By Gina Gapstur, PT, DPT
Physical therapy is a very popular avenue to conservatively manage and rehabilitate a spectrum of injuries and impairments all over the world. Most states in the United States have some form of direct access, enabling patients to receive physical therapy for an allotted amount of time without a referral or script from a physician. Physical therapy promotes early intervention, which has definitively been proven to decrease healing time and improve function.
Today, all physical therapy students graduate with a doctor of physical therapy degree, which better reflects the academic knowledge we have in this field and in the decisions we make. We are trained to perform clinical diagnostic tests of high validity and reliability to give the patient an accurate diagnosis, create a proper plan of care, and treat accordingly. If at any point during the patient’s care they present with a sign or symptom that may warrant further intervention from another health care provider, a referral will be given, and the patient will be guided in the right direction.
Each therapist will vary slightly in their treatments based on a variety of factors, including schooling, certifications, continuing education courses, patient populations, and clinical experience. During a typical treatment session, a variety of manual techniques, therapeutic exercises, and functional activities will be prescribed by your therapist.
At my clinic, I utilize manual techniques such as instrument-assisted soft tissue mobilization, joint mobilization, trigger point dry needling, cupping, and many others. Manual intervention is utilized to reset and restore tissue function that may have been previously contributing to the patient’s pain. It is then my responsibility to prescribe the appropriate intervention that best targets the tissue we addressed. This will help retrain the brain and body to move properly in a way that is least demanding on the body.
Progressing these interventions carefully and intentionally to functional tasks will provide the best and most effective carry-over to the patient’s daily activities. In addition to manual manipulation, I have other equipment such as electro-stimulation to activate increased blood flow to the region of the body that needs attention, and specialized machines that help focus on building strength in specific body parts.
I truly believe that flexibility and adaptability are extremely important characteristics in a physical therapist, whose job it is to shape and adapt a treatment plan that is specific for each patient. Every patient presents differently, with their own concerns, their own past experiences, and their own short- and long-term goals, which all need to be taken into consideration in order to be successful. My goal as a physical therapist is to educate my patients about their own body and give them the proper tools and resources to become their own future therapist.
At the same time, it’s the patient’s job to make sure they’re getting the most out of physical therapy sessions. That requires focus and consistency, a basic understanding of the human body, proper stretches and exercises to be performed on a daily basis (even after pain has subsided and the patient has recovered) and adaptations to their everyday life that will prevent further injury. As the patient spends significantly more time outside of physical therapy, looking outside of the clinic and into their daily surroundings—such as sleeping positions, desk ergonomics, car set up, standing posture—has just as much of an impact as what happens inside the clinic for the two to three hours they attend each week. Oftentimes the most limiting factor in a patient’s recovery is the lack of knowledge or understanding of his or her own impairments.
Pain is an experience from the brain that doesn’t always coincide with a harmful stimulus or physical injury. Acute pain that involves tissue damage to muscles, tendons, bones, ligaments, discs, and other structures typically resolves within three to six months. Chronic pain, however, can come from a variety of other sources, including diseases or defects, environmental factors, sensitivity of the nervous system, and emotional state.Even in physical therapy, we must take a holistic approach and address all of these areas of concern in order to retrain the brain and provide the patient with the most effective treatment possible.
In addition, I have had countless patients come to my clinic feeling defeated and dissatisfied after having MRIs, X-rays, CT scans, and many other tests that come back negative for any significant findings. It is imperative to understand that these tests are static pictures that show isolated injuries, whereas most often our pain stems from a movement dysfunction. Learning how to move properly and creating a strong foundation to build upon can help create the perfect environment for movement without or with less pain. After hearing over and over again that “nothing is wrong,” patients typically sigh from relief when their pain has finally been acknowledged and explained.
Proactively seeking out physical therapy as a first line of defense to treat pain and recover from an injury will increase your chances of returning to normal physical activity sooner.
Gina Gapstur, PT, DPT, was born and raised in Minnesota, has made her way around the country studying to become a physical therapist, and now calls Nashville her home. Gina’s background as a dancer along with her vast experience in movement related activities has driven her to assist others in living a healthy, active, and pain-free lifestyle.