HOW DOES PHYSICAL THERAPY HELP YOUR OUTCOMES? By:Vanessa Niemeyer, PT, DPT

As a physical therapist, I have had the absolute pleasure of assisting many individuals along with their recovery process.  I have helped rehabilitate pathologies of the shoulder, elbow, wrist, finger, back, neck, knee, ankle, toe, hip and many more; some of which include: sprain, strain, fracture, tendonitis, bursitis, headache, herniated disc, pre - surgery and post - surgery. I have also assisted individuals with recovery following a stroke, heart attack and traumatic brain injury.  Furthermore, I’ve been able to assist individuals with other diagnoses, such as: cerebral palsy, down’s syndrome, spina bifida, osteochondromas, and many more.   

While I can’t say that every single patient gets 100% better, I can say that a vast majority benefit significantly from physical therapy.  A lot of people get stronger, reduce their pain and return to their prior level of function.  The goal is always to assist the individual in performing the function that he/she desires, without pain and without difficulty.   This function may be return to sport, return to work, complete household chores, ambulate, perform stairs and more. 

What does the research say? 

The approach to this was quite simple,  pick an area of pathology and examine outcomes with physical therapy intervention.  A lot of this research compares physical therapy intervention to another form of intervention.  

In athletes with anterior groin pain, the average amount of time for recovery with physical therapy intervention is 10.5 weeks, while the average amount of time for recovery following surgical intervention is 23.1 weeks1.  

In individuals with neck pain, 4 weeks of physical therapy led to improvements in range of motion, reductions in pain, increased abilities to participate in functional tasks, and decreased levels of disability when compared to the group that did not receive any intervention (the control group).  The control group did not show any significant improvements over the same 4 week period2. 

Another study examined the impact of physical therapy (specific to stretching and strengthening) on rotator cuff pathologies.   These stretches and strengthening tasks were linked with improved short term and long term abilities to complete functional tasks.  Physical therapy was shown to be even more effective when the patient was involved with these stretches and strengthening tasks on a daily basis3.

In individuals with vertigo/ dizziness, physical therapy can also be beneficial.  It is estimated that nearly 80% of all patient’s experience relief from canalith repositioning4.  Canalith repositioning is a specific technique geared towards fixing the specific inner ear canal pathology that is causing the vertigo/ dizziness.  Physical therapists assist you with this technique and treatment approach.  

My personal opinion

Physical therapy decreases pain, increases strength, increases range of motion, increases balance/ coordination, decreases fall risk, promotes proper form with gait, restores patient’s functional abilities, assists in return to sport, assists in return to work, restores muscles to proper length, increases the speed of healing, and much more. 

Physical therapy also helps individuals to increase their confidence in their own abilities, increase knowledge and understanding of the human body and provides you, as the patient, with sufficient education on your mechanism of injury, prevention of future injury to your area of involvement, and education regarding anatomy. 

No matter what the problem is, we can either help you or steer you in the right direction.  The beauty of physical therapy is that it is a non - invasive approach.  Together, you and your physical therapist are a team.  If surgery ends up being required, better range of motion and better strength improve your likelihood of better results following surgery.  

Physical therapy provides you with a positive environment to grow, understand and overcome your problem.  You and your physical therapist will spend a few hours together on a weekly basis.  This will allow all aspects of your injury to be addressed.  

Possible physical therapy interventions

1. Initial Evaluation

   1. Measurements of range of motion, strength, balance/ coordination 

   2. Special tests to determine specific tissue involved

   3. Analysis of gait, functional tasks, and others as needed

   4. Other Baselines as needed/ as appropriate

2. Therapeutic exercises

   1. Strengthening, Stretching, and Endurance activities

   2. Example) Biceps Curls, Hamstring Stretch, and Recumbent Bike 

3. Therapeutic activities

   1. Functional tasks with assistance (as needed) via tactile, verbal and visual cueing 

   2. Example) Lifting/ Lowering Box crate with 10 lbs overhead 

4. Neuromuscular Re - education

   1. Balance/ Coordination, Posture, Proprioception and Dynamic tasks (sitting/ standing)

   2. Example) BAPS Balance Board; Grapevining; Tandem walking while catching/ tossing a ball

5. Manual Therapies

   1. Mobilizations and Manual Traction

   2. Example) Extension Mobilizations to the Lumbar Spine 

6. Gait Training 

   1. Gait analysis with facilitation for proper gait and stair training with assistance (as needed) via tactile, verbal and visual cueing  

   2. Example) Side Stepping on agility ladder with hand held assist and verbal cues for proper hip positioning 

7. Aquatic Therapy

   1. Any exercise or activity performed while in an aquatic pool

   2. Example) Heel Raises in the Pool

8. Modalities

   1. Hot Pack/ Cold Pack, Ultrasound, Whirlpool, Electrical Stimulation, Iontophoresis, Paraffin bath, and Mechanical Traction

Final Thoughts

Physical therapy is a non - invasive, hands on approach that is geared towards restoration of function.  There are many possible interventions.  As a patient, your therapy plan will be geared towards you and your specific complaints.  Physical therapy can help you get your life back.  

Every individual is taken into consideration independently.  All variables play a role in the care that you will receive.  An initial evaluation is necessary to determine which services are best for you and are appropriate for your recovery. 

Please feel free to reach out to us with any questions and/or concerns.  

References:

1. King, E., Ward, J., Small, L., et al. Athletic groin pain: a systematic review and meta - analysis of surgical versus physical therapy rehabilitation outcomes.  British Journal of Sports Medicine. 49 (22). 1447.   

2. Wang, WT., Olson, SH., Campbell, AH., et al. Effectiveness of Physical therapy for Patients with Neck Pain: An Individualized Approach Using a Clinical Decision - Making Algorithm. American Journal of Physical Medicine & Rehabilitation: 2003; 82 (3): 203 - 218.  

3. Burbank, K., Stevenson, J., Czarnecki, G., et al. Chronic Shoulder Pain: Part II. Treatment. Am Fam Physician. 2008; 77(4): 493 - 497.  

4. Mayo clinic. July 2018. Canalith Repositioning Procedure. Retrieved from: https://www.mayoclinic.org/tests-procedures/canalith-repositioning-procedure/about/pac-20393315