Physical Therapy First

originally written onJuly 16 2019

So I might be biased here and this may turn into a mini rant BUT, I think it is an important rant.  A rant that is near and dear to my heart. I am going to try and keep it short and sweet.

We live in a modern world with AMAZING technology and medical advances.  We are truly blessed and lucky to have all the knowledge and technology at our fingertips.  I am truly grateful for all that has come out of the medical field in the past 10 years, even past 5 years, and I am sure most people can agree with all the above.

We are also spoiled and lazy AF.  We abuse technology and medical advances so that we can get quick fixes and crystal clear certainty in our diagnoses.  Oh and by the way, WE WANT IT NOW. **stamps her feet**

I’m being a little sarcastic here but my point still stands.  In the modern medical world, patients are looking for the easiest solution/fix/answer available and easy is not always the way it is going to go.  Believe me, I’ve been there. I wrote all about my personal highs and lows of health over here.

The problem with going for the easy route is it often leads to unnecessary surgeries, potential complications and risks, and a shit ton of money (and time) on things that don’t actually help.  It leads to patients being frustrated and disenchanted with the medical field as well as feeling broken and unfixable.  It leads to patients losing their strength AND their hope that they will get better

I don’t know about you but, I am NOT okay with that.

As a physical therapist, I see it all too often.  Let me give you a couple of recent examples

A young late 20s PHD student comes into my clinic after a R knee surgery to remove hardware and a L knee meniscus tear.  Within minutes of meeting her I hear these exact statements, “I have bad knees”, “My trainer in college told me to never squat because I have bad knees and squats are bad for your knees”, “I really don’t want another surgery but I also don’t want to be in pain anymore”, “I feel like my last meniscus surgery didn’t do anything for the pain” so on and so on.  There are so many things to comment on about these statements and the beliefs behind them, but I want to focus on the surgeries.  By the time she is 30, she will have had 5 knee surgeries-- no wonder she thinks she has BAD knees and will never be fixed.  She came to me truly thinking that at age 30 she will never squat or run or do anything she truly loves physically because surgeries didn’t help.

Another example, My patient was told by her doctor that she had a massive disc herniation and she cannot bend over again.  My patient is 24.  His only solution for her was steroids, pain meds, and no more bending ever.  That’s fine, she won’t tie her shoes again, pick up a child, reach something she dropped.  She’s 24 she doesn’t need to EVER bend again. 

The problem here is not the surgeries the patients had. The problem is not the medication.  I am going to say that again and make it VERY clear. The problem is not the surgery.  I am NOT completely against surgeries or injections or shots or medications.

I am against unnecessary surgeries, injections, shots, and pain medications. I may be biased but I wholeheartedly believe that every patient deserves and will benefit from physical therapy.  Why? BECAUSE I HAVE SEEN IT WITH MY OWN TWO EYES. Too many times to count

Even if a patient ends up getting surgery in the end, which happens, my patients go into surgery knowing what to expect, feeling strong, capable, and ready to put in the work on the other side. Even if a patient has to take medication, it is short term so they can get ahead of symptoms and inflammation and can work with their body, not against it.Even if a patient has to limit their activity, it is short term activity modification and they are getting back to the things they love to do and need to do as soon as they can.

Walk before you run anyone? Something is better then nothing?

The problem here is patients are NOT educated.  They are not given all the options, all the information, or all the potential outcomes.

This is where physical therapy comes in and this is where we as physical therapists can do better.  In physical therapy, our job is to help people heal and get back to what they want to do in their life.  So yes, that includes exercises, stretches, (sometimes) activity modification, and proper load management.  What I am finding is that the most important piece and often the most commonly missing piece is education.  I have patients come into me and say “thank you so much I never learned so much in physical therapy before.” or “I have been to physical therapy 5 times and it never helped.”

If physical therapy has not helped you in the past, I am here to tell you, “It is not your fault”. It is most likely your healthcare teams fault and more likely, the broken systems fault.  Physical therapists are inundated with patients and NO time to spend with them because thanks to insurance you need to see an obscene amount of patients to stay afloat (but that is a rant for another day).

Every patient deserves to be listened to and heard. They deserve their story to be heard in full and to be fully understood by their healthcare professionals. They deserve someone to sit across from them and say “I hear you and I see you. I see where you are coming from and I am going to do my best to help you.”  That in itself is why I think ALL patients deserve physical therapy first.

Every patient deserves to understand what is going on in their body.  They deserve to hear all the information about their injury, the pain science behind it, and have a proper mindset for their outcome.  A lot of times, patients hold onto random bits of information and misinformed ideas about their condition which holds them back from fully healing.  Most times, patients beliefs about their condition is what is holding them back from being 100% and those beliefs come from doctors, the internet, and other medical professionals.  These patients deserve to hear the right information and to not be scared into never doing things again because one person said so.  These patients deserve to be told (ever so nicely) that their long held beliefs are in fact wrong and they can and will feel better.

Every patient also deserves to know that they are not broken.  They are not unfixable.  They are not a lost cause.  Most importantly, they don’t need to just suck it up and live with it.  Just because surgery/pain meds/injections did not work does not mean you are unfixable.

Patients deserve physical therapy first. I believe that each person deserves to be empowered, uplifted, and encouraged. In each session, they should learn, listen, and be heard. After each session, they will feel strong, capable, and in control of their health.

If you are not getting this in physical therapy, please get the f*ck out of there.  Seriously, you do not have to go to a healthcare professional you don’t want to.  If you are not feeling empowered, uplifted, and encouraged with your physical therapist, GET THE F OUT OF THERE.

If this experience is what you are looking for in physical therapy, reach out. I can do that for you!  Even if I am not the physical therapist for you, I know some other bad*ss PTs thanks to The Level Up Initiative and people trying to disrupt the status quo.

Physical Therapy first my friends.

End Rant