PT Identity Crisis: What PTs actually do. Opinion.
Let’s address what I eluded to in my introductory blog: the PT identity crisis.
Spoiler alert!! Conclusion: If you catch and treat movement issues early, it stops arthritis, and thus negates the need for surgery. The ultimate purpose of physical therapy is to save you from a preventable surgery.
Now let’s work toward that grandiose and sweeping statement.
It seems that in general, people in pain ignore it until it stops them from doing something they care about. When asked, why are you here? A patient will almost always start with “Because my _____ hurts.” With further investigation, that turns into “My back hurts and I can’t garden as much as I’d like.” Or “My shoulder hurts and I feel like I can’t reach to hit a volleyball.” So people don’t come to PT just because of pain – they come because the pain is affecting their ability to perform – to function.
Obviously this on a high level, but this is what PTs do. Help you perform better by addressing movement problems whether it’s because of pain, weakness, tightness, stiffness, etc. PTs are the only profession which combines soft tissue and joint manipulation, therapeutic exercise, and patient education.
It is very common that I get the question “What will you actually do if I come to PT?” Or, “I didn’t know PTs do that.” Now, I’m speaking about this matter from my perspective – as a manually trained and certified physical therapist. Think of a manually trained PT as highly educated mix between a massage therapist, personal trainer, and chiropractor (more to come later on the differences from a PT standpoint).
I had a person say to me last weekend when discussing a rib that goes out, “I didn’t know you could treat that, I thought you just… healed things.” Well, no. Your body does the biological healing. PT’s treat ANY body part that isn’t moving right because of any reason.
Let’s get specific. Here is my exact philosophy on PT and the purpose of what I do. This is how I was educated. This is what I believe.
PTs do not treat disease. Doctors do that. PTs treat movement issues, identified as a body part that is moving too little (tight/stiff/hypomobile), moving too much (loose/unstable/hypermobile), or moving in some aberrant/unexpected/painful way. More or less: “This doesn’t move right.”
When I treat these, if the joint or muscles surrounding the joint are tight, I mobilize it. If loose, it needs to be stabilized. Advanced knowledge of anatomy and biomechanics is required to assess and treat dysfunction.
PTs do not treat pain. Pain is a product of prolonged movement issues. Treat the movement issue and the pain will go away.
Movement issues that go on for a long time create compensation, inflammation, and wear and tear on joints (arthritis). Arthritis results in need for surgery. THEREFORE, if you catch and treat movement issues early, it stops arthritis, and thus negates the need for surgery. PT’s ultimate purpose is to stop preventable surgery.
You have a rib out? Yes. I can treat that.
Your neck feels tight and you get headaches. Yes, I can treat that.
You have a pelvis issue and one leg is longer than the other. Yes, I can treat that.
Your back hurts because you lifted wrong and you have no idea what the problem is? Yes, I can treat that.
You have lived a happy active life and your spine is worn down and you have radiating pain in your arms or legs. Yes. I can treat that.
You had ankle surgery 6 months ago and feel stiff and it hurts to run take your dog for a run. Yes, I can treat that.
You have “sciatica”. It might not be sciatica, but yes, I can assess you and treat the problem.
Your knee has hurt since you were 15. Yes, I can treat that.
Your core is weak and you feel like you lack control. Yes, I can treat that.
Your labrum is torn, you don’t want surgery, you’re getting popping, clicking and pain. Yes, I can treat that.
You had an MRI that shows a bulging disk. So do 30% of people without back pain. Let’s figure out what is giving you pain and treat it.
You have tendinitis. Yes, I can treat that.
You had a baby and your low back hurts. Yes, I can treat that.
Stop living with pain and go see a PT!! It’s an all-encompassing profession for your muscle/skeletal issues. Hooray for PT!