Going to physical therapy is a commitment of time, money and energy. A successful outcome will enhance your quality of life, but a poor outcome can leave you with the same problems that sent you to PT in the first place.
It’s Like a Sailboat
Imagine buying a sailboat, but you don’t know how to sail. Before you conquer the high seas, you’ll want to understand the basics, make a game plan, and take an experienced sailor along to show you the ropes.
Physical therapy is like sailing. If you know the keys to success when you start PT, you’ll be on course to reach your goals. And your PT’s knowledge and experience will help you navigate challenges along the way.
What to Expect in Physical Therapy (For New Patients)
Feel free to skip this section if you’ve done PT before.
If you’re new to PT, you’re probably wondering what it’s all about. I work in outpatient physical therapy, so I see patients after surgeries or if they have orthopedic pain or injuries.
For example, patients see me after shoulder surgery, or when they have sciatica, neck tightness or knee pain.
Here’s what to expect on your first visit to an outpatient PT clinic.
First, you’ll fill out a lot of paperwork. I know, no fun. But it’s only a one-time deal.
Arrive early so you can finish the paperwork and start your evaluation on time.
Next, you’ll meet your physical therapist who will evaluate you. Your PT will get a thorough history from you to get a clear picture of what’s bothering you and how it affects your daily activities.
Physical examination comes next; your PT will watch you move and check your strength, and range of motion.
Finally, your PT may give you a few exercises to work on at home. It’s key for your PT to figure out what’s going on to select the best treatments for you. So the evaluation is most important on your first visit.
Any treatment you get the first session is a bonus!
At the end of your visit, you’ll schedule future visits, typically 1-3 sessions per week. The duration of PT is variable, depending on your symptoms and recovery. On average, physical therapy lasts 4-12 weeks.
The Keys to Success
I’ve learned how patients succeed with physical therapy, and common pitfalls along the way. Scientific literature and my experience as a PT inform these strategies for success.
Here are 7 keys to get the most out of your physical therapy:
1) Identify Your Limitations
Understanding how your symptoms limit your activities is key. It helps your PT zero in on areas to treat and set appropriate goals for you. Your physical therapist will help you figure out which day-to-day activities you have trouble performing.
Physical therapists treat pain frequently. Beyond addressing your pain, your physical therapist will help you return to the activities you enjoy. Your lifestyle, hobbies and activities help to guide your treatment.
For example, if grandma has trouble getting out of the car because of knee pain, treatment will involve optimizing her transfers out of the car. But I don’t practice car transfers with high-functioning college athletes.
2) Monitor Your Symptoms
Keeping tabs on your pain provides 3 distinct benefits:
- It helps your PT figure out what is going on. Musculoskeletal issues present with characteristic patterns. For example, osteoarthritis is characterized by stiffness in the morning which improves with time and motion of the affected joint.
- Identifying aggravating activities provides a great starting point for your treatment. If your pain worsens every time you sit, or chew gum, or Toby Flenderson walks into your office, tell your PT. Identifying and removing irritants is a simple way to speed up recovery.
- Your PT can figure out how irritable your symptoms are based on what aggravates and alleviates your pain. This helps your PT plan appropriately gentle or aggressive treatment. Treatment looks different for a patient whose pain starts after running 5 miles than it does for the patient whose pain flares after walking to the dairy aisle at the back of the grocery store.
3) Be Honest
Whether it’s good news or bad news, be honest with your PT.
If you had a busy week and didn’t do your home exercises, that’s okay. It happens a lot.
Just don’t tell your PT you did the exercises diligently if you forgot about them. It can worsen the quality of your treatment. Your therapist may change your treatment plan, thinking the current exercises aren’t working. (When in fact they might be exactly what you need).
If an exercise flares your pain from 2/10 to 8/10, your PT needs to know. I promise it won’t hurt their feelings. More relevant information is always better.
4) Ask Questions
There’s a difference between cynicism and curiosity. Do you like when your work is questioned, doubted and scrutinized? Chances are, your PT doesn’t either. Opt for curiosity.
If you have unanswered questions, ask your PT. If you don’t understand why you’re doing a specific exercise or treatment technique, ask your PT. If you’re wondering how long your recovery will take, ask your PT.
Expert PTs educate their patients throughout the treatment process. But your PT can’t anticipate every possible question you might have.
So if you have questions, ask away! Your PT will be happy to share their knowledge with you.
5) Stay Positive
Your expectations affect your outcome. Research has proven this over and over and over (1-5).
Patients who expect chronic pain to plague them forever are usually right. Those who expect a fast recovery feel better faster.
I know firsthand how tough it is to be positive when dealing with pain and limited function. You can read my story here. I’ll give you 3 quick tips to help you stay positive during the rehab process:
- Celebrate Progress
Whether you can do more or you have less pain, enjoy the little milestones along the way.
- Be Grateful
There’s always someone who has it worse. Practicing gratefulness can help improve your attitude and help you feel more positive.
- Take Time for Yourself
Do something you enjoy.
Whether it’s getting outside, talking with friends, playing with your dog, or listening to music, relaxing activities can melt your stress and brighten your outlook.
6) Collaborate with Your PT
Patient preferences are key to evidence-based-practice (6). If you’ve gone through physical therapy before, let your PT know which treatments helped (or didn’t help) last time.
It’s a huge head-start to know what treatments helped a patient feel better in the past. Or if a treatment didn’t work, I’m less inclined to use that approach this time around.
The best physical therapists see their role as that of a teacher or coach. They focus on empowering patients and collaborating with patients to solve problems (7).
Your PT’s job isn’t to heal you as you lie on the treatment table. Passive treatments (like manual therapy, manipulation and dry needling) can help, but active treatments work better and should take priority (8). If your treatments don’t involve an active component, your care is probably sub-optimal.
I love the McKenzie Method because it emphasizes patient-driven treatment and puts patients in control of their symptoms. It’s especially powerful for treating low back pain.
To learn how to apply the McKenzie Method yourself, check out the best-selling book:
7) Take Care of Yourself
You’re prioritizing your health by going to physical therapy. Great choice!
Your PT is highly educated to take excellent care of you in the clinic. Your habits outside the PT office are key to a successful recovery.
Even if you’re in PT 3 hours/week, you’re outside the clinic 98.2% of the week. Your PT will optimize the other 1.8% of your week, but your lifestyle the rest of the time can make or break your outcome.
Stress management, quality sleep and good nutrition help promote recovery. A few hours of physical therapy each week can’t offset consecutive all-nighters and an ice-cream-only diet.
If the “ice-cream-only diet” hits too close to home (like it does for me), pick up this evidence-based guide to healthy eating:
There you have it! 7 keys to success with physical therapy. Recovery is often a winding pathway with unforeseen challenges.
Having an expert to guide you along the path makes the journey easier.
Which key to success surprised you most?
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