Posted on October 3rd, 2022

If a doctor has told you that physical therapy could help you and you’ve never had it before, you probably have some questions about what to expect from physical therapy.

Physical therapy helps to identify, treat and diagnose movement problems in people of all ages and abilities, says Anita Bemis-Dougherty, vice president of practice at the American Physical Therapy Association.

Conditions That Can Be Helped With Physical Therapy

Physical therapy focuses on the joints and muscles of your body, and is often associated with the treatment of pain from an injury or to aid in post-surgery recovery. However, licensed physical therapists, or those working under them, actually treat a variety of conditions.

Here are just some of the health issues for which physical therapy is used and how it may help:

• Arthritis. Physical therapy can improve mobility in the affected joint or joints.
• Balance problems. The exercises used in physical therapy can help you to improve your balance and strengthen muscles, so you're at a lower risk for falling.
• Broken bones. Physical therapy can help you recover your mobility in the area where you broke a bone.
• Cancer. Physical therapy can assist in regaining strength and speed up healing, particularly after cancer treatments like surgery.
• Chronic headaches. Targeted stretches and massages help chronic headaches, especially tension headaches caused by tight, tense muscles.
• Parkinson's disease and other neurological disorders. Physical therapy helps make it possible to maintain movement even as the disease progresses.
• Pelvic floor problems such as urinary incontinence. With physical therapy, the pelvic floor muscles are strengthened to make it easier to control your bladder.
• Sports injuries. Depending on the sports injury, physical therapy aids in recovery and gets the patient back to their sport of choice.
• Stroke. Assistance with walking, sitting, lying down and going from one motor activity to the next is part of physical therapy for many stroke patients.

Physical therapy is performed by licensed physical therapists and physical therapy assistants. Some physical therapists specialize in certain areas, such as wound management, pediatrics or sports. It’s possible to get physical therapy for chronic conditions, as well as newer, acute problems.

Benefits of Physical Therapy

There are a few benefits associated with physical therapy:

• You can return to doing activities you enjoy that you've stopped because of an injury, pain or surgery, says Chris Tutt, CEO of ProActive Therapy Specialists in Portland, Oregon, and partner with Confluent Health.
• You may prevent future pain and injury.
• You may be able to avoid surgery and the use of prescription drugs. This includes addictive opioid drugs, says Julie Lombardo, founder and CEO of Capitol Physical Therapy in Madison, Wisconsin, and partner with Confluent Health.
• Your physical function, or movement, improves.
• Your ability to move more freely helps you to maintain independence, such as not having to seek help from others when you're standing or walking.

Choosing a Physical Therapist

You may get a referral to physical therapy from a doctor. It’s also possible to seek direct access to physical therapy yourself, although your state laws may have restrictions on how many appointments you can have without a doctor’s referral.

Although many health insurance policies cover physical therapy, check with your policy in advance to find out about coverage. Some may require you to have a doctor’s referral to get your care covered, says Lauren Lobert Frison, a physical therapist and owner of APEX Physical Therapy in Brighton, Michigan.

You can compare physical therapy clinics before starting treatment, and even get a tour if they offer that, to help you find the right clinic for you. When you visit, you can also ask how many patients are treated by a physical therapist at one time. It’s common to treat a couple of patients within the same hour, but you’ll get better care if the therapist limits how many patients are seen at one time, Lobert Frison says.

How to Prepare for Your First Physical Therapy Session

Your first physical therapy appointment will probably go a little more smoothly if you take a few minutes to prepare for it. Here are some tips to prepare.

In the days leading up to your appointment, make a note of any symptoms you have related to the reason for your physical therapy. Some questions to consider: What makes your pain or physical problem worse? What makes it better? Can you describe the pain? Is the pain worse at a certain time of day or during certain activities?

If you can, complete any paperwork in advance, advises physical therapist John Reddon of Teton Therapy in Riverton, Wyoming. If your first session is an hour and you need 15 minutes to complete your paperwork, you’re cutting into time for the therapist to get to know more about your problem.

