“I’m not sure I should even be here today…I’m not that bad…other people need your help more than me…Isn’t physical therapy just for major injuries or after a surgery?”
That is just a brief sampling of comments overheard at a typical outpatient physical therapy clinic. Yes, physical therapy is well established as the “go-to” profession following major surgeries to help aide in a speedy recovery, but there is a multitude of additional treatment options available to help manage less “serious” conditions. Let me offer up a few real-life examples of patients I have worked with over the past few months who all greeted me with a similar comment as laid out in the beginning of this article.
A 50-year-old female who lives an active lifestyle, works out regularly at home, who slowly developed shoulder pain that limited her work outs. At first, it just meant making some adjustments to her exercise routine, then she notices more difficulty with simple daily tasks such as putting on her clothes, rolling over in bed, and putting on the seat belt in her car. The pain had evolved from a nuisance to now affecting aspects of daily living and her quality of life. This is the point when most people finally “give in” and contact their primary care physician (PCP) for some guidance. Fortunately, her PCP referred her to physical therapy and following a brief exam was diagnosed with shoulder impingement. I recommended a simple home exercise program designed to correct muscular imbalances in her shoulder and remove aggravating exercises she had been doing at home all along. We followed up in the clinic a few weeks later, made a few more adjustments to her routine, and she is now back 100% and living her normal active lifestyle after just 2 visits to our clinic.
A 65-year-old male who just retired from a long career in corporate life sitting at a desk 40-hours/week for the past 40 years. He’s excited to be retired but feels like his body is broken down and has no idea where to get started with exercise. He tried going to the gym, but nagging knee and back pain flared up and got concerned he would only make it worse. Eventually, he goes to his PCP for annual wellness check and mentions this to his doctor which is how he landed in my office. In his case, there was no specific “injury” or precise location of his pain… he hurt everywhere! Following a thorough examination which included strength, range of motion, balance and gait analysis, we had a lengthy discussion regarding his diagnosis, plan of care and rehab potential. We started with basic flexibility training and established a walking program. He comes to the clinic 2x/week, and we focus treatment on his biggest concerns of the day. Often, this means reviewing challenging exercises to ensure proper form at home, progressing his exercises when appropriate, and using manual therapy or modalities as needed. He has less pain with activity, is more flexible with improved range of motion, and his balance has gotten better. We are now working together towards his long-term goal of safe return to the local gym so he can work out regularly in group classes and with resistance training.
A 33-year-old female with neck pain and headaches which she has had since college which she thought was just typical for someone her age with a stressful job and young family to care for at home. We developed a simple 10-minute home exercise routine as well as made ergonomic and postural adjustments for home and work to decrease strain on her neck. Following these recommendations, as well as in clinic visits emphasizing manual therapy with dry needling and soft tissue mobilization, she has reported greater than 75% improvement in her neck pain and almost complete resolution of headaches. Following this success, she then casually mentioned to me that she has battled vertigo for many years but always just “dealt with it” for a few miserable hours then eventually it would improve after lying in a dark room. I referred her to our vestibular specialist who immediately diagnosed her condition and taught her safe maneuvers and exercises to correct the underlying cause of her symptoms. She is over the moon with her progress and often comments that she regrets not coming to physical therapy sooner.
A skeptical reader of course will comment that I am only highlighting success stories. Yes, there are examples where our interventions are not appropriate or effective for a variety of reasons, most often because the underlying degenerative changes in the body are so advanced that even the simplest of exercises are too painful. For example, severe knee osteoarthritis “bone on bone” which requires a joint replacement for the patient to move forward in life. Guess what? We will see you in the clinic to help with your post-op rehabilitation too!
The purpose of this article is to suggest to the general public to consider coming into physical therapy for an annual wellness check-up. Physical therapists are the musculoskeletal and movement experts in the healthcare arena. You already go to the doctor, dentist, and eye doctor once a year for a check-up to avoid things getting “too bad”. Why not incorporate an annual check-up with a physical therapist? The entire team at Smoky Mountain Sports Medicine and Physical Therapy looks forward to meeting you and helping get you back on track!
Ryan Marquart, PT, DPT
