What is Physical Therapy?
What is Physical Therapy?
The aim of physical therapy is to diagnose the problem at hand and create a treatment plan to relieve pain, help people move better and achieve their functional goals. It will typically include a combination of movement assessments, manual therapy, exercises and education to help patients reach their desired goals. Goals may include pain relief, return to activity/sport, or related to performance enhancement, body maintenance, lifestyle and longevity. Physical therapy is performed by a Doctor of Physical Therapy.
Physical therapists are movement specialists. They are doctors who identify and address issues related to pain, injury and performance through the lens of biomechanics, movement and function. They partner with you to understand your functional goals and create a plan to achieve them.
A physical therapist should perform all 3 of the following:
Give clarity between a “Medical Diagnosis” vs “Functional Diagnosis”.
Hands-on Assessment and Treatment
Determine proper exercise selection and execution, with modifications progressions built in.
“Medical Diagnosis” vs “Functional Diagnosis”
A medical diagnosis refers to the source of pain. What is the structure in your body that is giving you the sense of pain? Examples are “rotator cuff tear”, “sciatica”, or “tendonitis”.
In modern medicine, treatments are heavily focused on the medical diagnosis which temporarily helps relieve pain but fails short of addressing the root causes that may have led to the injury.
A functional diagnosis refers to the root cause(s) of pain. These are potential reasons related to why your pain or injury happened in the first place. This is formulated through a thorough evaluation, including a movement screen, biomechanical exam of each body part and observation of posture and movement patterns.
Physical therapist should work with you to make sense of the pain by capturing both the medical and functional diagnosis. Essentially physical therapy should include a plan to relieve the pain itself, while addressing the root cause and compensations to create lasting changes in the body.
Hands-on Assessment & Manual Therapy
Hands-on assessment and manual therapy can be helpful in improving joint mobility, soft tissue pliability and decreasing pain.
Every tissue in our body has an “end feel” to them. Think of “end feel” as a natural spring built into each structure of the body. This includes everything from joints, fascia, muscles, ligaments, nerves, visceral organs and even blood vessels. Every structure in your body has the ability to store and release energy. A hands-on assessment can evaluate the quality of how efficient, inflamed, restricted, tight, and stiff these structures are.
Furthermore, you can improve the quality of the tissues by utilizing different manual therapy techniques, which is not to be confused with general massage. Manual therapy alone can be powerful. However, it is imperative that it is paired with customized exercises, known as neuromuscular re-education, to teach the body how to utilize what you gained through manual therapy. This increases your body’s ability to carryover the improvements.
Proper Exercise Selection and Execution (plus, modifications and progressions)
“A critic sees your weaknesses and attacks your worst self. A cheerleader sees your strengths and celebrates your best self. A coach sees your potential and helps you become a better version of yourself. ”
A physical therapist should be a functional movement coach that can help you take the next steps in your health and fitness journey.
Based on the information gathered from the diagnosis, manual therapy and your personal goals, a physical therapist will help create a personalized exercise program to develop your strength, range of motion, flexibility and endurance. There should be layers to the program as both your pain and body’s capacity to handle load changes.
Finally, it is important to consider both the quantity and quality of movement. Functional Movement Systems said it best: Move well, then move often. Consistency leads to long-term adaptations which will help you from getting stuck in a cycle of pain and decreasing function.
The key points of emphasis here are:
Finding an appropriate entry point.
Creating a customized exercise plan.
Ensuring exercises are progressive toward goals.
Emphasizing both quantity and quality of movement.
Conclusion
As we age, the body changes in predictable ways. One of the primary changes being muscle loss. Muscle loss can be a primary contributor towards pain and loss of functional independence. Therefore, the ability to exercise and train your body appropriately is a skill that every human needs to learn and practice on a consistent basis in order to fight these predictable changes that happen over time.
In physical therapy, you partner with a physical therapist to get to the bottom of the problem that is holding you back. A physical therapist can help you identify and address issues related to pain, injury and performance. They can coach you through a personalized plan of care to help you overcome pain, so you can live your fullest life.
A treatment plan should be holistic in nature and will likely include a combination of manual therapy, custom exercises and education. As the plan of care progresses along, the treatment plan can continue to change and evolve with you to best fit your goals.