Ludwig's First-Ever Visit to a Physical Therapist

By LUDWIG VON KOOPA - An evaluation appointment. Treatment appointments to come. (Now updated at the bottom of the article.)

I haven't played Ring Fit Adventure since the start of 2023. There is something resembling a good reason for this: I've been in pain for the past four months, particularly on my right hip. As opposed to persistent pain in my left hip at the end of 2021. You probably have the impression that my body is a mess. You would be right.

Since I haven't been totally following my chiropractor's fitness advice (and my chiropractor helps me feel better but doesn't cure my pain in the long-term), my primary care physician suggested I go to a physical therapist (PT). It takes quite a while to schedule an evaluation appointment with a physical therapist, since I suppose they're in big demand. (My doctor also refused to let me get an MRI or X-ray because he thinks I'm too young to have problems). But today I finally got one! For the first time ever. Lemme tell you what happened.

First, I had to find the place and park properly. Which... didn't happen correctly the first time, since Google Maps told me to make unnecessary turns that, in fact, lead me to a private daycare of some sort. ...After arriving at the CORRECT location based on instinct and not an AI, I entered into the building and went inside a door labelled "Exit". Fortunately, it turns out that the way I came in was the unlabelled "Entrance". The PT's office manager identified me and handed me a clipboard full of papers, asking me to evaluate my pain levels and share my medical history, as well as consent my rights away. I filled out the paperwork but declined to sign the paper with the consent, since the document said that I'm acknowledging the physical therapist has had a discussion with me about what he'll do and the risks involved. At that point, I had not had any such conversation with a physical therapist. I only had spoken with the office manager, who herself seemed to be in some pain based on the icepack she was happy to be equipped with.

The office manager seemed fine with me not signing this form yet, saying I could sign it at the end. She beckoned for my designated physical therapist to come to me, and he sat me by a table with a chair. He had a computer, and asked me several of the same questions I had just filled out on the papers. He also asked me what my goal of PT was—I said to be able to run without being in pain. (And to be able to walk without having to use a cane, which is my current condition.) He asked me to get up and walk back and forth. He wasn't very impressed by the limp I've developed. He sat me back down and started pulling on my legs and feet and touching around my hips. He wanted me to resist in the direction he was pushing or pulling. My right leg/foot was very incompetent in doing this, more than my left. The therapist then had me lie down on my shell and then stomach and pulled my legs in various directions, asking me to narrate any pain I may be having as he did so.

By the end, he stated his theory that my iliotibial band (or IT band) sucks, and that my body is remarkably not flexible. He compared the body's pain to a car alarm. Car alarms, especially old ones, can be sensitive. He said they go off when something is not right (but not necessarily wrong). But things don't have to be this way. With this cryptic message in mind, he said it can take as little as five days for a muscle to weaken when it hasn't been used much, but six to eight to ten days for it to strengthen back up, which is pretty much how long I'll need physical therapy for. He didn't give me exercises that day because he wanted me to gauge how much lasting pain his prodding did. I gotta say, I am in pain... in my left shoulder, which is probably unrelated to what he did. Yeah, I'm in pain all over my body, not just my hips. Bad shape! He said I've been “babying” myself for the past four months and now it's time to rebuild strength and apply myself, or I'll never get better.

So I went home and scheduled two appointments a week for next week and all of the weeks of July—and I ought to expect these to each last an hour. It turns out that while an “evaluation appointment” takes a month or so to schedule, “treatment appointments” are much more plentiful and can be scheduled in much shorter notice. Interesting how that works...

First Treatment Update

My first treatment was 08:00 on Monday, June 26th. Very quick turnaround. I quickly found out why treatment appointments are much more plentiful than evaluation appointments—despite my appointment being with the physical therapist with a doctorate, it was actually handled by his assistant (and his assistant's assistant, who apparently just joined the firm and was visibly and audibly not at all confident in what she was doing).

The assistant asked me to lie down on my back on a table as she and her assistant wrapped these wet and hot towels around both of my hips. I got to lie down there for about five minutes. It was very pleasant. Then I had to get up and warm up the rest of my body on an exercise spinning bicycle. Now, I do hate bicyclists, but I suppose this is okay because the bicycle is stationary. The bicycle had all sorts of settings it could be set to, but I was just spinning in place for six minutes without any real settings or resistance or speed to consider.

I returned back to the table to follow along with some stretches by the assistant. This included a lengthy strap that I was to push my foot on and then stretch my hamstrings and then the aforementioned IT band, for 30 seconds per side for twice each. (I regularly multiplied out the total amount of time or repetitions, and the assistant's assistant was frequently puzzled by basic arithmetic.) In this case, that's two minutes total.) I got to do knee-to-chests as well, which is a Ring Fit Adventure staple. In this case, it was one knee to chest at a time, while Ring Fit Adventure likes both knees.

