If I had to guess, most people have heard of physical therapists, but many people carry the misconception that physical therapists are personal trainers or massage therapists that are just covered by insurance. Amazing—free workout, free massage!! Sorry to burst your bubble, but WRONG! Sure, physical therapy likely will involve some exercises and some massage but it is much more.
Physical therapy is a long term solution. We strive not to just rid today’s pain, but prevent it from returning in the future. This takes time and it requires a team approach between the physical therapist and the patient. This might not be popular, but it’s the truth. For physical therapy to be successful, the patient must put in the hard work and dedication in order to allow a physical therapist to help them reach their goals. This often means consistent compliance with the prescribed treatment plan, activity modifications & diligence with a home exercise program. Otherwise, to be honest, it is a waste of your time, it will be an uphill battle, will take longer to get better and ultimately you will become frustrated.
Now, just as it is important that you are dedicated to your rehab, it is equally important that you find a competent and invested physical therapist. Like any profession, there are good physical therapists and, well, I don’t want to say bad, but….bad physical therapists. Find that therapist whose personality you connect with, who seems to love what they do, who goes the extra mile to help you, who spends time with you during your sessions, who individualizes your treatment and who genuinely cares that you reach your goals.
In today’s world, physical therapists are required to have both a Bachelors of Science degree (or the equivalent prerequisite classes completed) & a Doctorate of Physical Therapy from an accredited Physical Therapy School---yikes, seven years of schooling!! Why, you may ask? As we continue to strive to elevate our profession, one of the many ways is through increasing our access to patients. Direct Access, or the ability for a patient to come and see a physical therapist for an evaluation and treatment with out a prescription from a medical doctor, is one of many ways that our profession has accomplished this. With this new change comes great responsibility to be able to improve diagnostic skills. It is vital for physical therapists to recognize red flags that may make a patient inappropriate for physical therapy and require a referral to their primary care doctor, specialist or in severe situations, the emergency room. This heightened training gained in a doctoral program, as well as furthering imaging understanding are, in my opinion, two of the main reasons why it has been essential for our profession to convert to a Doctor of Physical Therapy.
Physical Therapist’s thrive in the early stages of rehabilitation after injury and pre/post surgery. This is the bread and butter of what we do. Now, maybe this is wishful thinking, but I look forward to the day that we can begin to gravitate towards preventative medicine in order to help prevent injuries versus just helping people after that fact. Unfortunately, insurance companies do not currently cover preventative treatment, but I remain hopeful they will change their stance on this eventually. But anyways, before I get too off topic, let’s return to what physical therapists do. I could quote what the American Physical Therapy Association (APTA) says, however that seems boring to me. If you are that interested, I promise you can find it on google. Instead, I am going to talk about my experience as a physical therapist--what does my day-to-day look like?
Most of my patients come from orthopedists and from past patient recommendations, however, as people become more aware, I have started to get a lot of direct access patients (remember, we spoke about that earlier!). I specialize in movement analysis in order to figure out why a patient is having pain, what is the underlying cause of dysfunction and what is the appropriate plan to fix it to reach the individual goals of the patient.
Well that sounds nice right? But what do I actually mean by this? Well, it’s not always the case that the location of the pain is the source of the pain. For example, if my lovely patient Betty has come to me with knee pain--does she have an injury at the knee? Does she have weakness in her hip causing too much stress through the knee? Or does she have referred pain, lets say from her back? We have several tools, measurements and special testing in order to figure out the answer. Once we have figured it out, then we can come up with a treatment plan. Now, every good physical therapist will tell you that no two treatments are the same and therefore we take pride in individualizing our treatment plans to the patient in front of us. That being said, each program typically has the same components including an exercise prescription, some manual treatments (soft tissue mobilization, joint mobilizations, scar mobilization etc..) and in my case, a HUGE amount of patient education. I view my role part as a physical therapist and part as a teacher. I try to help my patients understand every aspect of the rehab process, the how, why and what, to empower them to succeed long term and teach them about their bodies so hopefully they don’t have to endure physical therapy again. We’ll have more on that topic one day!
We are responsible for communicating with the referring doctor, forming an integral part of the rehabilitation team, all with a singular goal of getting the patient better as quick and safely as possible. This becomes especially important when dealing with patients who have just had surgery as it is important to have a comprehensive understanding of the particular tissues involved, the healing process, precautions and contraindications so that you can progress the patient appropriately—too slow can have detrimental effects as well!
While the focus of this and the focus of my career has been orthopedics, I do want to highlight that physical therapy is wide spread throughout medicine. In fact, in almost every specialty of medicine there is physical therapy. To name a few, there are pediatric physical therapists (think newborns, toddlers, teenagers), women’s health/pelvic floor specialists (think pregnancy, postpartum, bowel & bladder), cardiopulmonary physical therapists (think heart and lung problems), neurological physical therapists (think brain injuries, strokes), vestibular physical therapists (think inner ear problems causing debilitating vertigo) & hand physical therapists. Call me biased but I think that is pretty cool!
Like any profession, there are pros and cons but if you ask me the pros far out weigh the cons. Even on difficult days the satisfaction of helping people reduce their suffering and return to what they love carries you through!
Anyways, hope this helps you understand the how, why & what of physical therapy in order to help you be more informed when making decisions about your health. Remember our goal is to empower you to reach your goals & love life again!