Physical Therapy:What to Expect and Not Accept

If you are dealing with pain and/or injury that is limiting you from being able to do what you want or need to do, physical therapy may be a good option for you. Most people however, do not know what physical therapy entails and how to recognize if they are matched with the right therapist and/or receiving good care. In addition, many people have already “tried” physical therapy and may or may not have had a good experience. In this article, I would like to share with you some information about what you should expect from going to physical therapy as well as what you should NOT accept from therapy [...]

If you are dealing with pain and/or injury that is limiting you from being able to do what you want or need to do, physical therapy may be a good option for you. Most people however, do not know what physical therapy entails and how to recognize if they are matched with the right therapist and/or receiving good care. In addition, many people have already “tried” physical therapy and may or may not have had a good experience.

In this article, I would like to share with you some information about what you should expect from going to physical therapy as well as what you should NOT accept from therapy.

What to Expect:

• At your first visit:
  • You should expect a thorough Subjective evaluation. This should include:
    • A detailed interview that allows you to share about your problem or condition.
    • You should feel like you had enough time to explain your symptoms and share your thoughts about what you are going through.
  • A detailed Physical examination:
    • This will include tests to rule out something serious going on that would be outside the scope of a physical therapy treatment.
    • The area where you are having symptoms should be examined thoroughly.
    • Other areas that can refer symptoms to your area of problems shoulder also be assessed.
      • Often the pain felt in a certain area, can be coming from a different location in the body and these areas should be considered as well. For example, pain in the back of your leg could be coming from your hamstring muscle, but it also could be coming from your low back. Without this area being assessed, your therapist can be missing out on the area that is causing your problems.
      • Also, even though you may have pain or stiffness in one area, there may be other areas that are contributing, although not necessarily be causing your pain. For instance, many people I see with back pain or leg pain that occurs with walking, have restricted motion in hips that place more strain on the low back. Without this being addressed, maximum benefit may not be attained from treatment.
    • You should receive a detailed explanation of the therapist's thoughts about what is contributing to your problems and how long it will take to improve. If you are like most people, you want to pain/problem to go away as soon as possible. Sometimes with the right treatment, this can happen. Other times, the healing process takes longer than most people expect. Having this information up front can help you have realistic expectations about your recovery and help you stay optimistic as you continue down the path to recovery. 
    • A plan of care should be established with your input. Options should be discussed and with your input, a plan for moving forward shoulder be established. 
    • You should feel like any questions you have have been answered. If not, you should be given the opportunity to ask any further questions that you have. 
    • During your treatment:
      • The therapist should explain what they are doing and why.
      • There usually will be some “hands-on” treatment to help modify or decrease your symptoms.
      • You should be given some homework:
        • Any benefit from “hands-on” treatment will be temporary, unless it is followed through with some specific exercises (could be movements, stretches, strengthening) to help you move into functioning better. Again, knowing why you are doing these will help with your motivation to follow through. 
        • Treatments without this, usually give no lasting benefit. i.e. think about chiropractic adjustments only, which make you feel good for a while, but the pain keeps returning and you always have to go back for more treatment.

What Not To Accept:

• Lack of explanation about your problem and prognosis for recovery.
  • You should have a clear diagnosis, thoughts on what is contributing to your problem, and how long you should expect until a change is made.
• Your therapist not listening to you:
  • Do not accept your therapist just typing on a computer during your session. 
  • You should feel like you are being heard and understood.
  • You should not feel like you are being rushed in and out of your appointments. Enough time should be given for your questions to be answered and so that you feel like change is being made.
• Same treatments without noticing any change:
  • If you are not noticing improvement in a few sessions and you continue receiving the same thing each time you go in, do not accept this.
• Doing the same exercises in the clinic that you are doing at home
  • Your time is valuable. Don’t settle for therapy sessions in which you are just doing what you are doing at home.
  • Your 1:1 time with your therapist should be spent doing things you are not able to do on your own.
• A large amount of pain that you are not prepared for.
  • You are going in because you hurt. You should not leave worse that when you went in for your session.
  • In some conditions, experiencing some increased pain is needed and acceptable. However, you need to understand and know that this is the case and why? Doing things that increase your pain without knowing if this is good or bad, can really limit your progress.

It is my hope that any experience you have with a health practitioner is a good one. However, if you do not feel like you are getting the experience you deserve based on these tips, it is your right to look elsewhere for your care. Despite what your physician may tell you, you have a choice as to where you receive receive you physical hterapy treatment. Physician's that work in health systems are pressured to keep their referral "in-house." You still have the right to request to go somewhere outside the system if you feel like it would suit you better or if the treatment you are receiving is not what you expect and/or not helping. 

After reading this, if you have questions about the care you are receiving, or have received in the past, feel free to contact me. I would be happy to talk with you. Just click on the button below and we can set up a time to talk. 
Thanks for reading,
​Bob

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