When we look at the history of Physical Therapy the profession is only about 50 or so years old. We as a profession are in an infant stage of development. The medical profession is hundreds of years old and the amount of learning and discovery is still happening. As you might imagine the growth of Physical Therapy research is growing at an alarming rate. We have to in order to catch up. So every physical therapy school in the country will soon be a Doctor of Physical Therapy. This level of education is the same as a dentist or a lawyer and now requires a thesis-type paper. These programs are heavy research oriented. They have to be, we are catching up. In order to bring the Physical Therapy research to reach the community the students must practice “evidence based.” This means that all of our interventions (exercises, treatments, etc) must be backed up by science and the treatment must be scrutinized. The way it actually plays out is the physical therapy industry has split intentions. If I sit here and provide only evidence based interventions, what will I bill for? How much time will the PT’s spend with the patients? Insurance companies will deny unqualified treatments too, sometimes that’s good and sometimes not so good.
What if a patient walked in and said, “I only want you to scratch my back. Your fingernails on my back will make this neck pain go away.” The role of the PT is to say “Sorry, but this is what has been shown in the literature to be effective for treating the bulging disc in your neck.” There is an art to treating that bulging disc in her neck too. The PT must incorporate the personality type of the person and educate them as a person. The skill of communication is where the art of educating the patient takes place. As a profession we have less time to communicate or listen, our ability to grow the profession is losing. This post is designed to highlight 6 things that patients are very surprised physical therapists can help with.
1. Scoliosis or any “hereditary” spine problem. Our body responds to the force or pressure we put on it. So with attention to details, some hardwork, and proper education PTs can change the way a faulty spine moves. It requires a mechanical or physical change the patient has to be ready for and the PT has to educate what the person should feel and not feel. Ultrasound, electricity, and anything else from the outside in cannot change how the spine actually moves. Movement can improve the function and can help with a lot of the pain and stiffness associated with long term spine problems. If the spine moves the same way then that same spine will adapt to that same motion.
2. Intimate problems even sex associated problems. Womens Health specialty of physical therapy is growing at an alarming rate. Before and after pregnancy for women. Intervaginal techniques help restore normal function of the reproductive system. Inter rectum treated prostate problems in men. IT IS NOT NORMAL FOR WOMEN TO LEAK URINE AFTER THEY GIVE BIRTH. Exercises, manual therapy techniques, and movement retraining can definitely help these people. This can completely change a persons life. (There is very little expertise in this area from MVPT, LOL but I can get you someone who knows)
3. Wound Care. Now-a-days a big role for PTs in the hospital is addressing big ugly wounds. Bloody, pus-y, tunnels, dressings, ointments, stages of healing, wound vacuums, post-surgical, and any other method of helping people heal from these limits in function due to wounds. This education is part of the general knowledge base of every PT.
4. Arthritic conditions or presurgical care especially ACL. Our body craves moving. If there is no movement then the body breaks down. Arthritic problems are more associated with movement errors than “wear and tear.” It is not what you do, its how you do it. There are plenty of previous athletes who do not suffer years later. The ones who do not suffer continue to move and the ones who suffer either move in a way that creates the arthritis or they lose the motion all together. The answer is re-educating movement through strengthening and stretching. There is a lot of evidence to show that appropriate PT can be just as if not more successful than total joint replacement. Also, if you get one replacement the trend is to add hips and the other knees to the mix if you cannot get the movement problems under control. Before surgery have a movement reeducation PT evaluate your mechanics and learn to move better.
There is an extremely high incidence of total knee replacement in knees that have ACL reconstruction. It has nothing to do with the surgery but the mechanics to tear the ACL is the same as the mechanics that offer the arthritis to the knee. Get stronger first, learn what motions put tension on the graft, and what exercises you can do to eliminate the problem. If you move the same way, you will get the same problems. PT for the ACL for athletes should be up to 20 weeks long. Usually the patients get discharged at 12 weeks or so. Learn to cut well, learn to jump well, learn to run with no biomechanical errors. These concepts will save the graft for the long term. Any major surgery will have this same phenomenon. If your not sure what your PT will do about these topics, interview them before you go. Make sure you are getting value for your time and money. Be a good consumer, not all health providers are up on the latest techniques. At MVPT we specialize in ACL reconstructed knees and the rehab after. Running is a pre-cursor to sports. Good mechanics are a pre-cursor to running.
5. Balance problems like dizziness or vertigo. Your balance depends on 3 systems to hold you up: sight, body awareness or position, and vestibular or your inner ear. When these things are on the same page you have balance, when they stop working together you lose it. A PT with experience can treat you in the clinic without the big and fancy gadgets. The gadgets make it fun and cool and help to a certain extent but you still need movement re-education. It is not uncommon for weakness to bring on balance problems and get mistakenly referred to a balance clinic where they work on the vertigo stuff. Let a movement oriented PT teach you a strengthening program you can do on your own and eliminate balance issues in order to prevent falls. Falls are the leading cause of death in folks 65 or older. Falls lead to hospitals, hospitals are where people get sick (perhaps the topic of another blog post, lol).
6. Head Aches. The general health care system has to start realizing there is no one better at treating head aches than a PT. This is the only quick fix in PT. The upper cervical spine is the place that connects your skull to your spine. When your skull is moving incorrectly you can get head aches. They are very often mistaken for migraines. Your posture and your head position can greatly influence head ache pain. Teaching the spine and skull to move, strengthening the muscles that hold up right posture, and stretching if there is lack of ROM can eliminate a head ache in 1 visit.
At MVPT the answer to physical or functional problems will always be movement re-education. There is NOTHING we can do from the outside that is better than what the body can do for itself. We use cutting edge techniques to educate consumers on the best way to treat themselves. Evidence based practice is crucial to improving the functional lives of the patients that we see. Otherwise we might chase our tail and not know what is what. Prevention is the best way to treat injuries. If you or someone you know has a movement problem feel free to call, stop in, or email. I love taking inquiries. If it is something that needs one on one stuff for we handle it. If it does not require that then I will refer you accordingly. The focus is re-education. Feel free to call at 702-998-2900. The website is www.maxvelocityPT.com. Happy training!!