By Dr. Glenn V. Forsyth PT, DPT
If you ever had a flare-up of low back pain, sprained an ankle while playing sports, or had surgery on a bone or muscle, you may have visited your physician and been referred to “physical therapy.” If not, you may have missed out on a valuable opportunity to improve your pain, daily function, and quality of life in a conservative manner! In this blog, I want to introduce you to the world of physical therapy, dispel common myths about the profession/process, offer budget-friendly options for those seeking treatment, and provide tips for minimizing injury risk in the first place! But first, let’s discuss what physical therapy is and how it all happens!
Physical therapy, or “PT,” is a branch of rehabilitative health that uses manual treatment and specific exercise protocols to restore your health. PT is often our first line of defense in the treatment of injuries, physical ailments, or other painful pathologies. These Injuries and pain can occur in a lot of people for a variety of reasons.
Physical therapists treat issues with movement and daily function through a wide array of conditions ranging from sports injuries and musculoskeletal pain, to neurological conditions in adults and children, and even metabolic and cardiovascular diseases! To cover this wide range, a physical therapist can be found in many different settings such as outpatient clinics, hospitals, both long term and subacute rehabilitation centers, skilled nursing facilities, sports facilities, and home care. Treatment can occur throughout all stages of life, as age-related pain and certain injuries are inevitable and naturally-occurring throughout life. Since pain is such a natural part of life, physical therapists' serve such a vital function in encouraging and empowering patients to manage their pain and movement issues!
Physical therapy benefits those who are suffering from pain or injury through numerous routes: decreasing perceived pain response through manual (hands-on) therapy and physical modalities, improving muscular coordination and strength through precision exercises and neuromuscular re-education, and patient education. Patient education is arguably the most important tool in a physical therapist’s arsenal. This is because patient education provides the knowledge required for patients to treat their own painful states or injuries outside the clinic, or continue to do such treatments after the episode of care has ended. It’s for this reason that I want to educate YOU on what physical therapy has to offer–all while dispelling some of the myths surrounding pain/injury.
The In’s and Out’s:
Breaking Down a PT Session
First, let’s start from the beginning (have any interest in becoming a PT? If yes, this section’s definitely for you!). A typical first session will include a subjective portion, physical assessment, treatment portion, and then an education portion:
The subjective part of the initial assessment will involve the therapist acquiring information about the patient’s reason(s) for arriving to PT, including specific pain/symptom details, injury history, pertinent medical history, and the patient’s desired goals after completing an episode of care.
The physical assessment will involve the therapist observing a patient’s resting and dynamic (moving) posture, testing their strength and range of motion of muscles and joints pertinent to the region of pain/symptoms, and ruling out non-musculoskeletal origins of pain (such as pain referral from organs). The therapist will then move onto the “special testing” part of this assessment to uncover any specific musculoskeletal pathology. Lastly, the therapist will observe a patient’s “problem” movements, such as gait (walking or running), squatting, ascending/descending stairs, etc.
The treatment portion will include physical modalities (if applicable) such as moist heat, cryotherapy, electrical stimulation, and manual therapy (such as joint and soft tissue manipulation, which are techniques to get certain muscle groups to relax or assure the nervous system that “everything is okay”) to decrease pain sensitivity/prepare the patient for the active treatment. Last, but definitely not least, the treatment portion will include a therapeutic exercise performance, which is the active treatment. This “active treatment” is the most important part of the session because it solidifies the progress you’ve made towards being pain-free, and with improved function.
Finally, the education portion will be utilized to provide the patient with knowledge on the diagnosis (what’s happening), prognosis (severity and duration of said diagnosis), and self-management during and after your prescribed amount of care with us.
At first, this may all sound a little complex and overwhelming, but all of these steps are necessary for the therapist to build a good foundational relationship with you to help you reach your unique goals. Physical therapy sessions, although at first glance appearing like a typical “doctors visit,” are actually much more welcoming and fun than many believe!
Despite getting this far, I understand some people may still have questions about PT. You may have even heard some rumors about what to expect on your first visit. In this next section, I’m going to dispel five of the most common myths I hear about physical therapy.
Five Common Myths about Physical Therapy
1). I need a prescription from my physician to get PT.
