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Things That Make You Love And Hate Physical Therapy

What does the term Physical Therapy mean to you?

For some it may be the sounds of dumbbells clinking, or the loud shrieks of pain as a physical therapist attempts to work through scar tissue that has built up. There are certain features of physical therapy that may spark memories of when we had to endure the 2-3x/week sessions to help us overcome an injury.

In this post, I would like to share what I consider the love/hate relationship that my patients have spoken to me about in regards to Physical Therapy. While I may use "we" to refer to physical therapists, these are my own feelings and I only speak for myself. Feel free to chime in with your own experiences.


The Love

What's not to love about a profession that treats you as a holistic, unique, and complex individual. We cannot truly treat an injury without knowing the who, how, what, why, when, and where. We try to understand the unique experiences of individuals beyond the current injury to better understand habits, tendencies, life experiences, and other factors that allow for a more thorough treatment. Many patients love that they can come and talk about stressors, ask questions that have been pushed aside before, and have an outlet to participate in a total body healing.

Let's not forget the Art + Science of physical therapy. While anatomy, physiology, physics, chemistry, and all the other courses that we learn as PTs remain constant, it's the artistry that patients love/appreciate. Physical therapists are able to create exercises and treatments on the spot by blending what we know about the person (individualized approach) and our knowledge of the sciences. The creative side of physical therapy allows for what I consider detective work, which blends mechanical/movement assessment as soon as the patient walks into the door with awareness of how the patients body and mind are responding to the day's activities. We have to be flexible, understanding, aware, and be great at actively listening to our patient's concerns.

Let's not forget about all those fun exercises that we have you do!!!

Exercises for me are far more than a movement pattern to strengthen a muscle group. Exercises are the bridge between prior dysfunctional movements and new patterns that act to stabilize, control, perform activities in a safe manner, and gain self-awareness. Patients love having the ability to learn "why is this exercise important to me?", because this leads to better consistency and independence with their own recovery. The exercises should be unique to the goal of the patient, which allows for improved adherence to a home exercise program, which is an essential part of the patient-PT relationship.

The best love of them all is reaching the goal of discharge from physical therapy, which is the first step towards taking control of each person's own injury and now being sent out into the world to use the tools/new found knowledge in continued success. While the formal course of physical therapy ends, patients that have received a unique/personalized care tend to express how valuable it was to learn the "Why" of their injuries, which now allows them to become an expert at their own injury.


The Hate

Can there really be "Hate" in association with physical therapy? I mean, what's not to love about healing from an injury and feeling better?

I would rephrase "Hate" into terms such as discouraging, annoying, uncomfortable, and dislike. When dealing with people's pain, there are obstacles that make the recovery process less linear than what some may expect. Pain is a subjective and while a physiological source of pain may exist, the extend and magnitude of the perceived pain is unique to each individual. It is easy to become frustrated with physical therapy when pain may shift to another area, become more prominent, decrease for a short time only to regain its intensity, or fluctuate throughout the course of PT. This is especially notable with chronic pain, which may have extensive connections within the memory centers of the brain, have emotional/psychological implications, and may be a result of many injuries that have built up with time.

It is our job as physical therapist to take these negative emotions/perceptions and to approach our patients with compassion and understanding, from which we may be able to break this pain cycle and give them a different perspective on PT.

A personal example was working with a patient that had been seen by multiple practitioners in the past, but always felt like it was a "waste of time and quit after a couple of visits". While the patient had multiple areas of concern (orthopedic), it was her feeling of being "pretty hopeless" that drew my attention at creating the best possible rapport, making sure I explained the "Why" at each step of the process. As time progressed, my patient began experiencing relief, but more importantly understood the nature of the pain, the benefits of each exercise, the importance of consistency, the role of external/internal variables, and became motivated to continue after PT was completed.

While physical therapy does involve stepping out of the comfort zone and going through difficult milestones, it is meant to provide an opportunity to learn with the physical therapist and become your own advocate for your health and wellbeing.

This is why we became PTs.

Thank you for tuning in.

Alex Zhidetskiy PT, DPT

Wellness Tribe Physical Therapy


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