How to get the most out of physical therapy

This may surprise you, but lately I’ve had patients that come for therapy and seem like they are just fulfilling a requirement. They have minimal questions, one word answers and frequently ask how much longer until they are better.  Maybe they have had bad experiences in the past, or have lost hope of getting better.  But with everything in life, whether its work, fitness, or relationships, we get the most out of things we put time and effort into. Physical therapy is the same.

I thought it might be helpful to give a physical therapist’s honest perspective on how you as a patient can be sure to get the most out of your physical therapy sessions. First, it’s important to want to get better, and to prepare mentally for the likelihood that it will take time and patience to get there. You should be ready to put in the time needed for appointments and a home program. Also, part of wanting to get better is being flexible and open to limiting or changing current workout regime if needed.

Secondly, ask questions! Ask why you are doing specific exercises or why your therapist is using a specific manual technique on you. This is a great way to be involved and learn about your body. After all, this is YOUR body and you only have one! You can also do your own research on the web and ask us questions about what you find.

Lastly, be honest from the start. If you can only make 3 sessions or there is no way your life can go on if you have to quit running then tell us. Open communication is a key part of a patient-therapist relationship. We can be flexible too. If you can only make 3 sessions instead of 10 sessions, there is a big difference in what your therapist might spend their time doing during your sessions.

I enjoy being a physical therapist because of the relationships I build with my patients and the opportunity it gives me to help and motivate patients. These things work so much better when patients are ready and willing to be active participants in the rehabilitation process.

Candice Amat, PT, DPT
candice@duffyandbracken.com

The Power of Manual Therapy

Physical Therapists (PTs) use a number of different strategies to help restore an ailing client’s functionality. The three most popular restorative propellers are: manual techniques, modalities, and exercises. These three treatment resources are commonly combined into some fashion that aide in physical rehabilitation. As a passionate physical therapist, certain distinct things being practiced often bother me. For starters, it BLOWS my mind when a new client comes into my office for an evaluation with me, and tells me that they were treated in a previous PT facility that did little to no manual therapy. It also BLOWS my mind when referring medical doctors (MD’s) have prior conversations with patients strongly advocating the use of modalities as a major component in restoring functionality. Great… Thanks to that and their status on the hierarchy of the medical system, a nescient patient is now brain-washed into believing a passive, non-cerebral object is going to bring him/her to fame. Furthermore, I now have the pleasurable responsibility to try to convince otherwise; which, is more often than not, an impossible task. Concisely, manual therapy (hands-on treatment) is the driving force behind healing in physical rehabilitation. Simple.

Before I indulge in discussion about the preeminence of manual techniques, let’s define the term. Manual therapy can be defined as all the hands-on techniques that help reduce pain, increase mobility, increase muscle firing, increase strength, facilitate movement, increase function, decrease edema and/or reset or re-align anatomical segments. These techniques are provided by healthcare professionals in rehab such as: physical therapists, occupational therapists, chiropractors, osteopaths and the like. Manual therapy techniques include: joint mobilizations, soft tissue manipulations, deep tissue massages, rolfing, passive muscle stretching, muscle energy techniques, and proprioceptive neuromuscular facilitation to name a few. There are multiple reasons for the administration of manual treatment; moreover, the importance of manual work with injured patients is extensive.

For starters, it allows for an objective feel of the soft or bony tissue by the treating clinician. Clinicians can get an overall assessment of the static quality of the palpated tissues, as well as, the dynamic quantity and quality of movement. Moreover, certain manual techniques can deliver soothing sensations, which help patients feel better and puts them at ease. Most importantly, manual therapy can shorten the injured party’s convalescence by directly targeting the problematic source. Manual techniques can help a client move better, move faster, and restore proper movement mechanics by increasing a patient’s range of motion in a specific joint.

On the other-hand, modalities are therapeutic agents, or machines mostly powered by electricity, that are designed to contribute to healing. These modalities include: electrical stimulation, moist heat, ice packs, ultrasound and the like. The inherent problem is that there is currently little to no scientific evidence in medical literature that advocate the rehabilitative efficacy of these said modalities.

Hands on techniques help develop a successful therapeutic relationship, which I’ll blog about on my next post. In my everyday practice, I employ hands-on techniques, and have developed great bonds with my clients. The fact of the matter is that the patient/client has to first trust you to allow you to touch them. It drives down insecurities and helps not only the physical rehabilitation process, but the never negligible mental rehabilitation process as well. Injury takes a toll on people’s body and psyche often equally. The warmness of your heart can be felt through your hands.


Bottom line: Passive modalities do NOT suffice. I know we are in the information age, and the trend is to believe that nearly all machines nowadays can take the place of humans, but this is not true for physical rehabilitation. For all patients and physical rehab clinicians out there, please know that the best way to tackle the issues head-on is hands-on.

 Clifford Civil, PT, DPT, ACSM-HFS

Great Expectations: How To Pick A Physical Therapist

As a physical therapist, all too often I have new patients come in who tell me that they’ve tried physical therapy in the past for six, seven, eight plus months, with basically nothing to show for it. The two questions I always ask these patients are: “What did they do with you?” and “Did you think that what they were doing was helping?” While I don’t expect patients to remember every detail of their PT regimens, they should be able to say with confidence whether or not they felt that PT helped them. For those of you reading this who can align yourselves with the plights of those poorly-served PT patients, I’d like to offer you these few pointers to help ensure that your next PT encounter doesn’t leave you feeling like all you’ve managed to accomplish is throwing a few dollars at that high insurance copay or deductible.

Your physical therapist should be:

1. Present – Your physical therapist should BE PRESENT. If your therapist is spending 5 minutes with you then passing you on to an aide or trainer never to be seen again, it’s time to look for a new physical therapist.

2. Hands-on – While physical therapy does emphasize exercise and therapeutic activities, the manual techniques employed by your therapist can greatly help accelerate your healing process or correct dysfunction that could lead to injury down the road. If the physical therapy that you’re used to centers around ultrasound, heat packs, and stim, (electrical stimulation) with the therapist basically spending three minutes giving you a bad massage, it’s time to look for a new physical therapist.

3. Approachable and Informative – Too scared to ask your therapist why they have given you a specific exercise or why they are using a specific manual technique? You shouldn’t be. While the busy schedule of a physical therapist does not afford them the opportunity to spend hours upon hours with each patient, a therapist should be both willing and able to answer any relevant questions asked (and not asked) by the patient, within the allotted time.

4. Creative – Don’t expect a poetry reading when you go to physical therapy, however, your physical therapist should be able to provide you some variety with your exercises and treatments. If you’re doing the same exact thing at every session, for weeks on end, with no progression and no improvement in your symptoms, it’s time to look for a new physical therapist.

5. Competent – It goes without saying that your therapist should know what they’re doing, however, it is important that you feel confident in their competency. I’m not advocating that you base your physical therapist selection on their pedigree or how many letters they have after their name, but the manner in which they explain things to you, the exercises they prescribe, and the manual techniques they perform should all instill confidence in you that they can help you achieve your goals and improve your symptoms.

Here at Duffy & Bracken each of the physical therapists on staff bring with them all of these characteristics, and many more. However, my intent is not to tout how much better our practice is than others out there. Let this blog simply serve as an informative piece for anyone who has been to PT, is currently attending PT, or is looking for a physical therapist and wants to ensure the quality of services being offered. 

It’s your body. It’s your health. Choose wisely!

   

C. Shante Cofield, PT, DPT, CSCS

Duffy & Bracken Physical Therapy and Wellness

Carmen@duffyandbracken.com