Physical therapy. Two words that rarely bring joy to those who find themselves perched in a doctor’s office. We get it. It’s probably not your “happy” place considering such referrals often arrive on the heels of some kind of injury, accident, or nagging pain that’s been lingering in your life for far too long.
But physical therapists can do a world of good, devising treatment plans that help put you on track to recovery safely and effectively. They can even help non-injured patients avoid future injuries, says Carly Graham, DPT of Finish Line Physical Therapy in New York City. “We can always address an issue if it’s already happened or you are injured,” she says. “But never be afraid to seek out physical therapy to stay healthy and maintain mobility through all phases of life.”
Whether you’re seeking relief for a seized up back, working to manage the pain of rheumatoid arthritis, or simply trying to be proactive to avoid potential injuries, you want to feel confident while choosing a physical therapist. Here, some top ones share their tips on what to consider before putting your body in someone else’s hands. Plus, warning signs that the physical therapist you did choose may not be the right one for you after all.
1. Are they skilled at treating your specific issue?
All physical therapists receive the same training in school. It’s mandatory for all new practitioners entering the workforce to have a doctorate education level, which translates to about 6 to 7 years of study. While that base training means that all physical therapists are versed in a multitude of therapies, including cardiovascular and pulmonary, oncology, women’s health, geriatrics, neurology, orthopedics, and sports, it often makes sense to seek out a specialist.
Just as you would see a neurosurgeon for brain help or a cardiologist for your ticker, make sure your practitioner has the training to treat your condition, says Kristen Gasnick, PT, DPT, a board-certified doctor of physical therapy at Holy Name Medical Center in Teaneck, New Jersey. “A therapist certified in a specific discipline has had more concentrated education that caters to a specific patient population’s needs,” adds Martin Ridley, DPT, a physical therapist at Tru Whole Care in New York City. “We gear a greater emphasis of our continuing education based on the discipline we work the most. Choosing a physical therapist based on your issue is a general rule of thumb,” Ridley says.
Finding a PT with a specific specialty is not as hard as you think either. A quick internet search in your chosen area—be it a women’s health physical therapist for myofascial pelvic pain or one with an oncology specialization who is adept in the needs of patients living with cancer—will likely reveal more than a few options to consider. And if all else fails: Ask your doctor for a reco.
2. Do they have additional certifications?
In addition to training for a specific specialty, many physical therapists undergo an additional residency to obtain training in other areas of interest. Look at a potential therapist’s specializations to gain insight into their expertise. “An orthopedic clinical specialist (OCS) or sports clinical specialist (SCS) will have extra clinical experience, coursework, and board-certification to treat musculoskeletal conditions such as strains, sprains, tendinitis, and fractures, says Gasnick, noting that this type of therapist can be beneficial for higher level athletes. Additionally, “some physical therapists may have a CSCS, a certified strength and conditioning specialist certification, that allows them to work at commercial or private gyms as a trainer.” This is helpful for highly active people who want to get back to fitness or sport post-injury.
Graham also cites fellow of applied function science (FAFS), functional range conditioning (FRC) as well as Herman and Wallace coursework for women’s health specifically (think pelvic rehabilitation) as notable continuing education coursework.
3. Will they give you an individualized plan?
Physical therapy should not be one size fits all. Two people with ‘IT band syndrome’ may have completely different underlying causes and should be treated accordingly, not just with blanket protocols. So be wary of a physical therapist that does not seem invested in your individual progress and goals, warns Graham, because that may lead them to not truly address what you may need to get better.
She recommends finding someone who provides personalized one on one care for at least 30 minutes. During your first meeting, the physical therapist should outline a plan. “This plan of care should have goals listed from day one and an explanation of why you may or may not achieve them,” explains Ridley.Remember to be flexible, though, because a physical therapist that is tracking your body’s movement weekly may determine that goals and timelines initially established might need to be adjusted as time goes on.
4. Do they put you at ease?
Trust is key in any doctor-patient relationship, and it comes, in part, from feeling comfortable. That’s why qualities such as kindness, empathy, and relatability are key. Remember: You are going to be spending a fair amount of time together, so you are going to want to get along. “We are the people that may be giving you your life back after a stroke or helping you run that marathon you never thought you’d make it to,” says Graham. “So being able to relate to that person and their goals helps drive the patient’s and the therapist’s motivation while helping that patient come out on top.”
Also important: that the physical therapist be a good listener. “So much of a PT’s diagnostic assessment comes from a patient’s subjective history,” says Ridley. “They must be an active listener to succinctly define your diagnosis.”
5. Do they let machines do all the work?
According to Gasnick you should be wary of any physical therapist who relies too heavily on passive modalities (think electrical stimulation and ultrasound). “This is a sign of low-quality PT,” she says, noting that these methodologies are supplemental treatment options intended for pain relief only. “While they can be useful for treating symptoms in conjunction with other interventions, they do not help correct the issues, such as muscle imbalances, decreased strength, poor body mechanics, or decreased flexibility, that are underlying many conditions.”
Another red flag: continuing to do the same exercises during your visits for multiple days or weeks in a row. “Your physical therapist should continually reassess your status and progress with therapy and increase the difficulty level so that you can continue to progress with physical therapy,” she says.Reached your maximum potential, and there’s no more room for progress? “That is when you should be discharged from physical therapy and continue your plan of care with a home exercise program.” Unless, of course, you are in physical therapy for preventative measures—then how long you stay is up to you.
6. Do they give out homework?
You can’t accomplish everything in a one-hour appointment. Period. That means that, whether it’s approved strength moves, stretching, or mobility work, you are going to have to put in some time outside of your physical therapist’s office too. And your physical therapist should be giving you take-home materials to complete. If not, your physical therapist may not be giving you complete care, which can slow your progress.
Education is also a part of the process. Think of a physical therapist as your guide: They are tasked with “showing you how to reach your goal and helping you address your issues,” says Graham. “But it is up to you to be able to maintain the adjustments and strength at home for long term outcomes.”
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