National Physical Therapy Month

October is National Physical Therapy Month!  Wahoo!!!  A whole month to celebrate physical therapists - which means celebrating so many of my friends, my coworkers, the providers who keep me moving when I need some physical help, and my old pals from UConn Physical Therapy!  If you're currently seeing a physical therapist for care, wish them a Happy PT Month!

I frequently get asked about what PTs do. The cool thing is that we can do so many things!  PT school is a little bit like medical school in that when you finish, you're a generalist and basically know enough to not hurt people (hopefully)... while you then continue your education to specialize.  The big difference is that PTs don't (yet) have to complete residencies and fellowships for our specialties - we learn them in our choices of clinical affiliations towards the end of school and then we further learn our practice on the job.  Physicians go into many years of residency to specifically learn the specialty they will practice.  

The current specialties for physical therapists - in which you can become board certified - are: cardiovascular/pulmonary, clinical electrophysiology, oncology, women's health, geriatrics, neurology, orthopedics, pediatrics, and sports.  But this is just areas we can choose to further our knowledge in, take a test, and then get some fancy letters after our names.  (Don't get me wrong, I'm working towards this and think this is great - I'm just pointing out that this is only the start of things PTs can do).  

Physical therapists are considered to be the musculoskeletal experts.  We help people optimize their functional mobility - whether that be rehabilitative (trying to gain a function they used to have but somehow lost) or habilitative (acquiring a new function they haven't previously had). This could include treatment for patients with burns and wounds, care for children born with developmental or congenital conditions, adults who have had a heart attack and are regaining their endurance, children who need help at school... so many things!  We can work in clinics, hospitals, sports venues, athletic training rooms, large corporations, nursing homes, schools, in people's homes, at a horse barn!, in a gym or fitness center, in a doctor's office, in the emergency department.  We can work with old or young people, males and females and those who do not identify with either of those, people who just had surgery or who are trying to prevent it, people with all different sorts of pain, and more!

The best part is - we don't really have to choose just one patient population or one location to work, either!  Personally, I only work as a Sports/Orthopedic Physical Therapist.  My full time job is at Seattle Children's Hospital's North Outpatient Clinic and I treat children between ages 5-21 with sports or musculoskeletal injuries.  The most common conditions I treat there are people with knee pain or who had a knee surgery, ankle sprains, broken arms, and back pain - though I also work with children who have been experiencing chronic pain, concussion symptoms, neck pain, and many other conditions.  The ways these kids get hurt varies considerably, too!  On the side of treating patients, I also participate in research projects around the conditions I'm working with, which helps me learn.  When I'm not at Children's, I also treat athletes in the athletic training room or at the basketball arena as well as at a dance studio.  I get to work in three different settings and find that to be cool  In the past I have treated people in nursing homes - and that setting wasn't for me, but some physical therapists love doing that!  And, if I woke up tomorrow and decided I wanted to start working in a different setting, I could change my continuing education and learn more so that I could transition to a different area of work.

Why am I discussing this?  Well... first of all, because so many people just don't know what we do... and that's partially because we do so many different things based on the environment we're working in.  But also because I've previously written about "What Physical Therapists Do" and those were more from my perspective as a Sports Physical Therapist.  This is one of the recurring themes on my blog - and you can check out "What Do Physical Therapists Do? Installment #1: We Look at Mechanics, here.  Or #2: We Listen. here.  And the third installment: "We Strength Train" here.  But truthfully - we do so much more!

One of the big initiatives the American Physical Therapy Association has been working on is fighting the opioid epidemic in the United States.  This is a target because physical therapists help patients who are experiencing pain to get back to a more functional life. Often times, people experiencing pain use medication to try to get rid of the pain... but pain is a symptom!  Medication can sometimes attack the cause of the underlying problem, but oftentimes - it will only mask the symptom, perpetuating the problem.  I've previously written about chronic pain several times: here, here, here, and here.  PTs are learning more and more about the science of how pain works and can help patients better understand pain so that they can move forward and back to their optimal level of function.

It should be said that not all physical therapists practice the same way.  This has made the general perception of what we do cloudy for many people.  At the end of the day, what should matter most is that you're feeling better and doing more of your favorite activities.  Here are a few things you should consider if you are currently going to physical therapy:

1) Your physical therapist should not be hurting you!  Now - if you just had surgery last week, and we're guiding you with some gentle movement, you may feel some discomfort... but you should only be working within your tolerance and if it's really painful, the PT should stop.  If you don't exercise often and you're starting PT and moving in new ways - your muscles may feel some soreness.  But again, this should remain within your comfort level.  Think about the last time you were having pain.  You tighten up and definitely can't relax. What good is it doing to fight through that?  I can't say this enough... treatment should not be painful.  Nobody should feel like they're receiving torture when they come to PT.  Physical therapy is not the place for cliches like "No pain, No gain." Period.  

2) Your physical therapy treatments should be specifically made to address your issues and goals.  If your goal is to walk without pain - and you're not doing any exercises that look like they're going to get you to your goal, you have the right to ask why you're doing the things you're doing.   Sometimes it's hard to tell how the path you're on may get you to the target destination.  But - in order to run, you must first be able to walk, and to walk, you must first be able to stand up.  When I'm working with patients, I'm breaking down the goal activities into components, and I can explain why I have chosen every single activity.  Healthcare providers should be encouraging their patients to ask questions and understand their own care.  They should also be educating patients/  

3) Physical therapy only works if a) the patient buys into the things the physical therapist is saying and b) the patient commits to doing the program.  You may only spend 1 hour per week with your PT.  That leaves you with a whole lot of time where you're not working with them - but should be working on things to improve yourself.  Take charge of your recovery.  Take charge of your own body! As a patient, it can be hard to understand medical conditions - and that's scary!  Your back hurts and someone you don't know is touching you and then telling you to move in weird ways... you have to feel comfortable and there needs to be a little bit of trust to be successful.  This is really difficult when patients have previously seen a different physical therapist and didn't get better.  Maybe it wasn't the right fit for you... give another PT a try and make sure they treat you differently than the last one.  

4) You have the right to "fire" your physical therapist.  At Seattle Children's, I often share the patients I'm treating with one other physical therapist.  There are pros and cons to sharing a patient - but my favorite pro is this: if you don't like me - see the other therapist!  My feelings won't be hurt... I just want you to get better!  I can promise you we won't do things exactly the same way.  The best way is the one you like most as the patient.  Sometimes I even recommend patients see one of my coworkers because I think they'll be a better fit.  I'm a female... sometimes young male patients just do better with a male physical therapist.  I'm very direct and tend to be pretty loud... sometimes the more shy kids need one of my more gentle or softer spoken coworkers.  Any PT who gets upset that you would prefer to see someone else isn't looking out for your best interests.   

5) If you feel like you've been going to PT for months and not making gains - you should see if you have a better outcome with another PT.  Don't give up hope!  I think - because health insurance often pays the bulk of the costs - and because people are having pain - they forget that their healthcare providers are PROVIDING SERVICES.  We only have jobs because patients find us to be helpful.  You wouldn't use a carpenter to fix your toilet instead of a plumber just because they both know how to use a wrench... don't settle for a physical therapist who isn't fitting your needs.  

Now that you know more about Physical Therapists, make sure you reach out to your favorite PT and let them know that you're celebrating them this October.  If you're experiencing pain or having trouble with one of your favorite activities - sports or otherwise - find a PT near you to get treatment.  Having trouble finding the right fit? I'm happy to help you find someone near you.  Reach out with questions.  And know that the biggest compliment you can ever give to a physical therapist is to send your friends or family members to see them.