Happy New year 2017!
My New Year's resolution is to make the physician more aware about PT.
In our day to day practice we come across amazing facts to know, about the mentality and unawareness of physicians or allopaths. These things sometime seems very strange, funny and puzzling to all of us. Their are some physicians and allopaths who know the importance of physiotherapy/ physical therapy. Motive of this post is not to hurt any allopathic doctor. We love our doctors and they are a critical part of the health care team, but there are some things we hope physicians/allopathic doctors should know about physiotherapy/ physical therapy, and things we hope informs the patient about physical therapy.
8 Things We Wish Physicians Knew About Physical Therapy/Therapists
(1) It’s not just a sheet of exercises.
Many times patients tell us that their doctor “gave them some home exercises” to do for their condition. While that may work from time to time and people want “home solutions” nowadays, there is much more to physical therapy than exercises.
1. We do a thorough physical assessment and manual therapy and mobilizations to help things move smoother and easier.
2.Time and time again, therapeutic exercise, education, manual therapy, and pain management is the tried and true method to get people better.
3. Physical therapists are experts at that and can significantly help patients lead healthier, happier lives following this treatment plan.
(2) Modalities don’t do a whole lot
For some reason, there are many physicians that have grasped onto the idea that physical therapy is all about ultrasound, TENS units, hot/cold packs, and electrical stimulation.
While these things may help at times, the evidence supporting their use is scant at best.
Physical therapy is much more than passive treatments like these.
Sure, they can help someone in pain “take the edge off,” but ultimately they will need manual therapy, exercise, and education to maximize their outcome.
Physical therapy is an “active” process in the end
(3) PT clinics have different specialities
Physical therapy have different super specialities for different cases.
Physical therapy for sports injury can not be taken best treated at paediatric physical therapy clinic. the setup for different clinics are different the doctor providing physiotherapeutic treatment is also different in his qualifications like ortho, neuro, cardio paediatric,sports or geriatric and many more.
It’s not just who’s closest to work or home. Like any business, there are different levels of quality.
Patients should be encouraged to look for a physical therapy clinic that suits their individual needs case to case.
It would really help if physicians took the time to get to know the physical therapists in the area and help the patient make an informed decision, not leave it to front office staff.
(4) Residual deformity and Limping is not normal
Many patients walk into our PT clinics limping and say, “Doc said I could get rid of the crutches!” Unfortunately, that is a really bad idea. The abnormal walking pattern not only changes the mechanics of walking, but also can delay healing, increase pain, prolong swelling, and delay return of function. You should use an assistive device of some kind until gait is normalized.
(5) Patients need a few visits after any soft tissue or joint surgery
We’re always surprised how many patients tell us that “ My doc said I didn’t need therapy after this surgery.”
The problem with this is that many people unknowingly compensate after a surgery and this prolongs the healing process and think is is the amount of deformity we have to live with.
Most of people end up needing physical therapy more later than if they would have come right away.
Due to the delay the number of visits required increased some time to double.
That is obviously more time and treatment cost on the patient.
(6) Physical therapists are also source of new business to physician
Physical therapists are also trained to pick up “non-musculoskeletal problems.”
Many patients come to physical therapy complaining of things that are systemic in origin, not musculoskeletal.
Physical therapists are trained to recognize when a patient presents with symptoms that are not compatible with physical therapy and properly send them on to their doctor.
Having a good relationship with a physical therapist helps facilitate this with patients.
(7) Many problems patients have are in areas other than where the pain is.
For example, many patients complain of shoulder pain but the problem is really in the neck. Another example is that many patients have low back pain and the patient gets MRI’s, injections, etc for the back but the problem lies in the hip. If patients aren’t responding to treatment or if MRI’s are inconclusive, consider sending them onto a PT for a thorough biomechanical assessment to determine the source of the problem.
(8) Physical therapy is a better option than injections or pain medications. Several studies have shown that physical therapy is better for chronic back pain, and for tendinopathies, injections are no better than therapy after 3 months. We’re obviously a little biased but why not try the cheaper PT before an expensive MRI or try PT before a more invasive injection. Sure, injections are needed at times to help calm the pain down so the patient can do PT – we have no problem with that. However, injections aren’t a panacea for everything.
