Alex twisted his knee during a soccer game when he stepped in a hole on the field. Although he iced the injury afterwards, the pain continued to bother him. A visit to the doctor revealed that Alex had torn his anterior cruciate ligament (ACL), which connects two key bones in the knee. A few months later, he had surgery to repair the damage. But even after his successful operation, there was still work to do before Alex could heal properly: He needed physical therapy to help him rebuild muscle strength and recover the range of motion in his injured knee.
What Is Physical Therapy?
Physical therapy helps people get back to full strength and movement in key parts of the body after an illness or injury. Physical therapy doesn't just help a person build strength and range of motion, though. A physical therapist can also help someone manage pain, whether that pain is caused by bad posture, an injury, or a disease like arthritis. When done properly and consistently, it can help prevent permanent damage and recurring problems.
Most physical therapy uses a combination of techniques to relieve pain and boost coordination, strength, endurance, and range of motion. Physical therapists (PTs) often ask patients to use exercise equipment like bikes and treadmills. In addition to exercising the affected area, a PT may also treat it with heat or cold, electricity, ultrasound, biofeedback, and water or whirlpool baths. In many cases, PTs massage injured areas and oversee the patient during stretching routines.
Most of the time (but not always), physical therapists give their patients exercises to do at home. These at-home exercises work with the treatments and exercises done in the PT's office to help a person heal better, faster, and safely.
What to Look for in a Physical Therapist
You'll want to be sure a physical therapist is qualified to treat you. All PTs must have an advanced degree in physical therapy and be licensed by the state to practice.
Like doctors, some physical therapists can specialize in different areas: A particular therapist may work mostly with sports injuries, for example. Others may be experts in head injuries, or in caring for wound and muscle damage in people with burns or skin injuries. Some PTs focus specifically on athletes, children, babies, the elderly, or the very ill.
Your doctor will recommend the right PT for you — but you also need to be sure you feel comfortable with that PT. Don't be afraid to ask questions. Some good ones are:
- How much experience do you have treating people with my condition?
- How will you decide which treatment program I need?
- What equipment will you use to treat my condition? (This prepares you for when the PT shows up with a particular piece of equipment)
- How long will each treatment session last?
- How long do you think I will need to come for treatment?
If you don't feel comfortable (for example, the PT doesn't answer your questions or can't explain your routine in a way that you understand), let your doctor know and ask for another recommendation. The doctor will probably appreciate your feedback!
If your doctor doesn't have a recommendation, you can contact your state's physical therapy association for names of licensed PTs in your area. The coach at your school may also be able to recommend a PT.
The First Visit
Many states require a prescription from your doctor before you can be evaluated and treated by a PT. If you're going to a hospital or clinic, it's a good idea to take someone like a parent or older brother or sister with you the first time, even if you can drive yourself. Not only will you have support and someone to talk to about the experience, but you'll also have someone to help with your exercises at home — and maybe even give you a gentle nudge when you're feeling unmotivated!
Most likely you'll see a PT in a clinic or office. But some PTs work in schools, helping children with injuries, disabilities, or chronic (long-lasting) conditions.
During your first visit, the PT will evaluate your needs, and may ask questions about how you're feeling, if you have any pain, and where that pain falls on a scale of 1 to 10. Using the results of the examination and your doctor's recommendations, the PT will design a treatment plan and give you a series of exercises to do at home.
Many times, a PT will start treatment during a first visit — including giving a patient exercises to do at home. This is the time to be sure you know exactly how to do these exercises. The PT will probably ask you to go through any in-home exercises while you are in his or her office to make sure you know how to do them. Many PTs give their patients a piece of paper with the exercises written on them as a reminder of what to do and in which order (if any). Be sure to follow the plan exactly — most of the benefit of PT comes from the routines a person does at home.
Don't be afraid to ask for another explanation if you don't completely understand an exercise that you're going to be doing at home. It's easy to feel confused or overwhelmed with information during a first treatment session — lots of people (adults included) feel this way when they go to the doctor.
It's also a good idea to talk with the PT about how the exercises should feel when you do them — for example, if you're supposed to feel any pain or unusual sensations, and whether you need to stop if you do. Some people like to keep track of their progress during PT by taking notes on how often they do the exercises, how they feel, and how sensations change — this will help you and your PT monitor your treatment.
After the First Visit
Most physical therapy sessions last 30-60 minutes each depending on what you are receiving therapy for. As you make progress, your visits may change in length and frequency. You'll learn new techniques to help continue your healing.
In big offices, you may meet with different PTs during the course of your treatment. Alex lives in Washington, DC, and he visited an office shared by five PTs and lots of assistants. He usually saw the same physical therapist, but not always. Don't worry if you see a new face — but make sure each PT working with you knows your condition, and that you're comfortable asking questions. Remember: If you don't like the treatment, or something feels wrong, speak up.
Although the long-term goal is pain relief and recovery, physical therapy itself won't always feel good. Depending on your injury, you may feel uncomfortable or not used to moving the area. It's important to stick to the routine — and to breathe, be kind to yourself, and ask your PT for other hints on getting through. But it's also important not to put yourself through too much or to overdo it.
If you feel pain, call your PT to talk about it. "No pain, no gain" may work on the sports field, but it's no way to approach physical therapy. Pain is a warning signal, and by pushing yourself through too much pain, you can do more damage.
Practice Perfectly & Other Things to Keep in Mind
Following a few simple steps can help you make your PT treatment a success:
- Stick to the plan. It's important to follow the PT's instructions. Do your exercises at home in the number, order, and frequency noted. Don't skip any, and don't do extra exercises — following the directions will help you heal faster and get moving again.
- Know your body. It helps to know what's going on and why. Ask questions and pay attention when the PT explains the injury and the treatment. You'll probably be amazed by the way your body heals itself. And you'll want to know how the affected area functions so you can spot problems or avoid further injury in the future.
- Talk to your PT if you have problems. If things hurt, you have questions, or you're not making progress the way you thought you would: ask. The PT is there to help you.
- Celebrate your successes. When you follow the plan, you should see a difference in a few weeks or months. Bouncing back from more serious surgeries may take many months or a year, but there will be milestones along the way. Take a moment to appreciate the difference! Recovery can feel frustrating and slow — but it helps to stop and enjoy the successes, no matter how small.
Reviewed by: Julie Shulman, DPT
Date reviewed: October 2008