Putting the 'I' in Physical Therapy

Putting the 'I' in Physical Therapy

Sent in from Eileen Wheniwalk:

"So I've had back pain on and off for about 20 years. I've gone to PT in the past and they usually do the to tingly electrical stuff and some ultrasound and I rest, and the symptoms seem to mostly go away after a few weeks. I'm very busy and don't really have time to do my exercises at home. It's been about 6 weeks this time and my pain hasn't gone away. Can you fix me and how long do you think it will take?"  - Not a quote from an actual patient, but a very typical question nonetheless from someone who doesn't quite understand how PT works.


Well, for starters, my name is not Jesus, so no I probably cannot magically cure your chronic pain that's gone untreated for 20 years. What I can do is work WITH you, not FOR you, and come up with a plan to help you get relief in the short-term and ideally prevent but more likely better manage your symptoms should they occur in the future.  

PT can be extremely frustrating for both the patient and the therapist when expectations aren't managed and a clear understanding of the treatment process isn't laid out from the start. All too often I see new therapists struggling to retain patients because the patients feel they aren't progressing fast enough or that PT isn't helping them.

The fact of the matter is, getting better takes time. Tissue healing takes time. Unlearning bad habits and engraining new movement patterns takes time. Physical therapy takes time...and teamwork. 

The same way that I cannot diet and lose weight for you, I cannot exercise for you. I CAN design a program for you, show you stretches and mobility techniques that you can do on a daily basis, but you have to put in the time and the effort. Despite what every exercise-averse patient seems to wish for, I cannot actually do those 3 sets of 10 (or whatever rep scheme you use) or 15 minutes of mobilization for you. We have to work together. 

PTs often have people coming in 2+ times a week simply because individuals require accountability in order to stick with something. Now don't get me wrong, I can think of plenty of situations where multiple sessions per week is the appropriate prescription. However, I can think of an equal number of cases where one session per week or even one session every few weeks would be sufficient. 

The model I've been adopting more and more with my patients is that of a shared responsibility approach. I teach them the techniques necessary to mobilize tissues on their own and we review all the exercises they need to help restore function. In short, I seek to increase the role they play in restoring their function. When the responsibility is shared by both parties we get far better outcomes than with a treatment model that has the PT shouldering the burden and the patient sitting at home rubbing their lucky rabbit's foot.

I realize it's nice to be pampered and taken care of, but save that for the spa. When you are injured and need to get back to your regular level of functionality, you need to put in the work and take responsibility for your well-being. So the next time you're sitting in the waiting room, ask yourself "Can I put the 'I' in physical therapy?" If the answer is no, then be sure to take some of those waiting room magazines home with you, because you're going to be nursing that injury for a while.