What happens in physical therapy?

We’ve spoken before on what the role of a physical therapist should be when it comes to a person’s rehabilitation goals.  But the question most people still have is “What actually happens in physical therapy?”

Every now and then a patient will contact us asking for a specific set of exercises to do to fix a particular problem.  The conversation typically begins with them telling us about whatever ailment they have, us following up with some line of questioning about symptom duration, intensity, current thought processes about whatever it is that is going on, and the patient responding with an honest request for a short list of corrective exercises that will magically make the pain disappear.

At Headquarters Physical Therapy, the plan of care goes so much further than that.

It is our belief that your rehab needs to mimic your training to a great degree.  What does this mean? Below are a few examples.

If you have knee pain running 5 miles then maybe we limit you to 3 mile runs with more frequency throughout the week to develop a symptom-free base of mileage while implementing basic strength training principles to develop load and impact resilience in the lower extremities.

If you are returning to your sport after an ACL reconstruction the last phase of your rehab should include drills that mimic the anticipatory and reflexive components of your sport.

If you are an olympic-style weightlifter the majority of your physical therapy should be spent with a barbell, finding ways to maintain fitness for your sport while utilizing drills and movements that continue to improve upon technical proficiencies.

If you are a baseball player recovering from a shoulder injury your rehab should include a periodized throwing program that focuses on increased tissue tolerance and recovery capabilities while improving qualities needed for force generation.

This does not necessarily exclude exercises that appear to have little direct relevance to an athlete’s sporting demands as those exercises may be at the upper end of the athlete’s current level of stress tolerance to specific tissues in the body.  However, if those exercises remain in the program for an extended period of time one has to wonder if they are performed more for the sake of novelty at the expense of exercises that could potentially elicit a greater physiological adaptation of the body’s tissues.

While the intentions of a good rehab plan should mimic life movements (we will reserve the term “functional movement” for a later discussion) and athletic demands, these principles can also be taken too far and therefore become a little less than therapeutic.

While treatment plans at Headquarters Physical Therapy are largely based on solid exercise principles the most critical aspect of our rehab programs is our focus on quality education surrounding the patient’s current situation and how our plans of care are designed to carry them to their performance goals.  Each plan is specifically catered to the patient in front of us and every aspect of their treatment involves careful consideration of where they’ve been, where they are at, and where they want to go. For this reason we believe that giving a generic sheet of exercises in a one-size-fits-all approach would be considered an abuse of the trust each patient places in us as their healthcare provider.

At the end of the day, what happens at Headquarters Physical Therapy is each patient is carefully considered and matched with researched based treatment principles.  The plan of care is then administered by their physical therapist in a manner that prioritizes the patient’s self-efficacy and empowerment to reach the goals that they have determined to be valuable to them.