When I get the opportunity to talk with people who are struggling to do the things that they enjoy because of a physical problem (pain, weakness, stiffness, etc) one of the common things I hear from them is that they “tried physical therapy and it did not work.” To them this means that it is no use seeing another physical therapist because it did not help the first time. Fortunately, this is not the case. In this Blog, I would like to discuss a bit about how all “physical therapy” is not the same.
First, I think it would help to define what “physical therapy” is and is not. “Physical therapy” is a term to identify a profession. I am a physical therapist and my profession is physical therapy. Much like “Accounting” is a profession and person in the Accounting profession is called an accountant. The profession and label of the individual, does not define the specific type of services provided by that individual. This will depend on the person’s specialized training, experience, and interest in a particular subspecialty of their profession. Under the accounting profession, there are many subspecialties and you would not want someone who specializes in large corporation taxes or non-profit companies to do your personal taxes. Physical therapy is similar.
Although we all graduate from physical therapy school with the same general knowledge, specific training, experience, and our own interests allow us to specialize as we work within our profession. This is great because it allows some of us to become very good at what we enjoy and obtain a lot of knowledge in particular areas. The unfortunate part of this however, is that it does allow for a wide variation of treatment options for similar conditions under the profession of “physical therapy.”
The other thing related to this that I would like to stress is that “physical therapy” is a profession and NOT a treatment. I am a licensed physical therapist, but what I use for “treatment” is education, manual therapy, and exercise which may include general movement, flexibility, and/or progressive strengthening depending on what the patient will need. For me personally, the treatment that I provide to my patients is based off of the available research for a given condition and not necessarily the latest “fad treatment” that is popular at the time but which has no evidence that it is better than a sham (or fake) fad treatment. These type of treatments are commonly prescribed by other physical therapist (as well as other health care practitioners) and when the treatment does not help, a patient can be left no better and thinking that “physical therapy” did not help. The truth is, the specific treatment received was not beneficial and a different type of treatment and education provided by a different physical therapy professional, may in fact be very beneficial.
One more thing to consider before discounting “physical therapy” is the experience and training of the physical therapist providing your treatment. This is something that you should ask about and be interested in before “hiring” your physical therapist. Experience is many times beneficial because of the ability of an experienced physical therapist to work with many other patients previously and to learn from these experiences. However, I would be cautious in just looking for a more experienced/older physical therapist. I have seen in my years of working that some therapists who have been around for a long time are not the ones who have been engaged in life-long learning. They may be providing treatment the same way they were 15-20 years ago when new research that they have not kept up on, shows that what they are doing is not very effective.
This brings us to the last point which is the training that a physical therapist undertakes. Like I said previously, all therapists come out of school with the same general knowledge. The potential training that happens after that can determine how effective or skilled that therapist becomes in the area of physical therapy that they practice, as well as the conditions that they treat. Again, unfortunately, there is a lot of variation in the physical therapy profession so it is important to ask about or consider the specialized training that therapist you are working with or have worked with in the past, has undertaken.
So, how does this all relate to my initial topic of a person telling me that they have “tried physical therapy and it did not work?” I try to get them to realize and understand that all “physical therapy” is not the same. I ask about the previous treatments they have received, and many times I find that what they have had, is not necessarily what is best for the problem that they are dealing with, and/or that there are other ways of addressing their problem.
The majority of the people that I work with are individuals who have not been helped by previous physical therapy (as well as chiropractic, injections, and surgeries). If you are wondering about different treatment options, do not hesitate to contact me to see if there might be something else that can be done.
Thanks for reading.
Bob, PT, OCS, FAAOMPT