Mythbusting: You Need to be in Pain to See a Physical Therapist

 
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In our first blog for National Physical Therapy Month we wanted to bust a very popular myth in physical therapy that says that you must be in pain in order to benefit from seeing a physical therapist.

Most people think about physical therapy as receiving treatment for an ailment that is causing physical discomfort. It usually isn’t until a body part is feeling at its absolute worst until they consider reaching out to a physical therapist. While this is a completely valid and understandable approach as a consumer, the truth is a physical therapist can benefit you in so many ways other than resolving issues of persistent pain. The American Physical Therapy Association describes the role of a physical therapist as a person that ultimately enhances the life and wellbeing of another individual through exercise, patient education, and hands-on care. While we don’t particularly utilize hands-on care at Headquarters Physical Therapy in our patient care model, hands-on care can be a helpful aspect of assisting patients in their gross motor function in settings such as acute care, neurological rehab, and skilled nursing. Let’s take a look at some specific examples of how a physical therapist can help you even in the absence of physical pain.

Gait Training

Gait refers to one’s method of walking. Now, while everyone has a uniqueness to their gait pattern that may not be problematic, there are occasions when addressing and improving one’s gait mechanics can have positive, functional implications as well as reducing risk for further injury. Take for example the athlete who is 6 months out from an ACL reconstruction. While their day to day walking mechanics may not reveal much, getting this athlete to take a jog around the track might reveal a compensatory strategy in which they spend less time on their post-surgical leg or won’t allow the knee with the new ACL to bend as much when landing, thus revealing a weakness in the quad as well as a lack of confidence in that leg’s strength and loading capacity. If the quad of that leg does not meet an objective ratio of strength when compared to the quad of the non-surgical leg, that athlete has a higher chance of reinjuring the ACL. Additionally, the impact of the limp to the athlete’s confidence is a potential limiting factor to their performance on the field and the fulfillment they may have from participating in their sport.

Other instances of gait training in the absence of pain can involve relearning how to walk after the removal of a leg cast, after a stroke, or as intervention for progressing Parkinson’s disease.

Vestibular Rehab

Vestibular rehabilitation is used to treat patients who experience dizziness, losses of balance, postural issues, and vision issues. To be clear, we are not referring to postural issues as in “good” vs. “bad” posture, but rather, patients who have a difficult time maintaining an upright posture due to sensory or neuromuscular disorders.

Vestibular rehabilitation comes in many forms and can range from a quick 2-3 session intervention for benign paroxysmal positional vertigo (BPPV) to a few weeks to months following a concussion. While vestibular rehabilitation is primarily focused on sensory issues, some causes of vestibular dysfunction can be accompanied with pain, such as post-concussion. And while physical pain is not often the primary complaint from a patient with vestibular dysfunction, the challenge to daily function as well as the physical discomfort associated with elevated symptoms can be just as, if not more so, provocative.

General Health

The crux of the physical therapy profession is to improve the lives of those we interact with by encouraging physical activity and education regarding our patients’ current status and how to achieve their goals. One of the best ways that physical therapists can be utilized in this sense is by working with clients towards their health and fitness goals. While this is not something that is often covered by the traditional means of insurance based physical therapy, out-of-network providers typically have greater freedom and can therefore take you under their care for things such as weight loss, muscle gain, cardiovascular fitness, and the like. The physical therapists at Headquarters Physical Therapy maintain their out-of-network status intentionally to be able to help more people in this general health and human performance realm.

So as much as we love to help those in pain feel better and live better, we also love working with clients in the following populations:

Older clients who need more muscle to stave off the effects of aging such as fall risk due to muscle loss, difficulty keeping up with grandchildren due to cardiovascular decline, and bone fractures from decreased bone mineral density just to name a few. While these clients may not be in a current state of pain, the decline of health attributed to a lack of physical activity can be incredibly uncomfortable over time.

Clients in need of weight loss assistance to combat chronic illnesses such as diabetes, heart disease, and the like are often not in pain per se but benefit significantly from exercise-based interventions and education regarding the implications of their conditions.

Clients in need of exercise programming simply to maintain routine, mental health during a pandemic, and to fulfill the minimum physical activity guidelines for Americans per the Department of Health and Human Services.

It’s unfortunate that insurance companies base the majority of their physical therapy authorizations around the presence (or absence) of pain. As physical therapists, we believe that this only reinforces the misconception that physical therapy is only concerned with pain resolution. The truth is, physical therapists should be concerned with anything and everything that benefits from physical activity, health education, and the incremental improvement in daily function. If you are looking for a physical therapist that can provide those things in addition to addressing any pain that you are experiencing and can also operate outside of the strict confines of insurance companies then we at Headquarters Physical Therapy would love to help you.