my hamstrings all the time. Why do they still feel tight?

How I’d rethink it

Does it feel the same when you sit and straighten your knee as when you bend to reach the floor?

I’d compare those movements and ask what the sensation feels like. Pulling, tingling, and effort give me different things to check. I’d use the exam to decide whether stretching is a good fit for what you feel.

What we’d check afterward
Does the movement you actually want back feel easier, and for how long?

Read further Dove et al. Review of physiotherapy interventions for sciatica · Reddit discussion that inspired this question

Read the full guide →
Stiffness and coreWhy do I feel like I’m tensing my muscles all day?

How I’d rethink it

When does it feel hardest to let go: standing, sitting, or reaching?

I’d pick one everyday task and see what happens when we give you a bit more support. We can compare how hard you’re working and whether that changes how freely you breathe while you move.

What we’d check afterward
Does the same task take less effort after you’ve been doing it a while?

Read further Buryk-Iggers et al. Review of exercise and rehabilitation in Ehlers-Danlos syndrome · Reddit discussion that inspired this question

Read the full guide →
Stiffness and coreAm I supposed to tighten my core every time I lift something?

How I’d rethink it

Are you picking up groceries, lifting heavy in the gym, or bracing just to get out of a chair?

I’d watch the actual task at a comfortable load and see when you brace or hold your breath. Then we could compare what changes with support or a different load. I’m looking at how you adapt the effort to the task.

What we’d check afterward
Can you do the everyday lift with less effort and breathe comfortably while doing it?

Read further Talasz et al. Breathing and pelvic floor coordination · Reddit discussion that inspired this question

Read the full guide →
Physical therapyPhysical therapy helped for a while. Why does the pain keep coming back?

How I’d rethink it

What got easier while you were in PT, and what was still difficult when you finished?

I’d pick one real activity that still bothers you and see what changes it during the visit. Then we’d agree on what to watch between visits so we can tell whether to keep going or change the plan.

What we’d check afterward
After a normal week, what can you do more easily than before?

Read further George et al. Interventions for the Management of Acute and Chronic Low Back Pain. JOSPT, 2021. · Reddit discussion that inspired this question

Read the full guide →

These questions are adapted from public discussions found through web search. Reddit links show where the questions came from. The linked clinical sources give background for the assessment examples.

Clovis & Fresno

Bring the movement you want back

Tell me what’s become harder and show me how you do it today. We’ll look at how you move and talk through what may help. The hands-on evaluation takes 30 to 45 minutes and is free. If we decide to work together, one-on-one treatment is out of network and costs $200 an hour.