Some think that physical therapy is only for those who are recovering from surgery, had an accident, or maybe even just for athletes. And while physical therapy can certainly help in those situations, it offers benefits any time someone is experiencing pain, weakness or mobility concerns.
UW Health physical therapist Brian Bradley explains that often, pain doesn’t “just happen.” Tissue overload – a possible cause of pain – occurs over time, or repetitive use wears on the joints or tendons. Physical therapy can help through stretching and strengthening exercises with the goal of helping the body to be able to move and function without pain, or with reduced pain. But it does take time and work to reach that point, which can cause some people to think the therapy isn’t working.
Physical therapists – or PTs - have different backgrounds and skillsets, which can influence how they treat patients. For example, Melissa Fischer, a colleague of Bradley’s, often recommends yoga as part of her therapy plans to help patients improve range of motion, stability and flexibility. If you’ve tried physical therapy once before, both Bradley and Fischer suggest it can be helpful to try physical therapy with a different PT. “A different set of eyes may provide a new perspective and different treatment, which may be the key to your recovery,” says Bradley.
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Bradley adds it may not even be necessary to see a doctor first. “What many people don’t realize is that if they’ve had a minor orthopedic injury, such as a sprained ankle or pulled muscle, they can come directly to physical therapy through 'direct access'.”
Fischer suggests that it can still be helpful to check in with insurance to determine coverage for physical therapy. “You don’t necessarily need to know all of the ins and outs,” she says, “but it is helpful to know if you have any limits to the number of visits or if certain treatments are covered.”
Tips to Get the Most Out of Physical Therapy
When starting physical therapy, both Bradley and Fischer offer a few tips to get the most out of the treatment.
Be a good historian. At the first appointment, the PT will do an examination to see what’s going on with the body and they will ask questions to learn when the pain started, or in the case of surgery, what lead to the surgery. It is helpful when patients can say when their pain started since certain conditions are more easily identified if a timeline is given.
Set goals. Think about goals for treatment – is it to return to a particular sport or activity, or the ability to walk the dog without pain? The goals will help determine the course of treatment.
Commit to your appointments. Both Bradley and Fisher explain that the number of appointments will vary depending on how complex or severe the injuries or surgeries. A minor injury may only require two or three visits, while severe injuries may include 20 or more visits over several weeks or months. How quickly patients progress will depend on whether they are attending their appointments and their recommended exercises.
Do the homework. When it comes to physical therapy, patients do have to do some work outside of the visit. The exercises the PT recommends are to help improve muscle strength and joint mobility and often require repetition and consistency over time to see results. If patients don’t follow the directions, it is difficult to know why their symptoms may not be improving – and as a result, it’s difficult to know how to adjust the treatment plan.
Find a dedicated space to do the work. Fischer suggests having a dedicated space to do the exercises. Whether it’s a gym or a spare room in the house, having the space to move and focus on the exercises can help.
Don’t skip. Patients may be tempted to skip their appointment when they’re experiencing pain. But Bradley comments that is precisely when patients should go. PTs are highly skilled in assessing and effectively treating pain and can adjust the treatment for the day to help.
Speak up and ask questions. Some people may think an ache or pain is normal, and not mention it to their PT. But Bradley says sometimes even the smallest details can help solve the largest problem. And, he advises, ask questions because PTs want to make sure a patient’s concerns are addressed and that everyone is comfortable with the plan moving forward.
Stick to the topic. Both Fischer and Bradley say it’s common for patients to come in for one problem and then mention another problem that is bothering them. While PTs can treat multiple areas during a single visit, a new issue is really going to need its own evaluation to determine the best course of treatment. It’s also possible it will need to be pre-approved through insurance so the PT will often recommend scheduling a separate time to evaluate what might be going on.
Keep the lines of communication open. Depending on the practice, physical therapy may be a part of a patient’s electronic health record. At UW Health, for example, physical therapy appointments are recorded through MyChart. Fischer suggests using MyChart as a way of communicating with PTs between appointments if a problem comes up, something causes pain or the exercises are confusing. That way, it is possible to keep the exercises going rather than having to wait to clarify things at the next appointment.
Keep up the good work. The biggest risk of injury is a previous history of an injury. Once treatment has concluded, PTs can recommend how to prevent injuries in the future through things like exercises, adjusting equipment like a bicycle set up, looking at running gait and more.
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