Reality: This may apply in some cases, but in many states, such as New Jersey or New York, a person can arrive at a physical therapy clinic via “direct access” or without a prescription in order to be seen for treatment. Patients should check the APTA website to review their state’s direct access guidelines, as well as contact their desired PT clinic for more information on insurance, requirements for prescription, etc. We want your journey towards health to be as accessible as possible, and it starts with having the right information about what’s available to you.
2). PT is about getting heat, massage, and some stretches.
Reality: Although these may be portions of a session in an orthopedic setting, PT includes individually-prescribed manual treatments and exercises used to achieve specific outcomes that move a patient out of a painful state and back to their prior level of comfort and function. Patients should expect to work hard during their rehabilitation, with large payoffs for their dedication!
3). I am having pain because something is damaged/injured.
Reality: Perceived pain does not always equate to tissue damage. Pain is a complex process that researchers and clinicians are still trying to get a full grasp on. In fact, pain sensation in one area of the body can result from another separate area (more on this later). Regardless, if a patient’s pain is coming from actual muscle/ligament, it should be assessed by a professional.
4). I can’t afford PT and will do some of the exercises I found on Instagram to help.
Reality: If you are having serious and long-standing pain or pathology, PLEASE go see a professional to get assessed. Do not rely on social media for answers that may not fit your individual case. If it’s a financial issue, the physical therapist will try to work out a plan that maximizes self-management of the pain/injury through less frequent sessions and increased education, home exercise programming, etc.
5). PT will help me prevent injuries.
Reality: I saved this one for last because it serves as a great jumping off point for living a well-rounded and balanced healthy life. There is no such thing as “injury prevention.” Injuries occur due to a WIDE array of reasons/variables, and are not always caused by singular issues such as “muscle weakness” or “bad posture.”
What physical therapy can assist with is “injury risk management.” This management will help set you up in the best position possible to perform your necessary sport, task, or function with as little injury risk as controllable. You can also achieve this low-risk state without specific “PT principles.” I educate my patients all the time on the importance of sleep, nutrition, stress management, and lifestyle as necessary boxes to be checked during rehabilitation. These tips also happen to decrease your risk of running into issues down the road. Stress levels, metabolic health, past injuries, and even seemingly unrelated body regions can result in increased perception of pain. For example, if someone is having pain on the inside of the knee while running, the hip, foot, or even low back may not be moving or actively participating to its full capacity to help distribute the stress and force of running throughout the entire leg. It’s all connected and it all matters! So follow those tips to decrease your risk!
I hope this blog has helped give you a better understanding of what physical therapy is all about. You should now feel equipped to know when to listen to your body and call a PT before your pain becomes an injury. On behalf of PT’s everywhere, we are here to help you take control of your health.
Physical therapy has cemented itself in the world of medicine as a necessary and important practice for the health of an active and aging society, and I am thrilled to be a part of it! Thank you for reading, and don’t hesitate to reach out if you have questions!
Dr. Glenn V. Forsyth PT, DPT
I have been fascinated by human health through movement and nutrition since high school. As a life-long wrestler, I needed to embrace an ideal combination of physical fitness and health through proper exercise and nutrition. This combination helped me improve my physical and mental performance, while maintaining a baseline level of well-being. I later furthered my passion through formal education, receiving my Bachelor’s of Science in Nutrition and Dietetics at New York University and a Doctorate of Physical Therapy at Rutgers University.
I am currently a licensed physical therapist who practices in an outpatient orthopedic setting in New Jersey and treats a myriad of injuries and pain-related conditions. I am constantly inspired by my colleagues and patients to continue pursuing knowledge and adapting new methods of holistically-treating populations who are seeking better health through movement and fitness–all while empowering patients to pursue these goals in an efficient and, dare I say, fun manner! “Pain-free,” “perfect movement,” and “optimal patterns” are not goals I share with my patients, and should not be a final destination for anyone in life. Alternatively, I believe that the greatest tools for managing pain and injury risk are confidence and a positive outlook. That is ultimately the best route when building a robust, healthy body.
Have any questions? Feel free to reach out!
IG Handle: @glenn_dpt