If you think physical therapy is just about rehabbing after surgery or recovering from an accident, think again. For the vast majority, visiting a physical therapist should be about prevention, routine checkups, and health maintenance. “We are the best-kept secret in health care,” Sharon Dunn, past president of the American Physical Therapy Association, told the Associated Press.
Roger Herr, current APTA president, and Gammon Earhart, associate dean of physical therapy at Washington University School of Medicine in St. Louis, echoed Dunn’s message of prevention in separate interviews with the AP.
“We need to change our image by getting out of our bunkers, out of our physical clinics,” said Dunn, who teaches at LSU. The image of the profession is usually one-dimensional. You’ve had knee surgery, your back is still acting up, or you’ve had an injury and your doctor has referred you to a physical therapist.
You visit several times, get an assessment and leave with exercises and tips on how to move more efficiently. “That’s a big part of what physical therapists do,” Earhart said. “But I think a lot of people don’t understand. If they have a serious medical problem, they think the physical therapist will massage them until they feel better. It’s not what it is.”
Follow the dental model
Many in the profession prefer to think of physical therapists as we think of dentists; patients are scheduled for regular check-ups. “Even if you don’t have any problems, you go in and check everything,” Earhart said. “If there are any problems that seem to be brewing, you drive them away at the pass.”
The exam may include medical history and current health – physical activity, sleep, nutrition, etc. After that, how you move will be considered. This can include things like aligning your posture and movement patterns while walking, running, reaching, sitting, and standing. In terms of strength and flexibility, think about muscle imbalances.
The gentleman is a big fan of annual wellness visits. For all ages. “Physical therapists can fit into all parts of the spectrum,” Herr said. “It could be for young, emerging athletes or high-level athletes, or those who want to age in and be as functional and independent as possible.”
Think prevention
You can now see a physical therapist in all 50 states without requiring a referral from a physical therapist or surgeon. Here is the good news. “I just don’t think the public knows they can go to a physical therapist without a doctor’s referral,” Dunn said.
The bad news for the annual exam can be the price tag. These preventive visits are usually not covered by insurance. Earhart estimated that such a visit to the Midwest could cost $150 out of pocket. But an intervention like this can save costs — and add healthy years — in the long run.
Herr, who is based in New York, suggested a price of $200-$300 in the more expensive region of the country. “Surgeries and accidents can still happen, but generally you’re aware of those visits,” Earhart said. “I think if people were more aware that the way they move could cause them problems down the road, they would be much more likely to see a physical therapist.”
Thighs for ballet — or not
We are all built differently with variations in hip architecture and so on. It can be helpful to assess children early to decide which sports and activities are right for them. Testing ahead of time to avoid problems later is an ideal job for a physical therapist.
“If we screened kids when they were choosing a sport and said that this sport probably isn’t the right kind of stress for the way you’re put together, it could save a lot of pain and trouble down the road.” Earhart said. “Maybe they don’t have hips for ballet.” Distance runners should think like this. Some of them are built more efficiently to avoid injuries despite the high number of kilometers. Others are not, and it would be good to know in advance.
Fear of falling
Falling—and the fear of falling—is debilitating for an aging population. Gehr said physical therapists can help with relatively simple interventions. “You want to show people that they can get up when they fall,” said Ger. – And once they know they can do it, it will give them confidence and can reduce their fear of falling. One of the risks of falling is that people don’t do anything, so you don’t move, and so you become less fit and less functional.”
Gehr noted that floor-to-standing movements involve flexibility, strength, balance and coordination. And planning. “It sounds simple to get up from a lying position on the floor and stand up,” Ger said. “But it’s a great exercise for all age groups.”
Problems with weight
Earhart estimated that perhaps 50% of physical therapy patients come there because of weight-related problems. “Someone doesn’t have to be morbidly obese for their weight to affect movement,” she said. “The more weight a person carries, the higher the load on the joints.”
Earhart said she sees patients for “advance preparation” for weight-loss surgery known as bariatric surgery, also known as gastric bypass surgery. This involves the digestive system to limit how much the patient can eat or the ability to take in calories.
Surgery may also include a visit to a rehabilitation center. Gehr said he has watched obese patients lose weight. It may be a matter of motivation, although it is not always that simple.
“I’ve seen people change based on a big milestone, like having a baby, and they really want to be good parents,” said Ger. “They want to be good parents, and it’s the same with grandparents. So it motivates people to participate because of the lifestyle change.”
