How To Get The Most Out Of Your Time In Physical Therapy

A Patient’s Guide Written By A Physical Therapist

physical therapy goals
This is a guest post by Randal Glaser, PT, DPT, OCS, CEAS I. He is the Co-founder of Jetset Rehab Education, a continuing education company for Rehab Professionals. You can check out Jetset’s blog and podcast (which will both feature yours truly soon!). Follow Jetset on twitter and instagram for exciting con-ed opportunities in exotic locations, and for Randal’s incredible photography skills.

As a Physical Therapist, I’ve worked with – and treated – a lot of patients. I’ve had experiences with satisfied patients who have called me a miracle worker. On the flip side, I’ve also had patients who disagreed with my treatment altogether. And then there are those who were simply indifferent. If I’m completely honest with myself, I can reflect on – and learn from – each experience, regardless of the outcome, to improve patient care moving forward.

Over the years, I’ve taken notes on how to better my interactions with patients to get the best possible results.  I’ve also noticed that, although each patient is unique, those who have successful outcomes share a common set of attitudes and disciplines.

I’d like to share with you these best-patient-practices, which I hope can serve as a guide to help you get the most out of your time in physical therapy.

Tip #1: Have a goal.

You wouldn’t run a race without a finish line, would you?  Rehabilitation is a lot like starting a race.  Without identifying the finish line, there isn’t a clear direction to start running.  If you don’t have an objective, the treatment is without purpose and measuring your progress becomes impossible.

When I ask my patients what their goals are, a lot of them tell me they want to be pain-free.  This is nice, but I challenge them to go deeper.  What is the most important thing that their pain limits them from doing?  How long until this pain starts to limit them?

Once addressed, I can direct their treatment to meet the goal.  Together, we also establish when therapy is successfully completed.

Tip #2: Be focused.

There’s a plethora of treatment options out there…especially in California.  It’s common to have patients come to an appointment, saying that they treat their pain with a Chiropractor on Mondays, an Acupuncturist on Tuesdays, a Massage Therapist on Wednesdays, a Reiki Healer on Thursdays and me, the Physical Therapist, on Fridays.  This is in addition to their Doctor-prescribed cortisone injections and seeing a Personal Trainer at the gym.

Personally, I would prefer not to join this practitioner soup.  If a patient gets better, it’s hard to identify which treatment is responsible for this improvement.  And when the patient gets worse, is it the combination of Acupuncture with my treatment that caused their decline?  Or is it the new exercise the Personal Trainer gave them?  Perhaps the Chiropractor is working on more mobility while the Trainer is working on core stability.

I can admit that I’m not smart enough to figure out how all of these practitioner treatments co-exist.  Since it’s too confusing for me, I can’t muddle through the various treatments to get you to your goal (see tip #1).  I imagine that if several chefs were asked to add their best ingredients to a meal at the same time, the meal would be ruined.

Get focused.  I don’t need to be the one you see while you stop seeing everyone else.  If you choose a Massage Therapist over my treatment, I honestly don’t mind.  This is what you have to do to get focused.  If you get better, problem solved!  If not, move on to the next.  Remember, the objective is to figure out what works for YOU.  Limit your sources to one at a time.  This way, the cause and effect of your treatments will be clear.

Bonus Advice: We all know family members have a lot of advice for us. Part of staying focused is to not listen to them. They have good intentions and want you to get better. But they haven’t reviewed your medical chart; they didn’t take a proper history of your issue and may or may not be a medical professional. I have found the best way to appease them is to say, “that’s a great idea! I’ll consider that. Thanks!” This way, they feel validated and you haven’t lost focus by trying another rehab approach.

Tip #3: Be an active participant to your treatment.

Sometimes the pain is just too great and doing exercises sounds like a bad idea.  Guess what?  You may be right.  With an acute flair up, it’s not the best time to start new and “exciting” exercises.  This is when a Physical Therapist will limit the exam and use a more passive approach (e.g. you lie down and receive treatment).  Once you are out of this phase of healing, the active rehab starts – this means to actively prevent the symptoms from coming back.

If you’re still requesting passive treatment several weeks after your initial visit, you haven’t fully started active rehab.  Go back to your goal (tip #1).  Is lying on the table getting treatment going to get you to this goal?

Tempo Run DPT with Jess Mena

Tip #4: Participate…mentally.

In addition to physical participation, mental participation is imperative.  Throughout your day think about what activities make your pain worse and which ones make it dissipate.

Identifying the problem is essential to solving it.  Determine the problem with details to help your Physical Therapist figure out where the pain originates.  The patient who is mentally active in figuring out their problem is more likely to solve it. Ignoring the problem is a great way to never solve it.

Copious amounts of pain medication, ignoring when or why the pain gets worse, and continuing to “push through the pain” are great ways to ignore the problem. Your mindset is as important as anything.

Tip #5: Trust yourself!

I always tell my patients that they know their bodies better than I do. Trust yourself above all other advice you receive. There’s a lot of advice out there, and if you’re not careful, you can do something that aggregates the issue. Trust yourself and do what feels right.

In my clinic, I will give advice but not orders. I suggest a home exercise program and ergonomic tips and then allow the patient to decide what they want to do. If they feel that the suggestion was not a good one, I want them to tell me why they think so. After all, you the patient know best, you have been living with your body your whole life.

 

Randal Glaser Jetset Rehab Education Randal Glaser is a physical therapist for Kaiser Permanente in Santa Clarita, California. He is the co-founder of Jetset Rehab Education, a company that provides high-level continuing education classes for rehab professionals. You can follow his blog here: www.jetsetrehabed.com Twitter: @JetsetEducation Instagram: @JetsetRehabEd

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