As an outpatient physical therapist for the last 7 years, I have found many patients are told to go to physical therapy without understanding what it entails or how it could help. Some patients are not recommended physical therapy at all when it could have been helpful or saved unnecessary medical costs. I think it’s important to set the right expectations in order to maximize the benefits of the health care system. With rising insurance copays and deductibles, it’s more important than ever that the patient becomes more aware of their options. By understanding what physical therapy realistically can and cannot do, patients can begin playing a more active role in their care.
What is physical therapy and what should I expect from a physical therapist?
To put it simply, physical therapy focuses on maximizing human health and functioning and minimizing disability and pain through the use of conservative non-invasive interventions. To provide additional context, I will outline the process a patient can expect to go through when seeing a physical therapist.
Your physical therapist will first gather a detailed medical history
A physical therapist will get a detailed intake of your problem history, medical history, and goals. This allows them to get the necessary information to provide appropriate screening along with personalized assessments and recommendations to address your goals.
Your physical therapist will perform a comprehensive evaluation
Depending on your specific problem, a physical therapist may assess your body structures, body functions, activities/participation, and/or environment.
- Body structures include the physical things that your physical therapist can observe on your body or assess from existing results of diagnostic images such as x-ray, ultrasound, MRI, or CT scan. If you feel these results would be helpful to your physical therapist then you should bring them to your first visit.
- Body functions include how the physical parts of your body work. These include things such as muscle strength, power, endurance, range of motion, flexibility, agility, coordination, reflexes, heart rate, blood pressure, respiration, sleep hygiene, basic mental functions, etc.
- Activities and participation relate to activities such as learning, applying knowledge, self-care, household tasks, moving around in your environment, work tasks, school tasks, and participation in social activities and events.
- The environment includes factors such as the degree of a family support system, attitudes of people in your life, access to different assistive products and technology, and the attributes of your physical surroundings.
Physical therapists largely use the World Health Organization’s (WHO) model of International Classification of Health, Disability, and Functioning (ICF). The model is meant to be comprehensive and guides the physical therapist to assess and treat the patient as a whole.
Your physical therapist will provide personalized treatment
Through the above assessment, they may find impairments of body structures, impairments of body functions, activity limitations, participation restrictions, or environmental barriers that hinder your ability to function and reach your goals. They can address these deficits by administering interventions such as education, therapeutic exercise, functional training, manual therapies, or referrals to other healthcare providers.
Your physical therapist will track your progress over time
A physical therapist will frequently reassess your deficits and goals to gauge how you are progressing over time. The number of follow ups or duration of the plan of care will vary depending on the patient. Your physical therapist should make the plan of care transparent and answer any questions you have of how it relates to specific goals.
What conditions does physical therapy treat?
Pain with exercise and movements
This includes pain in muscles, joints, and ligaments during daily activities or exercise. The most common areas of pain that can be helped with physical therapy include shoulder pain, neck pain, low back pain, elbow pain, wrist/hand pain, hip pain, knee pain, and foot/ankle pain.
Difficulty with activities and participation
This includes things such as decreased endurance with walking or going up stairs, feeling off balance, difficulty dressing or performing daily activities. Sometimes patients can present with chronic conditions such as stroke that have already been accurately diagnosed and managed by a physician that could benefit from physical therapy to improve residual functional impairments.
Preventing injury and flare ups
This includes screening to identify and address mild impairments before they lead to pain or illness. Many patients also receive preventative medicine to maintain an existing level of function.
Improving functional performance
This includes things such as improved performance in sports and hobbies such as social events, soccer, football, cross country, gymnastics, or competitive physical events.
For more detail, I have also written about a comprehensive list of conditions that physical therapy treats.
Can I see a physical therapist without a doctors referral?
In most states, patients can legally and safely go directly to a physical therapist for evaluation and treatment without first seeing a physician and receiving a physical therapy order or referral.
If you are having pain with exercises or movements or having difficulty with activities or participation, then it would be appropriate to go directly to a physical therapist. Physical therapists are experts at helping you prevent and resolve pain and getting you functioning to your fullest ability. If you have questions about seeing a physical therapist without a doctors referral, any physical therapist will be able to answer questions.
For more information, I have written in detail about seeing a physical therapist without a doctors order.
How do I find the best physical therapist?
As a physical therapist, one of the things I have consistently noticed over the years is that patients usually see a physical therapist based on location and insurance coverage rather than skills or specialty. By searching on Google, patient’s can find information on various physical therapist skills and specialties, but it’s usually incomplete and not easily found in one location. Insurance companies also usually only have information on which physical therapists are in network, rather than their specific skills. For these reasons, I have been working to find ways to streamline the patient-physical therapist matchmaking process. Below, I will discuss two projects that are underway:
Matching patients with physical therapists
Through the Tagojo platform, we allow patients to sign up for physical therapy. We then internally match the patient with a physical therapist in our network based on the specified information. The matched physical therapist will then reach out to the patient to answer questions and assess whether they recommend setting up a formal appointment.
Choosing a physical therapist through the Tagojo marketplace
Tagojo is currently building a digital marketplace that allows patients to browse physical therapists in any geographical area. Over time, the marketplace will display a physical therapists skills, outcomes, and anonymized patient comments/ratings. The goal is to make it extremely easy to find the best physical therapist and streamline the process with scheduling, payment, and communication directly built into the platform. For more information, I have written an article on the Tagojo Marketplace.
I hope you have found this information helpful and now feel more confident about what physical therapy is and what to expect.