After stretching came actual exercising. My memory on exactly what I did is a touch hazy. We definitely continued to have props, including a bouncy ball (Guru Andma loves these in Ring Fit Adventure) that I'm supposed to press with my claws against my knees (in a 90-degree angled position) while on my back. There was also a band that wrapped my two legs together as I'm supposed to lay on my side and lift one leg up while keeping the bottom leg on the ground. Another one had me squat down to a chair but not actually sit on it, and then get back upright. Still another was the hip lift from Ring Fit Adventure, except without having a Ring-Con in-between my legs, which made the exercise significantly better and less dangerous. (They also called it “bridges.”) The last of the exercises was standing on one foot for ten seconds ten times per foot on a non-flat surface they provided.

To end the session, they rested me back on the table... but instead of a heated towel, they gave me towels around my hips with bags of ice, and had me nap for ten minutes. That sounds like a form of torture or hazing, but the towels insulated the threat of the ice cubes, so I was blissfully asleep until they woke me up and told me that's all for today. They didn't give me a packet of exercises to do at home, or even tell me to do anything on my own. They said just come in later that week for my next appointment. Hm. Maybe they'll do so in my second treatment appointment. All in all, I'm in more pain than I was getting out of bed this morning, but hopefully as I keep doing PT, I'll strengthen my muscles and it'll be less painful.

Second Treatment Update

I had my second treatment on Thursday afternoon. It was the same routine as Monday, though I failed to memorise it. ...But even if I did memorise it, the therapists/assistants were the ones with the props. They also had a checklist (that I didn't get to see) of what I did in the routine up to that point, so I'm pretty sure I'm not supposed to just skip ahead.

Anyway, the assistant that worked with me on Monday and some of today will stop working there on July because she's moving in August, so that's unfortunate. The physical therapist said my "pain pressure threshold" improved from Monday, based on when he was pushing against my hips. My left hip has a much higher threshold than my right hip, but the right hip's is better. Progress!

End of Treatment Update

Let's skip ahead to Thursday, July 27th. I've been discharged from physical therapy after eleven visits. My pain pressure threshold has increased significantly on both sides of my hips, and I can function without existing in a state of pain. I'm quite pleased, though it's also dramatically more pricey than, say, a gym membership.

My routine ended up being a daily Home Exercise Programme of a hamstring stretch (30 seconds hold for twice on each leg) featuring a strap, a single knee-to-chest (also 30 seconds hold for twice on each knee), an IT band stretch (again, 30 seconds hold for twice on each leg) also with a strap, and a “supine dynamic modified Thomas quad and hip flexor dynamic stretch” (also 30 seconds for twice on each leg), which is where you're flat on the edge of a bed and have your leg hanging off the side but bent towards your butt while the leg remaining on the table is also bent towards you with your hands on it.

The exercises within the physical therapy office all have props to them, and I ended up unlocking more advanced, more difficult versions of them. There are three exercises on a table: the hip-lift but my legs are on a giant exercise ball instead of being flat (10x3 reps); a clamshell where a tighter band than before is around my knee area and I have to lay on my side and lift one leg up while the other is against the table (10x3 reps per side); and an exercise where I'm laying on my back with a smaller exercise ball in-between my arms and knees (where my arms are pushing in) and my legs kick out one leg at a time (for 10x3 reps per leg). There are three exercises beside a table: table squats (10x3 reps) where I squat while holding onto the edge of a table with a chair in back of me; an exercise where I have a band around my two ankles and I need to extend one leg to the side and then bring it back in (10x3 reps per leg) while the other leg remains still; and a balancing act that requires I stand on one leg and have the other leg hanging up, where I upgraded from a flat surface to an uneven round disc (10 reps per leg held for 10 seconds each). And finally, I unlocked access to the “hip machine”, where I stand on one leg and have the other leg over a padded area on the machine, and I move that bent leg backward (10x3 reps per leg), switching the orientation of the machine when I switch legs. The machine would lift a total of a five-pound set of weights. The weight isn't the goal here—it's the movement.

Each session in the therapist's office always began with the hot towels around my hips for five minutes and spinning the resistance-less exercise bike for six minutes, and always ended with ice-bag towels around my hips for ten minutes to cool down my sore hips.

All in all, I'm supposed to continue stretching for at least a couple of months so I don't find myself right back to physical therapy. A little preventative care can keep me out of much more time-consuming and money-devouring treatment down the line. You ought to feel grateful that I updated this article well after KoopaTV is supposed to stop publishing new content!


This is the last KoopaTV Fitness Friday that'll ever exist. (Hopefully that doesn't represent the last time a KoopaTV staff member will do fitness activity on a Friday.) Ludwig has no idea about the validity of the therapist's theory about the IT band. It doesn't seem likely that he'd get an injury associated with running or cycling when he doesn't do those things. But what does he know? Science and anatomy are his sore and weak spots, in more ways than one.