You might be wondering if physical therapy is the right choice for you, or you’ve done physical therapy before and it didn’t help you get to your goal. I completely understand -- but humor me and read this list anyway, it’ll help! Here’s what you need to know.
In this post, we are talking about the top 6 reasons PT might not have worked for you before (and why now is the time to give it a try again) and the 6 things to keep in mind as you're getting ready to start PT.
1) Who is actually my physical therapist?
If your experience was that you were in a very busy clinic and you saw multiple people who you thought were all licensed healthcare providers and you were never really certain who was in charge of your care, then that is a very good reason to try physical therapy again.
Some business models for physical therapy have each physical therapist trying to provide simultaneous care to multiple patients all at one time. And so they utilize an aide (who is NOT a physical therapist and has not been trained other than being directed by the PT) to help them accomplish this difficult task.
If the physical therapist has to provide care for 2-4 patients within one hour, you are not getting that PT’s undivided attention and thus the care you receive is not of the utmost quality. You need to realize that there are other business models where you get the full hour or however long the session is, and during that time you get the full attention of the physical therapist and you have the same clinician treating so there is continuity of care and carryover from session to session.
2) Did they get to the root cause?
This is paramount and really vital to understand as you progress in your journey to recovery. Where you feel your pain or have an issue, may NOT be the root cause of you problems. It’s necessary to understand victims and culprits.
For example, you have knee pain…your knee is the victim. However, the culprit is often elsewhere, the culprit being the root cause of your issue. In the example of your knee, it could be a lack of ankle mobility (or stability) or look up the kinetic chain and the true culprit for your knee pain could actually be your hip or back.
If the root cause was not identified and addressed previously, then yes likely physical therapy did not work for you. Or at best it helped for a time but then later returned because the root cause was not actually addressed.
3) Not every physical therapist is the same. Finding the RIGHT one for you is key!
When one PT didn’t work for you, it will likely be a completely different experience with a different one (and if it isn’t, find one that has a different approach! Feel free to ask questions or interview them) Physical therapists are all trained to be generalists, which basically means in their schooling (which all are now doctoral-level training programs), they learn about all different types of problems that they can treat. They range from treating someone with an ACL injury, to someone who has had a heart attack, to a chronic neurological problem such as Parkinson’s, to even treating wounds.
Once we get out of school, by default we start to specialize in certain areas, merely by the patient population that we work with. We also take continuing education courses in order to maintain our licenses and so we learn new skills and knowledge that other PT’s may never learn. We continue to learn throughout our career and our interests may lead us in different directions. The point is that we do not all have the same skill set or knowledge base once we specialize and so what one PT did with you may not in fact be what another one does with you, in part due to the ongoing education that we focus on as we progress through our careers.
While this may feel frustrating, it should also be empowering because there IS very likely a physical therapist who can help you with your problem! The other piece of this is also one physical therapist may not push you enough. Or another one well you just may not gel with them (you aren’t likely to follow their recommendations if you don’t). Or perhaps you get along with them too much and it just becomes a chat session. Finding the right fit of a physical therapist in these areas is also vital and can play a big part in getting you to where you need to go.
4) Did you actually have a roadmap to get you to where you want to go?
When you are trying to go somewhere you’ve never been before, you typically rely on a map or in these days, you resort to maps in your phone. The same is true when you are trying to get out pain, recover from an injury, or trying to reach a new level to your fitness and health. If you don’t have a plan as to how you are going to there, you likely won’t. In physical therapy, we call it a plan of care.
Were you involved with your plan of care? Did you even know there was such a thing? Did your physical therapist talk about your activity level prior to the problem and leading up to the issue? Did they ask you what your goals were and where you wanted to ultimately get to? This also means that the exercises you are given are tailored to you, your current level of function, to your chosen activity or sport, and to the goals that you have.
If these things are not taken into account for your roadmap, then again you likely didn’t get there. It’s no wonder as you didn’t actually have a roadmap to get there (or if there was such a thing and you didn’t know about it, that’s worse!). You should have a full understanding of what exercises you are doing, why you are doing them and what things are needed to achieve and what the PT is looking for you to achieve in order for you to reach your goals!
5) It ended too early. Or ran too long. Timing is everything.
A very common timeframe that people will be seen for physical therapy is 2 times a week for 6 weeks, maybe 3 times a week for 4 weeks. It could be the recommendation or what’s scripted from a physician, which may just the be default on the computer. In other words, it too is also not tailored to you. Or it could be that your insurance will only allow for 12 visits. But you may honestly need more visits than that.
That’s the problem again, is that it wasn’t tailored to you and your issue, AND then perhaps even more important is WHERE YOU WANT TO GO?!!! Someone who has a knee injury and just wants to be able to do their daily activities like walking in their house likely will need a different amount of therapy versus the person who wants to return to marathon running. For the active individual, physical therapy often ends before you are back to your activity full force; if you haven’t been appropriately progressed back to your activity (and then also advancing past your previous PR’s), then you are prone to re-injury and will feel defeated and that physical therapy didn’t work. It did work, it just didn’t actually get you to your destination.
6) Lastly, you may not be ready to commit and make change.
While PT’s are great at many things and can help many people. You have to do your part. You have to show up. You have to do exercises and also follow the recommendations of the physical therapist in regards to progression back to your activity and modifications that need to be made. What do you do outside of your session(s) during the week far outweighs the 1-2 hours of treatment.
Making this a priority and actually doing the work is your responsibility. And honestly, often those that say that physical therapy didn’t work, more often than not, they were not compliant. They did their exercises every once in a while. They continued to push past their pain, only continuing the cycle of an overuse injury. And then by not doing the exercises which would help to break that cycle and then continuing to aggravate their symptoms, it’s no wonder it didn’t work.
All of this considered, what do you think? Will physical therapy work for you?