Sports injury? Frozen shoulder? Knees not behaving as they once did? Your health care team may suggest physical therapy to help treat these issues.
So now you’re heading for physical therapy, ready to do the exercises prescribed to help ease pain and restore function. Be prepared to answer questions, too; your physical therapist will want to know a lot more than just where you have pain. You can expect three main questions.
1. What are your limitations?
To determine a treatment plan, your physical therapist needs to know how pain is limiting your ability to carry out activities. "It’s critical to understand the problem impacting a person’s quality of life, so that everything we do is meaningful to them. They don’t care about their degree of shoulder flexion (range of motion); they care about getting a cereal bowl from the cabinet. We figure out what’s driving the problem so we can help them return to what they want to do," says David Nolan, PT, DPT, a physical therapist at Harvard-affiliated Massachusetts General Hospital.
Your answer about limitations will also help guide the initial physical therapy assessment that measures range of motion, muscle strengths and weaknesses, or joint restrictions. "Maybe you say you can’t clean the house because of knee pain. After an evaluation, I may determine that you have pain because of weakness in the gluteal muscles and tightness in the quadriceps or hamstrings, and that informs what we need to do to alleviate pain," Nolan says.
2. What are your goals?
Tell your physical therapist if you have a goal in mind — like going on a hike with friends, running around a tennis court, or playing outdoors with your kids. "There may be specific things we need to do to reach that goal, so I’ll need to know about it," Nolan says.
For example, if a knee injury is keeping you from playing tennis, the plan will focus on more than just reducing pain. Yes, you’ll likely strengthen and stretch muscles that support the knee (the quadriceps and hamstrings in the thigh, the gluteal muscles in the buttocks, and the abdominal muscles). But you’ll also work on improving balance and agility, so you can navigate the tennis court safely; and on improving upper body strength and shoulder range of motion, so you can swing a tennis racquet.
3. Are you committed to this plan?
Your ultimate success depends on your willingness to stick to the program during the course of physical therapy (which can last weeks or months) and long afterward. "If you’re only doing the work when you’re in the clinic, then it probably won’t be enough to have a lasting effect," Nolan notes.
Does that mean you’ll have to continue doing special exercises every day or on most days of the week, for the rest of your life? Probably not. "Once you’ve regained strength and reduced pain, you may not need to do the exercises with the same frequency. But you’ll need to make some lifestyle changes to prevent pain from coming back," Nolan explains.
If you don’t feel committed to the plan, be up front about it. "Give all the information you can as far as what you can do and what you’re willing to do," Nolan says. "Let’s share decision-making so I can make the plan as relevant to you as possible and you’ll be more likely to comply with it. That way, you’ll have a better outcome."
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