Bring a list of any medications that you use, including supplements and over-the-counter treatments. This is valuable for the physical therapist to review. Also, bring your photo ID and insurance card. If you have imaging results related to your injury or problem, such as X-rays, bring them with you.

Wear comfortable clothing so you can move around and so the physical therapist can touch the treatment area. Shorts, sweatpants or shirts you can easily move around in are best. This isn’t the time to wear your skin-tight blue jeans, Reddon says.

What to Expect During Your First Physical Therapy Session

Your first session of physical therapy is an initial evaluation to help the physical therapist get to know you and your problem better. This will typically take place in a private area of the clinic, not the open setting with equipment and tables that’s common in many physical therapy offices.

During the evaluation, expect your physical therapist to ask about your condition, medical history and current symptoms, Lobert Frison says.

Common tests that a physical therapist will use during the initial evaluation include:

• Balance.
• Flexibility.
• Range of motion.
• Strength testing.
• Walking, such as looking at your posture and gait when you walk.

All of this gives the physical therapist information to come up with an effective treatment plan. If there’s extra time, you may start some treatment during your initial appointment. Your therapist also may give you exercises you can do at home, such as stretches that target your area of concern.

Follow-Up Appointments

Some people expect their physical therapy sessions to just be exercises they do for the full treatment time, Reddon says. However, that's not usually the case. Don’t expect to just do an hour’s worth of exercises as you dive deeper into physical therapy, Reddon says.

As the physical therapy clinic’s staff start your actual treatment, there’s a wide range of treatments and techniques they'll use to help you feel better. Those treatments and techniques include:

• Customized exercises that target your area of concern and help to improve function and reduce pain.
• Education on proper body and posture mechanics. This helps you learn how to place less stress on your muscles and joint structures so you avoid future injury, Tutt says. This can include learning better ways to lift or bend forward, for example. Education also may include making physical changes outside of physical therapy. For instance, you may discuss how to set up the desk in your office for better ergonomics.
• Electrical stimulation, ultrasound, and other modalities that can help to improve circulation and reduce pain.
• Heat or ice used on your treatment area.
• Muscle stretching.
• Soft tissue mobilization, a hands-on technique where the therapist will work with your muscles and the tissues around them. A therapist may use a handheld instrument to help treat the muscles when performing soft tissue mobilization.
• Trigger point dry needling, which involves the use of thin, dry needles used through the skin into areas of muscle to help relieve tension and reduce pain, Lombardo explains.

It’s not uncommon for physical therapy clinics to schedule several appointments each week – usually two to three appointments – for you when you initially start treatment. There are a few reasons for this. More frequent appointments help you to get better, quicker. They also give the physical therapist a chance to target any new irritation that’s occurred to the treatment area in the previous few days, Reddon says.

The actual number of appointments you need will depend on your exact needs, but a general range is 8 to 14 appointments total for non-surgical conditions and 20 visits for post-surgical conditions, Lombardo says. It’s also possible to have a session every couple of months if you’ve recovered from a problem and just need some reinforcement to reach or maintain your goals, Tutt says.

3 Tips to Get the Most Out of Physical Therapy

With the time, and perhaps financial commitment, involved with your physical therapy, you’ll want to do everything you can to get the most out of your sessions. Here are a few tips to maximize your physical therapy:

• Keep your appointments. Frequent physical therapy sessions can be challenging from a scheduling standpoint, but those more frequent appointments aim to get you better, faster. In the end, more frequent appointments can save you on the cost and headaches of a new surgery or medication.
• Do your homework. You may not get a grade for this type of homework, but you’ll still get the end result of better physical function. Follow the home practice your physical therapist recommends as best as you can.
• Understand what you’re doing and why you’re doing it. This helps you “buy in” to your physical therapy, Reddon says. This will motivate you more to stick with your therapy.

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