OT: What is good physical therapy supposed to be like?
 

I am having the worst experiences with physical therapy, and I'm starting to wonder if it's me or them. I am scheduled now to see my 4th different physical therapist (at a 4th practice altogether) in the last year. The first therapist pulled on a broken bone and caused me to end up in urgent care with a swollen, painful foot. The second physical therapist saw me 3 times, and said if I wasn't limping when I walked I didn't need his help any more. The third therapist said he could get me running again (even though I had been told by my doctor not to do that) by "teaching" me to run in an entirely new way that has caused my ankles to hurt. Now I'm going to see a 4th person that was highly recommended by a friend of mine. What should I be looking for? Is there any way to tell at the first visit that this is not going to work out? I've spent a lot of money out of pocket, and I feel like I've gotten nowhere.

Here's a good article that summarizes pretty well what I think you should get when the relationship works well..
https://modernsportspt.com/switch/

Unfortunately it's often hard to find a good practice. I've mostly had duds in my backache career. Even when I've had a good one, after two or three visits I got the feeling they didn't want to be bothered.

One place in particular hurt me horribly, physically and emotionally. After a painful manipulation the man loaded up my butt and low back with those electrode shock gizmos and walked out to treat someone else. I could hear a BBQ going on outside for the people in the building. Everyone in the PT office went to it and they left me unattended. My electro treatment ended and I lay there on my stomach with the thing beeping and my bare butt jiggling and jiggling. I finally disconnected it myself and walked out. They never called me for payment, to reschedule or even to apologize! If that all wasn't enough, this man laughed outside my door and called me obese to another person. I could hardly walk for a few days. The only upshot was the experience got me to join WW.

Anyway, we have a nice PT complex where I live now and all of the people are professional and pay attention to patients' needs. They listen, instruct the exercises, know how to do manipulations if necessary, and respect physical limitations. They start with a full evaluation for the first visit, then begin slow and easy and keep challenging you as you improve. They also provide printouts of all your exercises with sets and reps.

Good luck.

wow, Pat, that is horrific!:eek:

Donna

I'm not sure if a virtual session would work, but Jessica Valent - an on-line Pilates instructor does offer virtual sessions. Jessica is a Physical Therapist as well as a Pilates insturctor.

I can't speak to it b/c I haven't tried it - but....I do like her on-line content and she seems knowledgeable and compassionate.

Donna

I had knee replacement in February 2019 and I will say my PT experience afterwards was very good. I had a good therapist and while experiencing vertigo in the early stages of my therapy they also did some vertigo therapy with me and all in all it went well. What I did not care for is 1) the receptionist, they were the most unfriendly 2 ladies I have ever met and 2) that after the first month you start to share your time with another patient meaning your PT is doubling up. The disadvantage of this is you may be doing the leg press machine wrong, be out of alignment, but the PT is across the room working with the other patient. I understand they are super busy and trying to get in as many patients as they can but the insurance company is getting billed for my full hour of therapy. My PT was good, helpful, caring in many ways. She did talk about her theories in gluten free eating, vegan diets, certain health drinks which I just listened to and said thank you. In March I started having very severe pains in that same knee in a specific spot. After xrays, cscan, MRI the doctor decided to try and avoid another surgery and do therapy first. I opted to stay with the Northwestern Medicine group but go to a different practice. I hit the mother load of a good therapist. I get 45 mins of her undivided attention. She is with me the entire time, watching me do each stretch, movement, machine etc. She makes suggestions, listens to me when I say it hurts, explains what she is doing and why. She listens, writes down everything and is so gentle with suggestions; "Mary biking 20 miles a day for 3 days is not a good idea, try going 10-12 instead of 20. It will help reduce the inflammation." Like anything else you will get a good PT or a not good PT. Don't be afraid to switch. The practice might be good but the PT is not good. While doing PT after the surgery and they have you on the pain machines, sitting there I observed a lot. Some of the PT's were amazing and others did not give good care or service. Keep shopping around. Ask your friends for suggestions. There are good ones out there. You deserve better than to have a PT that is not giving you the care you need.

I had a good experience after developing bursitis in my hip from running. The practice was located inside a fancy gym but had their own offices at the back of the building. Apparently they have treated a few pro athletes. My therapist was young but competent and friendly, and the exercises she had me doing at home to stretch my hips between visits were helpful and I still do them every so often. They only used the electrode thing twice, which was done by an intern, but she set it up almost like a spa treatment, speaking quietly and dimming the lights so I could just relax. Even after insurance it was pretty expensive, though.

This--what Pat said!

I guess I am really lucky when it comes to physical therapy care because I have had to go through it several times and I've only had one p.t. who I thought was ineffective (not horrible--she just couldn't help me with what I needed). Living near a university that has a physical therapist assistant program doesn't hurt, either.;)

My last physical therapist, Ida (and her assistants), who worked with me for my broken ankle injury were wonderful and I wish my insurance had allowed a few more weeks with her because I think that would have been really helpful to me for a quicker recovery.

In my mind, a good physical therapist will do an evaluation, set goals, and give you "homework," complete with printed (or emailed/texted) exercises. Your p.t. should be challenging, but the therapist should not push you to do anything that is unbearably painful or too stressful. (One pta did cause some discomfort with a manipulation, but he told me it would probably be pretty painful and would leave bruising. It wasn't as bad has he said, however, and it did really help with my ankle flexibility, so I forgave him.:))

Ida really pushed me to do more and more, but at the same time she was very empathetic and encouraging. After a few sessions, she told me that some of her clients didn't like her because they thought she was too tough. I told her I loved her because I was seeing results and that's what I was there for. Take away: Ida's goals were consistent with mine, so our relationship really worked for me.

Good luck!
Donna

well said.

bfit, i think before you spend more money it's important to talk to someone about what your expectations are including the timing of the expectations. even a conversation simply identifying possible expectations is good. because there might be goals that PT cannot repair, or even traditional medical intervention. your comment about being able to run again - i wouldn't choose that as a near-term goal, for instance. i'm just an outsider recalling your previous posts about severe pain, and apologize in advance if i sounded out of line.

I am currently in Physical Therapy for my shoulder. I also had PT about 3 years ago for my knee (which turned out to be related to core weakness). I had 2 different therapists. I have had a really good experience both times. Here on some commonalities (most echoed in previous posts):

1. Both started with a longer appointment for an assessment of the issue.
2. Both are associated with a large teaching hospital.
3. Both were focused on me and no other patients during my appointment time.
4. Gave me a website links and paper handouts of the exercises. The website/app is nice to be able to see the exercises in motion.
5. Graduated from the University of Wisconsin-Madison PT school.
6. Gave me progressively more difficult exercises to do.