If you think physical therapy is only about rehabilitation after surgery or recovering from an accident, think again. For the vast majority, seeing a physical therapist should be about prevention, routine assessment and staying well.
鈥淲e're the best-kept secret in health care,鈥� Sharon Dunn, the past president of the American Physical Therapy Association, told The Associated Press.
Roger Herr, the current president of the APTA, and Gammon Earhart, associate dean for physical therapy at the medical school at Washington University in St. Louis, echoed Dunn's prevention message in separate interviews with the AP.
鈥淲e need to change our image by getting out of our silos, out of our brick-and-mortar clinics,鈥� said Dunn, who teaches at LSU.
The image of the profession tends to be one-dimensional. You鈥檝e had knee surgery, your back keeps acting up or you鈥檙e injured and you've been referred by a physician to a physical therapist.
You go several times, you get an evaluation and you鈥檙e discharged with exercises to do and advice about how to move more efficiently.
鈥淭hat's a big chunk of what physical therapists do,鈥� Earhart said. 鈥淏ut I think a lot of people don鈥檛 understand. They think when they have a major medical problem that a physical therapist is going to massage them until they feel better. That鈥檚 not what it is.鈥�
Follow the dental model
Many in the profession favor thinking of physical therapists the way we do dentists; patients make appointments for regular exams.
鈥淓ven if you鈥檙e not having any problem, you go in and have everything checked out," Earhart said. 鈥淚f there's any problems that seem to be brewing, you head them off at the pass.鈥�
An exam could include health history and current health 鈥� physical activity, sleep, nutrition, etc. This would be followed by a look at how you're moving. It might include things like postural alignment and movement patterns as you walk, run, reach, sit and stand. In terms of strength and flexibility, think muscle imbalances.
Herr is a big backer of annual wellness visits. For all ages.
鈥淧hysical therapists can fit into all parts of the spectrum,鈥� Herr said. 鈥淚t can be for the young, emerging athletes or high-end athletes, or someone who wants to age well and be as functional and independent as possible.鈥�
Think prevention
You can now visit a physical therapist in all 50 states without needing a referral from a physician or surgeon. That's the good news.
鈥淚 just don鈥檛 think the public knows they can go to a physical therapist without a physician's referral,鈥� Dunn said.
The bad news for an annual exam might be the price tag. These preventative visits are not usually covered by insurance. Earhart estimated such a visit in the Midwest might cost $150 out of pocket. But an intervention like this might save expenses 鈥� and add healthy years 鈥� in the long run.
Herr, who is based in New York, suggested a cost of $200-$300 in a more expensive part of the country.
鈥淪urgery and accidents can still happen, but generally you鈥檙e on top of things with these visits,鈥� Earhart said. 鈥淚 think if people understood more that the way they move might be setting them up for a problem down the line, they鈥檇 be much more inclined to see a physical therapist.鈥�
The hips for ballet 鈥� or not
We are all built differently with variations in hip architecture and so forth. It might be useful to evaluate children early to decide what sports or activities suit them. Testing beforehand to avoid a problem later is the perfect job for a physical therapist.
鈥淚f we screened kids as they were choosing sports and said this sport is probably not the right kind of stress for the way you are put together, it could save a lot pain and problems down the line,鈥� Earhart said. 鈥淢aybe they don't have the hips for ballet.鈥�
Distance runners should think this way. Some are built more efficiently to avoid injuries despite pouring on the miles or kilometers. Others are not, and it would be good to know in advance.
Fear of falling
鈥� is debilitating for the aging population. Herr said physical therapists can help with relatively simple interventions.
鈥淵ou want to show people they can get back up if they fall," Herr said. 鈥淎nd once they know they can do it, it gives them confidence and it can help reduce the fear of falling. One of the risks of falling is that people don鈥檛 do anything, so you don鈥檛 move and therefore you become more out of shape and not as functional.鈥�
Herr noted that 鈥渇loor to stand鈥� movements involve flexibility, strength, balance and coordination. And planning.
鈥淚t sounds simple getting up from a lying position on the floor to stand," Herr said. "But it's a great exercise for all age groups."
Issues with weight
Earhart estimated that perhaps 50% of physical therapy patients are there because of issues related to being overweight.
鈥淪omebody does not have to be morbidly obese for their weight to be affecting their movement,鈥� she said. 鈥淭he more weight somebody is carrying the higher the loads are on their joints.鈥�
Earhart said she sees patients for 鈥減rehab鈥� for weight-loss surgery known as bariatric surgery, also known as gastric bypass. This involves the digestive system to limit how much patients can eat, or the ability of take in calories.
The surgery can also involve rehab visits.
Herr said he鈥檚 watched obese patients drop weight. It can be a question of motivation, though it鈥檚 not always that straightforward.
鈥淚 have seen people change based on a milestone, like having a kid and they really want to be a good parent,鈥� Herr said. 鈥淭hey want to be a fit parent, and the same thing with a grandparent. So that motivates people to engage because of a lifestyle change.鈥�
Stephen Wade, The Associated Press
