Most of us have been to a physical therapist before. I consider them an integral part of the healthcare team. This week I have invited my friends, Kim and Greg Gauronsky, to share their perspective on what its like to be a physical therapist, and what they want you to know about physical therapy:

Going to a doctor’s office can make many people feel anxious or intimidated. When you’re in pain, injured or recovering from surgery, it can make matters even worse.  As physical therapists, we have extensive training in helping people recover from these things. The first thing you should know when it comes to physical therapy (PT) is that we are here to help you, not to hurt you. There seems to be a stigma surrounding PT that even has some patients referring to it as “physical torture”. While we do coach and encourage you to push your body harder than you thought you could, we do not want you to be in pain. However, depending on why you are receiving PT, you might have to endure some pain in order to reach your goals. For example, if you are getting PT after a total knee replacement you can expect to endure a fair amount of pain when your new knee is being stretched. However, if you are receiving treatment for something like low back pain, the expectation is to work on manual techniques, stretching and strengthening in ways that are not painful. 

If you are coming in for physical therapy, there are a few things we want you to know prior to your visit. One of the most common misconceptions about PT is that we do not necessarily need an MRI in order to effectively treat your shoulder, neck, back, etc. Oftentimes patients are referred to PT with a general diagnosis such as “right shoulder pain.” We have been thoroughly trained in musculoskeletal and neuromuscular conditions and are educated in differential diagnoses. This means that we can use a careful physical examination to rule out or rule in diagnoses. For example, we are trained to examine whether your shoulder pain is coming from your rotator cuff, a labral tear, adhesive capsulitis (aka “frozen shoulder”), or if it is actually coming from your neck. If we find any “red flags” in your exam, then we would refer you to a physician to obtain an MRI or other more appropriate imaging.  So we want to reassure you that if we recommend against an MRI, then we are confident that we can reach your therapy goals without one.

We also want you to know the differences between acute and chronic pain. Pain from an acute injury is generally easier to recover from compared to chronic pain. Simply translated, the sooner you get to a PT after an injury the better. Generally speaking chronic pain can be classified as pain lasting longer than 6 months. The longer you wait, the more time your body has to develop muscle tightness or develop irreversible joint damage from inflammation. Another point to consider is the longer you have been suffering from pain, the longer it may take to resolve. So if you are going to PT for pain that you’ve had for “a long time”, please give your therapist time to work with you. It is very rare for someone with 10 years of low back pain to feel better in just one or two treatments. Long story short, see your doctor and get into physical therapy right away. Some states have actually streamlined this process in order to improve access to physical therapists. In these states you can see a direct access certified physical therapist without seeing a doctor first for a referral. Click this link to see which states allow direct access certified PT: https://www.apta.org/uploadedFiles/APTAorg/Advocacy/State/Issues/Direct_Access/DirectAccessbyState.pdf

Lastly, we want you to know that we are here to help you, but you have to help yourself in order to reach your therapy goals. With insurance deductibles and co-pays skyrocketing, patients are having a harder time affording their PT sessions. This makes it even harder for us to do any hands on work. Your physical therapist will likely provide you with a home exercise program from the time you start at your initial evaluation and will progress the program as you make improvements. So in order to succeed you must be diligent with your home exercises.

These are some of the main topics we find ourselves discussing with patients most often and hope that sharing this information may give you a positive approach to receiving physical therapy treatment.