If you have an injury or chronic condition that impacts your movement and ability to function, a physical therapist can help.
Physical therapy often gives at-home exercises that you should perform regularly to help improve your strength, mobility, and balance.
Physiotherapists also use treatments based on physical stimuli, such as heat, cold, electrical currents, and ultrasound.
As physical therapists, our first encounter with a patient is an evaluation. This is where the foundation of a successful journey begins. This initial evaluation session is also a key component of the documentation process that goes into each patient’s medical records. This information is important for patients, future clinicians, and even the patient’s health insurance company to reference later. Therefore, it is critical that a thorough evaluation be performed and documented in the best way possible.
During the evaluation, your physical therapist will ask you questions about your pain or symptoms, how they impact your daily activities, and other important details. The evaluator will then create an objective assessment based on the information you provide them with. This may include performing various functional tests to measure your strength, range of motion, and other relevant measurements that are specific to your injury or illness.
It’s important to be truthful during this process, as a lack of honesty can lead to misunderstandings and miscommunications. A great PT will understand that it can be difficult to reveal painful or uncomfortable information, and will help you feel comfortable throughout the process.
After the therapist has collected all of the necessary information from the subjective conversation, systems review, and objective data collection, they will write up an explanation of their findings and what they think the diagnosis is for your condition. They will also explain the plan of care (POC) that they have for you.
The evaluator will also schedule your next appointment at this time, typically for one week from the date of the evaluation. They will also explain any home exercise programs or other measures that you may be expected to carry out between your sessions. Many clinics will have their patients complete an intake form before the initial evaluation to help save time and ensure that all of the necessary information has been gathered. Some may choose to administer and track a patient-reported outcome measurement (PROM) at this time, although this can be done before or after the evaluation as well. For those who use an EMR software to document their sessions, this will automatically be logged in the patient’s records for them.
Assessment
A physical therapist is trained to assess the body in many ways, including observing movement patterns and muscle tone, comparing range of motion in joints, testing strength, checking balance, and assessing the integrity of the nervous system. Depending on the patient’s condition, the physical therapist may also review diagnostic imaging like X-rays or MRI to get more information about the problem area.
During the evaluation, your physical therapist will ask you questions about your symptoms and when they started. They will also want to know if your pain or symptoms have affected any of your daily activities and how much your life has changed due to them. It’s important to be as detailed as possible during the assessment, because your therapist will use this information to create a customized treatment plan that aligns with your personal goals.
Once the therapist has a full picture of your situation, they’ll begin the hands-on portion of the evaluation. They’ll move your affected area in a variety of positions and ask you to rate how much pressure or movement causes pain. They may also perform other specialized tests, such as joint stability tests or neurological assessments, based on the specific type of injury.
Throughout the entire evaluation, your physical therapist will communicate their findings and explain your diagnosis and treatment plan. They’ll provide you with a timeline for how quickly they think you can start making progress towards your goal. This timeline is also a good opportunity for you to advocate for continued care by highlighting your current improvements and pointing out any remaining impairments that should be addressed.
During the evaluation, your physical therapist might give you a list of things to do at home, such as stretches and exercises to continue improving your injury. These can include self-treatment, like manual therapy techniques to improve mobility and reduce scar tissue buildup, or modalities to reduce inflammation and relax tight muscles. They’ll also talk to you about what your life looks like after your injury and help you come up with goals for the future, like how you hope to achieve more mobility and strength as you recover from your injury.
Treatment
During treatment, your physical therapist will work with you to reduce pain and improve mobility by performing hands-on treatments and teaching you exercises. They may also recommend other types of treatments, such as iontophoresis (using an electrical current to deliver medication, usually a steroid, to inflamed areas), massage therapy, ultrasound and cold therapy.
Physical therapists are highly skilled at understanding how different body systems integrate movement. PTs are often trained to examine more than just the area of pain, such as looking at your hips and ankles if your knee is sore. This is because it is common for a problem in one part of the body to affect other parts of it, too.
Active exercises are a big part of physical therapy. These are movements you perform under your own power, such as walking on a treadmill or doing leg lifts. They help improve mobility, coordination and muscle strength. During your sessions, your therapist will teach you these exercises and help you practice them so that you can do them at home. This is important because the benefits of PT only come from regular exercises done consistently.
Other techniques that therapists use include joint mobilization (gently moving your body parts to relieve pain and loosen tight muscles), soft tissue massage (kneading and stretching to increase flexibility and blood flow) and breathing techniques (such as expiratory muscle force or EVLF). A special type of exercise called resistance training is used to build strength and endurance.
The types of PT you receive will depend on the type of injury or illness that caused your problems and how severe they are. For example, neurological PT can help people with conditions such as spinal cord injuries, brain injury, multiple sclerosis and Parkinson’s disease by improving mobility, balance and coordination. Cardiovascular and pulmonary PT helps people with heart and lung conditions, including thoracic outlet syndrome, dizziness and vestibular rehabilitation.
Other types of PT include wound care therapy, which is helpful for patients with open wounds to ensure that they get enough oxygen and nutrients to heal. And women’s health PT addresses issues such as urinary incontinence, pelvic floor dysfunction and prenatal and postpartum care.
Follow-Up
At the follow-up appointment, your physical therapist will review any new medical records or tests you have received since your previous visit. The therapist will also perform a physical exam and interview you to determine how well your recovery is progressing. Typically, physical therapy follow-up sessions last 30 minutes, but may take longer depending on the nature of your injury or condition.
In addition to discussing your recovery progress, the therapist will review any prescriptions you have been given by other health care providers and make any necessary changes. The therapist will also discuss any ongoing concerns you have with your injury or condition and recommend the best course of action going forward.
Once your recovery is at a point where it is safe to discharge you from physical therapy, the therapist will work with you to set a discharge date. At this time, the therapist will discuss your goals and help you to create an ongoing fitness and wellness plan to ensure that your injury or condition does not recur.
Often, your therapist will also recommend certain changes to your environment or daily activities to help prevent reinjury. This may involve modifying your home or work environment, changing your job duties to reduce repetitive stress, or avoiding certain movements that could increase your risk of pain and inflammation in the area.
The therapist will also provide you with educational materials to support your continued recovery and will answer any questions you have about your care. In addition, your therapist will assist you in scheduling your next PT appointments. This is important, as missing appointments can delay your progress and affect the schedule of other patients. It is best to attend all of your scheduled PT appointments, but if you do need to cancel or reschedule, please contact the clinic with as much notice as possible so that other patients are not affected.
Once you are discharged from physical therapy, it is your responsibility to continue to keep up your progress and continue to be proactive about your health. If you do experience a flare-up, call the SetPT team and we will be happy to help!