My New Year's resolution is to make the physician more aware about PT.
In our day to day practice we come across amazing facts to know, about the mentality and unawareness of physicians or allopaths. These things sometime seems very strange, funny and puzzling to all of us. Their are some physicians and allopaths who know the importance of physiotherapy/ physical therapy. Motive of this post is not to hurt any allopathic doctor. We love our doctors and they are a critical part of the health care team, but there are some things we hope physicians/allopathic doctors should know about physiotherapy/ physical therapy, and things we hope informs the patient about physical therapy.
8 Things We Wish Physicians Knew About Physical Therapy/Therapists
(1) It’s not just a sheet of exercises.
Many times patients tell us that their doctor “gave them some home exercises” to do for their condition. While that may work from time to time and people want “home solutions” nowadays, there is much more to physical therapy than exercises.
1. We do a thorough physical assessment and manual therapy and mobilizations to help things move smoother and easier.
2.Time and time again, therapeutic exercise, education, manual therapy, and pain management is the tried and true method to get people better.
3. Physical therapists are experts at that and can significantly help patients lead healthier, happier lives following this treatment plan.
(2) Modalities don’t do a whole lot
For some reason, there are many physicians that have grasped onto the idea that physical therapy is all about ultrasound, TENS units, hot/cold packs, and electrical stimulation.
While these things may help at times, the evidence supporting their use is scant at best.
Physical therapy is much more than passive treatments like these.
Sure, they can help someone in pain “take the edge off,” but ultimately they will need manual therapy, exercise, and education to maximize their outcome.
Physical therapy is an “active” process in the end
(3) PT clinics have different specialities
Physical therapy have different super specialities for different cases.
Physical therapy for sports injury can not be taken best treated at paediatric physical therapy clinic. the setup for different clinics are different the doctor providing physiotherapeutic treatment is also different in his qualifications like ortho, neuro, cardio paediatric,sports or geriatric and many more.
It’s not just who’s closest to work or home. Like any business, there are different levels of quality.
Patients should be encouraged to look for a physical therapy clinic that suits their individual needs case to case.
(4) Residual deformity and Limping is not normal
Many patients walk into our PT clinics limping and say, “Doc said I could get rid of the crutches!” Unfortunately, that is a really bad idea. The abnormal walking pattern not only changes the mechanics of walking, but also can delay healing, increase pain, prolong swelling, and delay return of function. You should use an assistive device of some kind until gait is normalized.
(5) Patients need a few visits after any soft tissue or joint surgery
We’re always surprised how many patients tell us that “ My doc said I didn’t need therapy after this surgery.”
The problem with this is that many people unknowingly compensate after a surgery and this prolongs the healing process and think is is the amount of deformity we have to live with.
Most of people end up needing physical therapy more later than if they would have come right away.
Due to the delay the number of visits required increased some time to double.
That is obviously more time and treatment cost on the patient.
(6) Physical therapists are also source of new business to physician
Physical therapists are also trained to pick up “non-musculoskeletal problems.”
Many patients come to physical therapy complaining of things that are systemic in origin, not musculoskeletal.
Physical therapists are trained to recognize when a patient presents with symptoms that are not compatible with physical therapy and properly send them on to their doctor.
Having a good relationship with a physical therapist helps facilitate this with patients.
(7) Many problems patients have are in areas other than where the pain is.
For example, many patients complain of shoulder pain but the problem is really in the neck. Another example is that many patients have low back pain and the patient gets MRI’s, injections, etc for the back but the problem lies in the hip. If patients aren’t responding to treatment or if MRI’s are inconclusive, consider sending them onto a PT for a thorough biomechanical assessment to determine the source of the problem.
(8) Physical therapy is a better option than injections or pain medications. Several studies have shown that physical therapy is better for chronic back pain, and for tendinopathies, injections are no better than therapy after 3 months. We’re obviously a little biased but why not try the cheaper PT before an expensive MRI or try PT before a more invasive injection. Sure, injections are needed at times to help calm the pain down so the patient can do PT – we have no problem with that. However, injections aren’t a panacea for everything.