With her expertise in musculoskeletal matters, Dawn Cox tends to worry about complete strangers.
“I see people on the street or in the gym or standing in the grocery store, and I think, ‘Oh, my gosh, they’re going to have a herniated disk in five years,’” she says.
Cox is owner of Prana Functional Manual Therapy (pranapt.com) in Lancaster—one of many physical therapists who are reshaping the image of their field. Yes, they’re still the go-to pros for help recovering from accidents and surgery, but physical therapy can also be pivotal in preventing injuries, staying active and managing chronic conditions.
Staying Active
In the wake of health care changes and skyrocketing costs, Ed Sanborn had an epiphany.
“I wasn’t taking full advantage of my skills and knowledge base,” says the manager of outpatient physical rehabilitation at Lancaster General Health’s (lancastergeneralhealth.org) Suburban Outpatient Pavilion. “There’s a lot I can do on the preventative side.”
Physical therapists can teach active adults to “work hard and work smart,” says Ann Dennison, doctor of physical therapy and owner of Advanced Physical Therapy and Fitness (advancedptinpa.com) in Mechanicsburg.
“Oftentimes, it’s teaching the person how to perform the exercise properly,” says Dennison. Strengthening targeted muscles can ease the pain from daily activities, such as sitting at a desk or playing with children. Even weight loss and strength maintenance have a physical therapy component as the body ages and changes.
Cox scrutinizes patients’ movement and neuromuscular interactions. Correcting an apparent foot dysfunction might mean retraining pelvic movement, she says.
“Your foot is trained to accelerate you,” she says. “That means repetitive stress over time. I integrate how your foot and pelvis interact, because of the neuromuscular connection. Maybe now we’ve prevented Achilles tendinitis.”
Cox would “rather see people for three sessions for things that aren’t so chronic instead of seeing them recovering from surgery or significant back pain.”
Some active adults see physical therapists for regular checkups, says Dennison. The physical therapist can spot predispositions to common injuries, minimize recurrences of past injuries, and model proper stretching to maintain flexibility.
Sanborn isn’t sure that symptomless active adults need PT—“If you don’t need a haircut, don’t go to the barber,” he says—but he believes that physical therapists should team up with physicians when things go wrong. The doctor’s order to exercise might frighten patients who fear aggravating an injury or worsening a chronic condition. Physical therapists can alleviate fears by explaining the benefits of exercise and the warning signs of danger, providing “a solid foundation on how to exercise safely.”
Managing Chronic Conditions
Heard of the “exercise prescription”? Doctors no longer treat exercise as an afterthought, secondary to medications in treating chronic conditions and ailments.
“People take a prescription more seriously than just being told to walk a little bit,” says Dennison. Still, they need to know “what to do, and how often. Physical therapists are the perfect people to give those guidelines to people who are obese, overweight, diabetic, have osteoporosis, maybe have M.S.”
Proper exercise can reduce the need for medications and prevent complications, says Sanborn. Whether it’s diabetes, depression, chronic lung disease, high blood pressure, “you name the disease process, and exercise is a key ingredient.”
Cox is even treating “visceral things” impacted by muscle strength and skeletal alignment—stomach and esophagus problems, chronic headaches.
“It takes a long time, because those muscles are hard to get back, but we do that,” says Cox. “We do a lot of postural training.”
People who know how to exercise properly are more likely to make the hardest move of all—turning the car toward the gym at the end of a long day, says Sanborn. “To move is to live,” he says, but such factors as intensity and heart rate must be fine-tuned for impact. The physical therapist can do the tuning.
Will your insurance pay for this? Probably not. But consider what you pay—on your own dime—for a personal trainer or acupuncturist, and ask if a few PT sessions could offer more bang for the buck.
To spend your money wisely, find a physical therapist with a direct access license for a thorough assessment. Check with the American Board of Physical Therapy Specialties for therapists with specific expertise—in sports, geriatric, neurologic, or women’s health care, for instance.
As Cox puts it, “We treat the why, not just the what.”
A New Take On Health Care
Today’s physical therapy is a team sport, built on two-way communications between therapist and patient. “I can make goals for the patient, but they may not be what the patient wants,” says Dennison. “If the patient isn’t getting what they want out of my exercise prescription, they’re not going to do it. I have to make them understand why I feel they should do something, and they have to tell me what they really want to get out of their exercise.”
Physical therapists “are trying to get the word out” about their role in promoting healthy, active lifestyles, says Cox. Her field is becoming “a more highly educated, skilled profession.”
“We could be,” she says, “that smoking gun of why you’re not getting better.”
