Phit’s Friend, Dickle

Dickle is a 45-year-old computer programmer who has been obese for years. He has lived a sedentary life since he discovered his talent for programming computers at age 16. At that time, he gave up sports and most physical activities to spend long hours at his computer, mastering code and creating software that millions of people use around the world.

Recently, Dickle went to see his doctor about chronic knee and back pain. His doctor performed standard tests and found that Dickle was prediabetic. His doctor told him his joint pain and prediabetes diagnosis were a result of his obesity, and his obesity was a result of his sedentary lifestyle. His doctor recommended that Dickle immediately address his condition by learning about nutrition and to start exercising. Dickle expressed fear that he might worsen his knee and back pain if he tried to exercise by himself. His doctor referred him to a physical therapist.

Dickle’s physical therapist performed a full evaluation of his knee and back motion, strength, stability, and pain. She calculated his BMI, measured his waist circumference, and recorded his “skinfold” thickness over his triceps muscle. She checked his overall flexibility, strength, and posture.

She talked to Dickle about his physical activity levels over the last 30 years, and asked about his personal goals. Dickle revealed that he would like to join his friends in a weekly bowling night and play Frisbee golf with his family on Saturdays, but he was too weak and overweight to do those activities right now. His primary goal, however, was to not suffer back pain when sitting, and knee pain when trying to stand and walk, which he had dealt with for a long time. He also reported shortness of breath walking up half a flight of stairs.

Dickle’s physical therapist designed a comprehensive treatment program that started off at a low level, so he wouldn’t suffer discomfort and muscular pain from the new exercises he was learning. She incorporated gentle strength training into his routine, using weight machines and Dickle’s own body weight to strengthen his legs, back, core, and arms. She also included some aerobic conditioning on a stationary bike. Dickle’s sessions always ended with a few gentle stretches.

Dickle and his physical therapist also discussed what factors made him want to eat more calories than he was supposed to each day. He noted that staying up late at night, or working at the computer longer than 3 hours without a break, seemed to trigger his desire for sugary and unhealthy foods. They discussed strategies to help break the cycle of unhealthy eating, such as setting an earlier bedtime, and using an alarm during his work hours to cue him to take a quick walk for 5 minutes every hour

Dickle attended physical therapy 3 times per week for 6 weeks. He participated eagerly in his program of strengthening, stretching, aerobics, and posture training. He was soon able to do a full 30 minutes of aerobic training in each session, and he felt invigorated, rather than exhausted, as his body adapted to his new activity level. He noted that he quickly felt stronger overall, and his knee pain reduced significantly. After 2 weeks, he could walk quickly up a flight of stairs with almost no shortness of breath. He proudly reported he was enjoying his new diet full of fresh, healthy foods. After 4 weeks, he lost 10 lbs. After 6 weeks, he lost 18 lbs, his BMI measurement was improved, and his back pain was less frequent.

Dickle was encouraged by his progress, and decided to continue going to physical therapy for another month. At the end of that month, he could walk quickly up 2 flights of stairs without shortness of breath or knee pain, sit for 2 hours without back pain, and—most exciting for him—he was able to join his friends for bowling night! He reported he had a terrific time, with no knee or back pain.

Dickle was discharged as a patient, but visited the physical therapy clinic during open gym hours to continue his program of weight loss, physical activity improvement, and prevention, under the knowledgeable eye of his physical therapist. Three months after starting his physical therapy program, Dickle joined his family for their Saturday Frisbee golf game—and won!