Don’t just “go to physical therapy”

Don’t just “go to physical therapy”

Don’t just “go to physical therapy”

A common misconception has been that physical therapy is a place you go or a thing you do – an add-on to medical care. But it’s really a stand-alone partnership with a unique health care professional.

I really don’t like the expression, “go to physical therapy.” And the practice is a whole lot different from that, these days.

“Physical therapist” is a profession that’s evolved tremendously over the years. When you look back to the early days of my profession, physical therapists were in the business of fulfilling treatment programs ordered by a physician – a doctor might prescribe hot packs, ultrasound, or massage, and the patient was ordered to “go to physical therapy.”

What I prefer is for people to, “go see their physical therapist.” That’s an important difference and here’s how…

Over the years, as people were being sent to physical therapy, we physical therapists started to do more than just fill orders. We would evaluate people. And based on our evaluations, we would determine which treatment was most likely to provide a favorable outcome.

Start a partnership 

So now when you go to see a physical therapist, first and foremost, you should anticipate forming a partnership with an expert in movement disorders. And a movement disorder could be as common as the stiff neck you notice as you turn to back your car out of its parking space. Or it could be a person with multiple sclerosis who’s developed impairments in their balance and is having a hard time walking. We treat a wide variety of such movement disorders.

You’ll be a participant

The patient’s role in physical therapy has moved away from being quite passive to being much more active. When people come to see me, it’s not only active in the sense of I’m going to have you move – rather than just put a heat pack on you – but it’s also active in the communication and problem-solving aspect.

I ask a lot of questions. When you say, “I have back pain,” the first thing I want to do is to understand the nature of your back pain. Did it start recently, or did it start some time ago? How is it affecting your life? Is it keeping you from doing the things you enjoy? Or is it not having much impact in that way? What sorts of things trouble your back?

Then we move to prior history of similar troubles and other medical conditions. I’ll do a physical exam to measure and document how you move so we’ll have a baseline to compare to as you progress.

Testing specific therapeutic movement

Here’s an example of how I work with a patient. Let’s say you come into the clinic and say “My back hurts. I have trouble bending. Usually, I’m able to touch my toes and now I can barely reach my knees.” That will set a goal: to restore your ability to bend.

Next, I’ll ask you to try out different exercises. I’m not prescribing these exercises but testing the effects of various movements to see what kind of response you have to it. We’re looking for your symptomatic response and your mechanical response.      

A symptomatic response is a change in symptoms, “Before doing this exercise, just standing here my back was hurting. Now, after doing that exercise, the pain I was having has decreased considerably.” Okay, good positive symptomatic response!

A mechanical response would be a change in how you move. I would say, now that you’ve done that exercise, try bending forward again and tell me how it feels compared to before you did the exercise.  You might say, “Before, I struggled to reach my knees, but now my fingertips are touching my ankles.” That’s a good positive mechanical response.

Listening and problem solving

You can see that the role of a physical therapist is to understand what a person with a movement disorder is experiencing, measure how well they are or are not moving, and then determine which interventions may work best.

In a sense, a physical therapist is like a detective. We use clues to help solve your problem with movement. To “solve the case” it is important for both the physical therapist and the patient to carefully listen to each other. I ask patients to notice how they feel before, during, and after an exercise. Communication is vital to developing a personalized action plan that is truly tailor-made especially for you!      

That’s something you won’t get by “going to physical therapy,” but you will get when you partner with me. Let’s get you moving better and feeling better, together!