Who You Gonna Call?

"Who you gonna call?" Given any other circumstance, the correct answer to that question would of course be "Ghostbusters!" But today I want to provide you with some insight regarding a more immediately relevant matter than the super-natural (if this is not the case, feel free to call 555-2368), namely your body, and who to call when it's broken.

I recently sent an article out to my colleagues at work, and my director immediately responded back with a call to action to write this very piece. Her point, well made as always, focused on the notion that despite our skill-set, for many people, physical therapists are far from front-line warriors when it comes to battling injury. When people think of physical therapy their minds seem to immediately go to a hospital setting filled with elderly bed-ridden folks. Guess what folks, there’s more to physical therapy than that. In fact, I have never worked in a setting like that, nor have a good number of the therapists that I know. While that scenario does exist, orthopedic and sports physical therapists work in a variety of settings, treating everyone from the desk jockey to the professional athlete. Physical therapists have the knowledge to design everything from modified rehabilitation programs to high-intensity prehab workout sessions. For those of you who like names, Gray Cook, he’s a physical therapist. Kelly Starrett, he’s a physical therapist. We fix athletes, we do cool things, you should check us out.

Quite some time ago I wrote an article detailing what we as physical therapists know and bring to the table. If you haven't read it, then you missed out, so please feel free to join the cool kids club and check it out immediately. For those of you who have already absorbed my knowledge, you'll recall that the three years of PT school produces extensively trained folks with doctorates, well on their way to becoming movement experts.

A study from 2005 reports that physical therapists are second only to orthopedic surgeons when it comes to knowledge of the musculoskeletal system. For those of you not in need of an immediate surgical consult (aka likely everyone reading this article) this should come as excellent news. Over the years, physical therapy school has transitioned from conferring a bachelor's degree to conferring a doctoral degree as extra years of schooling have been added with a heavy emphasis on differential diagnosis. In regular speak, that means more class time is now required that teaches DPT students how to figure out what is wrong with you, and whether or not it is both appropriate and within their scope of practice to treat you. In even more regular speak this means physical therapy school prepares one to become a primary care giver.

In New York state we have what is known as direct access, which means you can see a physical therapist without first going to the doctor. While the specific guidelines for direct access vary from state to state, in New York, a prescription from the doctor is only required AFTER ten visits or 30 days from your first treatment, whichever comes first. The caveat being that the treating physical therapist must have been practicing for at least three years. Overall, more great news for those of you with nagging injuries or even acute injuries such as an ankle sprain or the dreaded "blown out back", whatever that actually means.

For any of you who have actually had the pleasure of attempting to navigate the healthcare system, you know that even the smallest physical ailment can be something that takes weeks or even months before it is addressed by a professional. Ignoring the exorbitant cost to the healthcare system imposed by meaningless tests and surgeries that could have been avoided, it can be weeks before you can finally get in to see a specialist, and then additional weeks as you wait for authorization for whatever battery of tests have been recommended. During this time your tissues are tightening, your muscles are weakening, and your "small" ailment is becoming a big chronic injury. Seeing a physical therapist right off the bat cuts this waiting time down to days, cuts your healing time down exponentially, and decreases the financial burden to not only you, but the entire healthcare system as a whole.

For those of you ready to live and die by the MRI, take note that the special tests performed by physical therapists have diagnostic values nearly equal to that of standard imaging. Furthermore, in the majority of cases, the results of imaging don't change the course of treatment unless surgical intervention is warranted. Physical therapists can assess ligamentous integrity of all the joints, determine muscular or tendinous involvement, but above all they know when to refer you to a physician. Keeping in line with this notion of referring out, physical therapists are basically your friends with VIP passes to the health care system, able to offer recommendations about which type of doctor to see, questions to ask, and even specific doctors best suited to treat your particular injury.

For those of you still reading, I reward your dedication with a nice little summary:

  • Physical therapists treat people of all ages and abilities.
  • Physical therapists know a TON about the movement and the musculoskeletal system.
  • Physical therapists are primary care givers, and you could absolutely benefit from seeing one before, during, or after your next injury.

So, again I ask you, “Who you gonna call?” Choose wisely. Your body will thank you.

 

References:

Childs et al. A description of physical therapists’ knowledge in managing musculoskeletal conditions. BMC Musculoskeletal Disorders 2005, 6:32 

Moore et al. Clinical Diagnostic Accuracy and Magnetic Resonance Imaging of Patients Referred by Physical Therapists, Orthopedic Surgeons, and Nonorthopedic Providers.  J Orthop Sports Phys Ther. 2005;35:67-71.

Images:

http://forwardthinkingpt.com/2014/09/19/pros-and-cons-of-mri/

http://imgur.com/jmUdlgB