Do I need to see a PT or can I just get some exercises from Dr. Google?
It's tempting to Google your symptoms when you've got pain that's keeping you from doing your favorite things. It's fast and it's free but it's not specific at all and often times, it's not right. If you Google your cold symptoms, it might tell you that you have lung cancer. If you Google your headache, you might have a brain tumor.
You see, the problem with just searching symptoms online is that it's not specific to you. Your headache might just a be a headache from being dehydrated or spending too long at your computer. Someone else's headache just might be that brain tumor, so you'll get both answers on the internet because it doesn't know anything about you.
If you search "what's causing my knee pain" it turns up 117,000,000 results. 117,000,000! How in the world are you supposed to get a correct answer from that?
If you search "exercises for knee pain" it returns 223,000,000 results. Do you think you can find the specific exercises YOU need for YOUR knee pain in over 200 million results? Probably not.
As tempting as it is to just search the internet for symptoms and exercises and other solutions, your best move is to contact a physical therapist. Physical therapists are the medical world's movement experts. We have an extensive knowledge about how the human body moves (both normal and abnormal movement), how strong and mobile you need to be for particular movements or activities, and how to prescribe the right exercises and treatments that are going to help YOU with YOUR problem.
So what exactly does a physical therapist do when you come to them with something like knee pain or back pain? I'm glad you asked...
1) We get a thorough history. We want to know everything - when did it start, how did it start, any new activity or change in volume lately, any history of other issues or injuries in that region, what are your sleep patterns and stress levels, what are your goals, what do you want to be able to do, how is this issue affecting your life - we want to hear it all. Getting a thorough history allows us to start to pick up on patterns or potential contributing factors. Pain somewhere in a joint or tissue rarely has just a single cause.
2) We want to see you move. We'll check your range of motion, flexibility, strength, and look at your movement patterns. We want to know more than just how far can you move but how well can you control it and what does that pattern or quality of that movement look like. This piece is very important and often missed in a very quick exam with a busy physician or standard physical therapy practice (more on that later...)
3) We're going back to YOUR goals again. We want to design a customized treatment plan that makes sense for you and your goals. Do you want to get back to running? Squatting? Getting down on the floor and playing with your kids? Going up or down the stairs in your house without your knee hurting? Those different goals and scenarios help carve out the right path with your treatment including hands on treatment, exercises, and activity modifications for workouts and daily activity.
4) We might do some manual or hands on therapy for you. Manual therapy is a great tool to allow you to be able to do your exercises without pain. Manual therapy will not fix your pain. I repeat, manual therapy will not fix your pain. Ok, hold on, hold on, don't get too fired up yet, let me explain.
Passive treatments like manual therapy, dry needling (and we love both of those and Nashville PT for the right patient), heat, traction, foam rolling, theragun, etc can ease your symptoms. However, if you don't add another major component (exercise) to it, that relief will only be temporary and nothing will change in the long term. We want our patients to find a solution, not just a temporary band-aid.
We will use those things as part of your treatment when it makes sense, typically that is to be able to reduce symptoms enough or improve your movement so that you can do the exercises pain free and do them right. Over time, the need for those passive treatments usually decreases. We want our patients to be independent with their programs and managing their symptoms and not feel like they are dependent on us to do hands on treatment to "make them better." We want to make sure you're in the driver's seat of your program.
5) Exercise. The biggest part of your treatment. This is ultimately what will "fix" you. The trick here is, it needs to be the right exercise for YOU and YOUR impairments. This goes back to my earlier example of searching the internet for "exercises for knee pain" and getting over 200 million results. You can't possibly come up with the right exercises to fix YOUR pain. But do you know who can? Your physical therapist who took time to get a solid history, talk about your goals, and spent the time to properly evaluate you.
Your PT will make sure you're getting exactly what you need, no more, no less. There are plenty of exercises out there that treat <insert body part here> pain but they aren't all the right ones for everyone. In fact, some exercises might make your pain worse overall, even though it feels good at the moment. We find this happens a lot with back and neck pain. There are certain movements that "hurt so good" in the moment and feel like they're probably doing something good but really aren't helping at all and might make you worse after. Don't you want to make sure you're doing the right things for you? Your PT will help you figure that out and then develop a custom exercise plan for you to work on at home or the gym.
6) Your PT will become your coach and guide you through the process of recovering from pain or injury. We want to be your cheerleader and your guide. We want to celebrate the wins with you (you went down the stairs this morning and it didn't hurt?! YES! <<high five>>) and help keep you on track or redirect when something isn't working for you.
We don't want anyone to become dependent on us forever. The last thing we'll tell anyone is that they need to come 3 time a week for 6 months, then 2 times a week for another 6 months, then maybe down to once a week for a while and then maintenance visits once or twice a month forever. We want to get you better in as few visits as possible and get your back to your life without having to worry about pain and dysfunction anymore! Sure, we'll need some check-ins to make sure you're progressing well and change up your exercises as they become easier, but it's often less frequent and fewer overall visits than traditional PT or other conservative treatments.
Now, earlier I said... This piece is very important and often missed in a very quick exam with a busy physician or standard physical therapy practice (more on that later...)
Well, here you go. Many outpatient physical therapy practices are large practices that see many patients in a day. Each PT can be responsible for as many as 4 patients AT THE SAME TIME! How much attention do you think you're getting in that scenario? Likely not as much as you need. If you go to the doctor's office, it's often the same story. You might only get a few minutes with them and often times your questions may go unanswered. We're not knocking physicians at all; we really like physicians. We just know they are very busy and unfortunately the current medical model drives a lot of volume to these offices. Greater volume equals less time per patient.
At Nashville Physical Therapy & Performance, we only provide completely one-on-one PT services for our patients. One PT and one patient at a session, that's it. Always. We want each patient to have the necessary time to be thoroughly evaluated and heard at their visits. This results in better care, fewer visits, and greater independence for our patients.
We know that things are different right now with social distancing and safer-at-home orders. That's why we offer telehealth or virtual visits for our patients. We can fully evaluate and treat a patient via videoconference (secure and HIPAA compliant) and begin that customized exercise program as well as show you some self manual therapy techniques at home to help ease your symptoms quick. Again, our goal is to help you gain independence and be able to manage your symptoms and rehab with us coaching you along the way. This concept is perfect for virtual visits.
If you've been having pain and can't do the things you want to do because of it, stop consulting Dr. Google and instead consult a physical therapist. We'd love to help you. You'll get exactly what you need for YOUR symptoms and goals and get back to doing the things you love so much faster.