I’ve been to several physical therapists over the years. When I was in my mid-forties, I split my kneecap in half, requiring an ankle-to-groin cast that resulted in atrophied thigh muscles. In that case, my physical therapy was crucial in helping me regain muscle strength in my quadriceps and flexibility in my knee. In subsequent years, I’ve been to physical therapists for hip pain. In those cases, the therapy was useless. Most recently I’ve been to physical therapy following knee replacement surgery. Those sessions were useful, mostly because of the equipment, such as the leg press machine and stationery bicycle, that I don’t have at home.
According to an article in The New York Times, “there’s
been a quiet revolution taking place in the field of physical therapy.” That “revolution”
is basically an effort to create evidence-backed treatment guidelines. (Duh.) For
example, evidence has shown that exercises to increase quadriceps strength
after an A.C.L tear get an A. Electrotherapy to improve heel pain for plantar
fasciitis gets a D. As a rule, most “passive” treatments, such as
electrotherapy, lasers, ultrasound, heat, and icepacks have been deemed useless.
(Ice packs prevents blood and inflammatory cells from reaching the damaged
tissues—but blood and inflammatory cells are a necessary part of the healing
process. Using ice can delay or prevent recovery.)
What works are exercises that improve strength and
flexibility, as well as ergonomic adjustments to prevent future injuries.
Most important, in my view, is a response to the article by a practicing physical therapist bemoaning the fact that “…patients often approach their healthcare with a less-than-optimal sense of agency about their own role in their rehabilitation. Far too many of the people who come to me following a surgery have little to no idea of what was done to them or what the implications of their procedure might be. …The best physical therapy, in my view, promotes patient responsibility…” Amen to that. I am still working diligently to improve the flexibility of my knees.
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This was quite interesting to me as I have had PT for two different injuries and the help was minimal!
ReplyDeleteThanks Connie for all the information you share. Keep it coming. I do my water aerobics 3 times a week.
ReplyDeleteI am more capable and youthful at 86 than I was at 82. This has happened in large part because of PT following spinal surgery and knee replacement. I have come to understand that exercise, of the correct kind, is a necessary way of life. The center where I go, provides a wellness program; exercise specialists follow me closely, chart my progress and set up the equipment. They provide continuity with the plan of the Physical therapist. I provide the motivation and determination. My body provides the endorphins.
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