1. What’s the goal of physical therapy (PT)?
The primary goal of physical therapy is to optimize your
body mechanics, so that you may return to sport or chosen physical activity.
While pain relief is not the primary purpose of physical
therapy, most often the pain goes away and stays away when body mechanics
issues are corrected.
Ideally, all persons with a sports or back injury should
see a physical therapist first, before seeing a medical doctor. The
majority of the time, physical therapists will lead you successfully back to
full function without a hitch. In some cases, problems persist despite
physical therapy, and then ideally your physical therapist will refer you to a
musculoskeletal specialist medical doctor.
I like to use a 4 visit threshold — you should see improvement in PT
within 4 visits, and if not, then seeing a specialist doctor is appropriate. Why not first see your primary care
physician? Well, in most cases your
primary care physician will rely on a physical therapist to evaluate and treat
an injury. So if you’ve already been
responsible enough to participate in PT, then you’re ready for specialty care
with a sports medicine physician.
2. What should you expect from a PT
visit?
Expect to arrive 10-15 mins early, dressed for
exercise. The sessions usually last 45-60 minutes. During the
initial assessment the physical therapist will get to know you and your problem
by taking a history and performing an extensive physical examination. Each
follow up session typically involves some period of reassessment (i.e. talking about
how you’ve been doing since last session), a physical examination to check
biomechanics, sometimes an intervention (i.e. hands on treatment that might
feel like massage, stretching, or joint manipulation), and then additional
exercise instruction.
We expect you to attend physical therapy sessions once or
twice per week for several weeks before we follow up together. Typically
within 4 visits a person will notice some improvement. The overall
duration of physical therapy depends on several factors including the
complexity of a condition and its chronicity.
3. Why spend the time and resources to
participate in PT? Why don’t you just hand me a printed exercise
handout?
A physical therapist is a medical exercise specialist,
and they are able to design a customized exercise program to help you achieve
your particular exercise goals. Each person’s body mechanics are different.
It is the physical therapist’s expertise to understand what normal
flexibility and strength looks like. Every person has areas of
inflexibility and areas that are weaker than what is optimal. Often
making tailored corrections to your flexibility or weak areas will make all the
difference and allow you to return to full function.
Exercise handouts are designed to treat the “average”
person in a general sort of way. Perhaps up to 50% of the time this
approach works. However, we take your recovery seriously, and we prefer
better odds. With physical therapy intervention for most conditions, the
likelihood of improvement goes up to 75-85% in our experience.
Sometimes I’m asked why I can’t just teach the exercises
at our office visit. The simple answer
is that I’m not a specialist in teaching people how to properly exercise. Additionally, most physical therapists
understand how to assess biomechanics on a more sophisticated level than most specialist
physicians. So they can both assess
complex biomechanical issues, and they are experts in creating an exercise plan
to correct those issues. Just to
overemphasize, when I have an injury or issue, I personally go to see a
physical therapist because I won’t appreciate my weak spots nearly as well as a
physical therapist.
