Author: Angela Little

Physical Therapy helps patients heal from injuries or manage long-term medical conditions that affect their mobility. It can alleviate pain, improve mobility and strength, and boost self-confidence.

Some treatment options include therapeutic massage, soft tissue mobilization, and traction. Other methods, such as electrical stimulation and cold therapy, help reduce swelling and ease pain.

Physical therapy (PT) is a non-invasive healthcare profession that improves movement and reduces pain, swelling, and inflammation. Physical therapists are trained experts in movement and have extensive knowledge of anatomy, physiology, and biomechanics of the human body. They use hands-on care, patient education, prescribed movement, and functional training to help patients get back to their normal lives.

Your doctor may refer you to a physical therapist or you can seek treatment on your own. When you see a physical therapist, they will evaluate your symptoms and how they impact your daily life, then develop a care plan to address those needs. In many cases, your PT will work with you alongside a physical therapist assistant (PTA). These assistants are supervised by a licensed physical therapist and can perform certain tasks under the direction of your therapist.

Depending on the injury or health condition, your physical therapist will use different techniques to treat you. Some treatments include manual therapy, stretching and joint mobilization, cardiovascular endurance training, strength-training exercises, balance and coordination training, and other modalities.

When it comes to balance issues, your therapist may perform a vestibular evaluation to determine if the issue is due to muscle weakness, problems with the inner ear, a problem with how you sense where your body is in space, or another factor.

Some therapists will also do a falls risk assessment to determine if you are at risk of falling and recommend ways to minimize your risk. Your therapist will work with you to set goals and determine when you are ready to return to your normal activities.

Some people need short-term physical therapy after an injury or surgery, while others need it for months or even years to manage chronic or long-term conditions that affect how they move and use their bodies. In the United States, physical therapists must earn a doctor of physical therapy degree from a Commission on Accreditation in Physical Therapy Education-accredited program and pass a state licensure exam. In Canada, some universities are transitioning from three-year bachelor’s degree programs to two-year Master of Physical Therapy (MPT) programs.

Assessment

At the beginning of your physical therapy journey, your therapist will evaluate you. This is a critical part of the process and is an opportunity for you to be completely honest with your therapist. They will ask about your pain levels and other symptoms and how these have been impacting your daily life. They may also ask questions about your medical history and other health problems.

As they assess your pain and function, they will also record this in their notes. This is important information that will help them create your treatment plan, which includes both physical therapy sessions and home exercises you can do between sessions. Your therapist will also provide you with some tips for managing your symptoms, which can be helpful when dealing with chronic pain or a long-term health condition.

Your physical therapist will perform several functional tests to assess your range of motion, muscle strength, balance and coordination, posture, and gait. They will take your temperature, check for skin changes (e.g. bruising), and may also do some blood work, depending on the nature of your injury or condition.

They will also look at the location, intensity and duration of your pain, as well as how often it comes on and when you experience it. They will then make a diagnosis, which is what they believe to be the cause of your symptoms.

The evaluation will typically conclude with a discussion about your future goals for functioning and feeling better. This is an important part of the session and a chance for you to explain what you are hoping to achieve through physical therapy.

A PT can also use this assessment as an opportunity to advocate for continued care. For example, if the patient is not seeing improvements in the outcome measurement tools like LEFS and Quick DASH that are used to track functional status over time, the therapist can highlight these impairments to make a case for continuing care.

If you are covered by Medicare, your therapist will use the results of the evaluation to determine a complexity code. The complexity codes indicate how complicated or routine the PT’s evaluation was and help to inform the amount of reimbursement the patient receives.

Treatment

Whether the problem is an obvious injury like a back or knee injury, or something more subtle, such as poor posture or an overuse syndrome, physical therapy is designed to improve movement and reduce pain. It also addresses problems with balance and strength, so you can return to your normal activities more easily.

Depending on the problem, physical therapists use many techniques. They may use hands-on therapy, electrical stimulation, massage or heat/cold treatments. They might also use special equipment to help your body move more freely. For example, they might use a traction table that applies force to the back or neck to ease compression and improve spinal flexibility. They might also recommend the use of a dry needling technique that uses short needles in painful parts of your body to release tight muscles and promote healing.

They might recommend exercises to build strength and improve your balance, such as weight training or balance exercises. They might also prescribe aerobic exercise to improve your endurance and reduce your risk of cardiovascular disease and diabetes. They might teach you how to sleep better at night, which can be hard if your injuries or pain make it difficult to fall asleep or stay asleep.

Your physical therapist might use manual therapy to manually adjust the bones and joints of your body, including your spine, to relieve pain or improve movement patterns. They might teach you to do this on your own, too. They might also use modalities, such as ultrasound and electrical stimulation, to control the pain or speed up the healing process.

When your injury has healed sufficiently, your physical therapist will begin to transition you to a “train it” phase of treatment. During this time, you will learn to perform your sports or work-related movements correctly. This will increase your chances of avoiding another injury to that same area in the future.

Your physical therapist might give you a home program of exercises to do between your sessions. These can be either passive exercises (where your therapist applies stress to your body, such as with a stretch), or active exercises (where you do them on your own with your own strength). You might do these at a clinic, in the hospital or at home.

Follow-up

After your initial evaluation, your physical therapist will design and implement a treatment plan. They may use manual therapy techniques to reduce scar tissue and relax tight muscles, modalities such as heat, cold or electrical stimulation to help relieve pain, and exercises to restore mobility and prevent future injuries. Often, patients will be given at-home stretches and exercises to continue rehabilitation between sessions. They will also reassess their condition and determine how far they have come in recovery.

If they are not making progress, your physical therapist may recommend more intensive or frequent treatments to get them back on track. Depending on the severity of your injury and treatment goals, you may need to undergo several months of PT sessions. Some people require physical therapy for their entire lives to manage chronic conditions or rehabilitate from injuries.

Once your physical therapist has deemed that you have reached a level of independence that they are comfortable with, they will discharge you. Whether you are returning to a hospital setting, an outpatient clinic or home health care, your physical therapist will work with your other caregivers to ensure that there is continuity of your care.

Your physical therapist may recommend the use of equipment at home, such as splints or crutches. They can also assess your needs for adaptive devices, such as wheelchairs or walkers, if you are unable to move on your own due to an injury or illness.

If you are considering receiving physical therapy, be sure to check with your insurance provider first about what coverage you have. Some plans only cover a limited number of visits, and if you miss sessions, you could be stuck with costly co-pays in the future. You should also be aware of any limitations of your medical coverage, including how many times you can see a physical therapist per year.

Incentives are a great way to boost patient retention and grow your physical therapy practice. Encourage your existing patients to share their positive experiences on social media, write reviews and film testimonials that you can use for marketing purposes. You can also offer an annual visit for a discounted rate, or even free of charge.