Not all Physical Therapy is Created Equal
I’ve been in clinical practice almost ten years as a Doctor of Physical Therapy. Often, patients will come to my clinic because they have received physical therapy elsewhere and have not been happy with their care or the results of their treatment. They are often hesitant to participate in physical therapy because “it didn’t work before” or “physical therapy doesn’t work” or “exercise will make my pain worse.” Not all physical therapy is created equal. Think of this as a guide to help you ensure that you’re receiving the best possible care!
You should never be handed a sheet of paper with exercises on it and be told to “do these.” After a thorough examination your physical therapist should provide you with a home exercise program. This is often a sheet of paper with exercises listed on it. Your therapist should take the time to ensure that you understand this exercise prescription, how you may feel during and after performing the exercises and what the expected outcome is. When you return for a treatment session, you SHOULD NOT be exercising from the piece of paper originally provided.
You should see your therapist during your treatment. This means that they are with you while performing your exercises. They SHOULD NOT instruct you in an exercise and run into the office to complete paperwork. Your therapist should be watching and, if necessary, correcting your form or providing cues for the proper performance of your exercises. They should also be determining if you are ready to progress in your program.
You should be given a thorough evaluation prior to starting treatment. This means that your therapist should be asking you questions regarding your health history and your current complaint. He or she should ask questions about your activity level, and anything that aggravates or relieves your symptoms. Your therapist should also be asking for your input and what your goals are. This will help your therapist to determine the appropriate course of treatment.
You should be given a prognosis. This means that your therapist should discuss with you how long they believe it will take for you to see results. They may discuss different things that may impact your success with physical therapy (compliance with your home program, workplace ergonomics, the effects of smoking on healing, etc). If, after time, your therapist determines that you need care beyond what they can provide, they should be able and willing to point you in the right direction.
You should NEVER work through the pain. Often, patients think that physical therapy means “no pain, no gain” when in reality, this is far from the truth. Pain is your body’s way of telling you that something may be wrong. It is important to discuss with your therapist if an exercise is causing you pain. They should ask you the qualities of your pain. It is common to be sore after your treatment sessions. This will feel different than any sharp, shooting or stabbing pain.
You should be consistently re-evaluated. Your therapist should be closely monitoring your progress. You SHOULD NOT be performing the same set of exercises for weeks on end without any results. Your treatment program should change with your healing process.
The list can go on and on. If you feel like you are not getting quality care, be sure to discuss it with your healthcare professional and seek out alternative physical therapy options. In most cases, physical therapy is extremely effective in decreasing pain, improving mobility and strength and creating a better quality of life!