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Does physical therapy HURT?

Running

Are you thinking of becoming more physically active but you are afraid increasing your activity will cause pain? You have heard that physical therapy can help but sometimes is painful.

If you are I’m thinking of starting physical therapy, you are probably wondering: “What methods does the physical therapist use?” “What is physical therapy really like?” “Does it hurt?”

The physical therapist’s will start by evaluating how you ARE moving and find the problem areas compared to what would be your ideal movement.

The first step is the therapist sits down to meet you. Imagine you are in the physical therapy office, the therapist will take you back to a evaluation room or area and begin by asking you questions about how you were hurt (if you were or not), where you are hurt and other questions about your history. Importantly, the therapist should ask you what YOU expect out of physical therapy, in other words what is YOUR goal?

After the therapist has met you understood your concerns, history and expectations, he or she will ask to change into clinic appropriate clothing if necessary. For example, if you have an ankle problem the therapist may ask you to pull up your slacks or skirt above the knees so she can see HOW you move below the hip. The therapist may want you to change into shorts (which the clinic usually have on hand or you can bring your own) if you have knee, hip or back problems. If you have a shoulder problem the therapist may ask you to change into a gown, open in the back and under the armpit of the bad shoulder. The therapist will then leave the room to allow you to change if it is required.

The therapist now will watch you walk (if you have a lower body problem) or raise your arms (and watch from behind to check your shoulder blade position, motion and strength) if you have an upper body problem. She will check each joint’s amount of motion AND strength (unless you are too painful). The therapist will focus in on HOW the motion and strength work together to make you move, either poorly and well. Sometimes you can be sore after an evaluation; the soreness can last for about a day. Tell your therapist if something is painful so he or she doesn’t push you too far.

NOW the therapist is ready to come to a conclusion about where your body moves well, and where it needs improvement. The therapist will again sit down with you to explain the findings and educate you about your condition. The therapist will show you pictures of the anatomy, and what your specific problem is.

On this visit or at the beginning of the next visit the therapist will start you on an exercise program to begin to correct the problem, and probably use specific massage or joint stretching techniques to loosen tight, guarded or spasmed muscles. A few exercises may hurt and if they might but are necessary the therapist will tell you in advance. Most exercises should not hurt and if you have pain with your exercises, please tell your therapist.

If your pain is on the lower end, you will probably be seen about 1 time per week, so the therapist can make the exercises harder as you gain more movement and strength. If you have had a recent surgery, you may need to come more often, or if you have a higher level of pain.

There is good news AND bad news: the good news is you have the power to improve your problem by doing the exercises the therapist gives you and the bad news is you have to do the exercises to get better.

Usually you will get better in about 8 – 10 visits if you have a lower level of pain to start with. If you have had recent surgery or more severe injury you may need therapy for 2-3 months. Either way, your progress will be gradual, and sometimes almost imperceptible. You used to have pain when you walked for 2 miles, now you don’t hurt after 2 miles. You used to have pain bringing in your groceries, now you don’t.

Physical Therapy sounds scary and the good news is it is usually not painful and can get you back to where you want to be!