At some point in our lives we all face injury, pain, or discomfort. Let’s face it, initially our reaction is to rest, ice, and stay off our feet. At some point the pain and injury slows us down. Often, you will seek your Doctor’s expertise. They may recommend Physical Therapy (PT), but often only after weeks of dealing with your issue. By the time you get to PT you are probably tired of the proposed solution to your pain: “just rest and stay off your feet.”
Fortunately, in Illinois, we are a direct access state. This statute allows patients to seek the care of a Physical Therapist without prior prescription from a physician. In other words, you do not need to wait in pain before consulting with a physical therapist!
Having direct access to a Physical Therapist often leads to additional questions from patients about the quality and reliability of their care. Let’s address those concerns.
How will my physical therapist know what is wrong with me?
As a physical therapist, we do not “diagnose” an injury. We try to come up with a rationale or cause for you discomfort or pain, and develop a plan to treat it. Diagnoses are often blanket terms to describe what you are feeling. As a therapist it is our job to identify your source of pain, the factors contributing to your pain, and uncover any poor movement patterns further exacerbating the pain. As the clinical movement expert, our job is to identify and eliminate the source of pain, rule out severe concerns, and educate you on how to avoid the pain in the future.
With sufficient evidence and clinical judgment, a quality physical therapist should be able to give you answers to help you manage and relief your pain. If the therapist is concerned with your physical presentation or if they can not identify your underlying issue, they should have the right clinical skills to direct you to an expert who can find those answers. An initial plan for treatment and next steps will be identified and addressed in the first 1-2 sessions based on the patient’s initial clinical presentation.
During the initial evaluation your therapist will gather subjective information regarding your history, your injury, and your daily activities, which may or may not contribute to your injury. It is important to understand your work tasks, leisure activities, and household activities. Your physical therapist will run through a functional movement screening involving mobility and strength. They will watch you move and will assess your standing posture, sitting posture, tissue tensegrity, and alignment. If your goal is to walk without pain, they should assess your walking mechanics. If your goal is to perform an overhead squat, they should be tailoring treatment to this goal and watching how you move through this motion when it is safe for you to do so.
What if my physical therapist makes it more painful or worsens my injury?
A good physical therapist should recognize healthy pain responses. You may hear the mantra “no pain is gain” from a therapist. You also may hear the opposite: that a patient should never experience pain when recovering. Neither philosophy is necessarily ideal. Pain is intensely related to and influenced by our limbic system (emotions); how we experience pain is very subjective. Pain will often drive the direction and goal of each session. The therapist is trained to make modifications to your long-term plan, factoring in pain relief and management.
At Smith PT, you will receive individualized treatment and attention during each session. We listen to your complaints, goals, and concerns, and we adapt our plan around your pain and presentation. Each PT session may look different based on your needs for that given day. Our objective at Smith PT is to meet you where you are at on your road to recovery and to see progress towards your long-term goals.
What if my physical therapist doesn’t know how to help me?
During your initial evaluation, your therapist should discuss your goals and their plan to help you to reach those goal. This should include an approximate timeline, potential obstacles, and alternatives if things do not go as planned. As clinicians, we try to explain and lay out this plan as clearly and informatively as possible. We understand that your pain, treatment, and road to recovery are more often shades of gray, rather than black and white. Your physical therapist should be checking in with you each session to measure how you are progressing. That may include demonstrating pre- and post-exercise video to show progress, measure strength or range of motion, demonstrate improved functional movements patterns, or just to ask you to reflect on your own progress. The therapist should educate and guide you throughout your time with them.
There may be other questions and concerns when figuring out where to go for the best conservative care. The biggest questions you need to be able to answer are:
If you can answer those questions affirmatively, then you have likely found a great therapist. At Smith PT, our hope is that you can get back to the things you love to do without pain.