In our second post in honor of National Physical Therapy month, I thought we’d take a look at a common question- what is physical therapy? Also sometimes worded as “what do physical therapists do?” Well, the answer isn’t exactly straight forward, read on below to find out more!
Broad Range of Specialties
Physical therapists work in an array of settings and therefore have a very wide scope of practice. PTs can work in hospitals, skilled nursing facilities, outpatient clinics, and even in their patients’ homes! The American Physical Therapy Association has nineteen different sections which represent nineteen different fields of PT. Within these sections, there are often what are called special interest groups which are like “sub-sections” representing even more diversity of that particular field of PT. These cover everything from animal physical therapy to research in the field of physical therapy. The American Board of Physical Therapy Specialties recognizes ten specialties in which PTs can earn a board certification ranging from orthopedics to wound management. So you can see that what a physical therapist does varies dramatically by what setting they work in!
Altitude Physical Therapy
Because we at Altitude Physical Therapy have a little more narrow scope than the whole field of PT in general, I will talk more about what your physical therapist at Altitude does. All of our six locations are outpatient locations meaning that our patients come to us for treatment instead of us going to them in their current living space (home or hospital room.) We mostly treat patients with orthopedic and neurologic conditions. Orthopedic conditions are those involving muscles, joints, tendons, ligaments, or bones. Many of our patients have had surgeries such as total knee replacements or rotator cuff repairs, but many also present with pain or other symptoms in various body regions with or without a known injury. We mostly treat an adult population. While none of us are specialized in treating pediatrics, it is not uncommon that we will treat patients of the pediatric population who present with orthopedic conditions.
A few of our therapists have specialties or have taken extra courses in treating neurological conditions. These are conditions involving the brain, spinal cord, nerves, and the vestibular system. Common diagnoses falling into these categories would be vertigo, concussion, stroke, and spinal cord injury. It is important to note that although all of our therapists can treat most of these things to some degree, each of our therapists does have a field in which they have more interest, education and training. Neurological conditions is a particular field that most of our therapists can do some of, but a few of our therapists are more equipped to treat more complex cases in this field.
Three Main Things
When I summarize, to patients, friends, or strangers on the street, the essence of what a physical therapist does, I often say that we focus on three main things. These are range of motion, strength, and movement patterns. We find the things that are too tight and loosen them, we find the things that are too weak and strengthen them, and we find movement patterns that are not ideal and we retrain them. That part makes it sound easy, but the tricky part is that there are LOTS of ways we can do those things. There are about a billion different manual techniques, with new ones being developed (which are just sometimes old techniques being rebranded) constantly. There are various modalities, such as ice, heat, electrical stimulation, etc.
Then there’s maybe one of the most important parts of physical therapy- the exercises. If you’ve ever been to physical therapy, you were probably given “homework” in the form of exercises. These home exercises are intended to do a few things. They are likely trying to address deficits in any of the three things I mentioned above- range of motion, strength, or movement patterns. Sometimes they are trying to reinforce something that you gained while in the clinic. Perhaps your physical therapist used a technique such as dry needling on your shoulder and your range of motion improved. Your therapist will likely give you an exercise to try to maintain this improvement.
I tell almost all of my patients at their first visit, that their exercises are maybe the most important part of their therapy. It doesn’t matter how awesome I am at all of my manual techniques and the other things I might do in the clinic with my patients (and trust me, I am awesome at those things!) if my patient isn’t doing their home exercises, we’re not likely to make significant improvement in their symptoms. This is because most patients will come into the clinic once or twice a week for their 30 minute visit with me. That’s only a maximum of one hour out of the week. Assuming that my patient sleeps eight hours per night, that leaves 111 hours that the patient is awake but not in the clinic with me. That amounts to less than 1% of their week spent with me. The changes we can make for a patient in less than 1% of their week will be minuscule compared to the changes a patient can make if they are consistently doing their home exercises during the other more than 99% of their week.
In a Nutshell
Bob Cranny, PT