You don’t have to be injured to benefit from physical therapy

NEW YORK – I cried when I graduated from college – because I had to say goodbye to my physical therapist. He had brought me back from many running injuries and patiently talked me down when I wanted to start training again before I was ready.

Finding a good PT can feel like magic, and I was lucky to learn that early on. Many people do not turn to physical therapy until after they have been injured or had surgery. But it can help with much more.

“We’re sort of the Swiss Army knife of orthopaedic health,” said Dr Joe Uhan, a physical therapist in Eugene, Oregon. “We can push on bones like chiropractors can, but we can massage tissue like massage therapists can and we can exercise like a personal trainer can.”

Here is how to tell if you need a physical therapist and how to make the most of your sessions.

When can physical therapy be helpful?

Physical therapists are not just for sports injuries or post-surgical care. They can also help you develop a routine to prevent injury or improve your mobility.

Preventative physical therapy, sometimes called pre-hab, is generally focused on strengthening parts of your body that could contribute to future injury or discomfort.

Knee pain, for example, can stem from issues in the ankles or hips, Dr Uhan said, which can be prevented with targeted exercises. Some athletes or people following consistent training schedules incorporate preventative physical therapy into their regular fitness routines to stay ahead of injuries before they happen.

For chronic injuries, like tendinitis, a physical therapist can help identify the cause of your recurring issues and create a plan to improve your strength or mobility.

If you have a nagging injury or any pain or discomfort that affects your daily activities, it can be a good first step to seek out a physical therapist, said Dr Maureen Soliman, a physical therapist at the University of California, San Francisco.

For acute injuries, like a torn Achilles tendon, you should see a sports medicine doctor or an orthopaedic specialist as your first step. He or she can advise on when to start physical therapy and give you a referral. Your readiness for physical therapy will depend on how severe your injury is and how much you have recovered.

Following a major surgery, like a total knee replacement, physical therapy is typically a key part of the healing process, said Dr Sue Wenker, director of the Doctor of Physical Therapy Program at the University of Wisconsin-Madison.

In those cases, you will typically be referred to physical therapy by your orthopaedic doctor or surgeon. Post-surgery programmes may focus on gradually putting more weight on your joints, strengthening the muscles around the surgical area and rebuilding your range of motion.

How to find the right physical therapist

If you do not have a referral, seek out word-of-mouth recommendations.

If you have a sports injury, for example, asking members of a local running club or gym can help you find a PT who is the right fit.

A good physical therapist should spend a lot of time with his or her clients – much more than many other healthcare professionals typically do – so it is especially important that you feel at ease with him or her, Dr Wenker said.

Consider your own preferences too, said Ms Nicole Greufe, a sports scientist at Training Haus, an athletic facility and sports medicine clinic in Minneapolis. Are you more comfortable working with someone of the same gender or someone around your age? Do you like someone who pushes you or someone who is more gentle?

Many physical therapists are specialised. They may primarily treat a certain type of injury or work in a clinic that is geared towards athletes in a particular sport.

You should ask about whether your potential physical therapist’s background is aligned with your needs, said physical therapist and chief development officer Chris Bailey for Twin Cities Orthopedics.

Be wary of any clinic that feels like a “PT mill”, said Dr Charlie Homoky, a physical therapist at the Sports Performance Center at NYU Langone Health. You should not be quickly passed off to a rehab attendant or aide, and you should have quality one-on-one time — at least 15 minutes — with your physical therapist at each session.

Your appointments should also be mostly active, including exercises and mobility work, Dr Homoky said. Passive treatments like hot packs may offer some temporary pain relief, but they usually will not solve your underlying issue or speed up your recovery, so they should not be the focus of your appointments.

How to make the most of your sessions

Go to your first appointment with a list of movements that are difficult or painful to perform. It can be helpful to share what makes your discomfort better or worse, Dr Soliman said.

After an assessment, your physical therapist should create a plan based on your needs – this typically includes exercises to practise at home. Your PT may give you additional notes on your exercises, but you can also ask him or her to take videos during your appointment so you can be sure you are using proper form on your own.

In order to progress, it is important to be honest with your physical therapist at each visit about whether you are doing your exercises consistently, or if there are any changes in your symptoms.

And make sure to follow your programme outside the clinic. As Dr Bailey tells his clients: “This is a great group of exercises, and they work best if you do them.” NYTIMES