Physical Therapy is a profession that is somewhat unique from other types of Healing Practitioners. If you have for example low back pain and go to 5 different physical therapists, you’re likely to get 3 to 5 different explanations of what’s wrong with your back and the treatments can be quite different from therapy clinic to clinic and even within a clinic, different physical therapists will likely give you a different type of treatment.
So what’s going on? And how would you find a physical therapist who is not only going to find the correct cause of your problem but also treat it effectively and hopefully quickly so you can get back to doing what you want to do; namely live pain-free and doing the activities you want to do.
The deal with Physical Therapy is that there are so many types of it. And for example with the low back pain, there are so many schools of thought of what causes lower back pain and then how to treat it. If you go to a Chiropractor, most times you’ll be told there is a mal-alignment issue that is impinging on a nerve, blocking flow, and by adjusting it you can restore symmetry and function. Treatment would consist of some modalities like heat or electrical stimulation or massage followed by the pop or the adjustment.
With Physical Therapy, you might have a therapist trained in the Mckenzie Method which is used to determine if you have a disc problem or a mechanical joint problem. Based on the findings you would get a session of various exercises which you would do in the clinic and also at home usually every 2 hours along with instructions on how to sit, stand and move.
If you went to a manual or orthopedic physical therapist, you would likely get an evaluation consisting of checking your range of motion, strength, reflexes, sensation and he or she would palpate or touch you on your spine to determine how well the joints were moving. Based on these findings, the therapist would use their hands to do joint mobilizations and massage type techniques to restore motion to the joints and connective tissue. You might get a series of exercises as well.
If you went to a big mill type P.T. clinic, you might have a therapist do a similar looking evaluation but in some cases it would be a ritual that really didn’t give the therapist much information and you would be handed off to an aide or assistant to do heat, electrical stimulation and ultrasound followed by generic exercises you could have thought up yourself or at the gym. They might even have a gym where an aide counted reps as you did a routine of exercise.
You might even find a more holistic type of physical therapist. This type of therapist might use some very gentle or energetic ways of feeling for restrictions or problems in your body. In some cases the therapist may not touch you as much as scan you. Then the treatments might be more gentle and energetic.
So what is right for you? And how do you find someone who will accurately determine how to fix up your back pain? This is where I feel I can shed some light for you.
First let me say that, among doctors, chiropractors, physical therapists and energy workers there really is no absolute agreement on lower back pain; the cause or the best treatments. Even the medical research is poor in regards to what is really going on and what works best.
So here’s what I recommend. Finding a physical therapist who tests and then treats and then retests at least each treatment but ideally throughout the treatment is vital. How will you know? And what does that look like? A good physical therapist will explain in language you can understand, what he or she feels is going on with you. And during this process you will know which movements or actions cause pain. If there was a high school student in the room, they would know as well. There should be a series of test movements or activities that test your pain. This is so that after the therapist does something; a treatment or technique or exercise, the initial test movement or activity can be re-tested. And I mean re-tested right away; not a week later. If you have a physical therapist who is testing, treating and then re-testing then you, them and anyone in the room can see if you are getting better, the same or worse from what is being done for you.
Just because someone can dig a thumb into a sore muscle or pop a joint doesn’t mean it fixed anything. You need to re-test something and see if it is better. This can involve walking before and after; bending forward or side to side before and after. Something that was tested for at the beginning of the session should be re-tested so everyone knows what’s working or not or worse yet hurting you.
I personally have trained in Mckenzie Method, Manual Therapy methods, Integrative Manual Therapy methods, Energy Methods and exercise methods. With all that, I can test for signs and symptoms so as the session goes along we can re-test and see how it’s going.
Testing and Re-testing during the same session is I feel an important aspect of what makes a great physical therapist. You should be better if not totally fixed up in a visit or two in most cases with a great practitioner. If you are going for long periods of time, you may want to find someone who can truly help you.
I recommend calling therapists and asking them what their philosophy of treatment is. If they are good they will be able to tell you how they search for the actual cause of the problem and not just treat the symptom. If you want more information on this please email or call me.
Ralph Havens, PT, OCS, IMTC, certified Matrix Energetics Practitioner
Physical Therapy Bellingham, WA
Ralph Havens Physical Therapy Bellingham, WA