Patients often ask me...
don't I need to see my family doctor before starting physical therapy?
what if I need an MRI?
don't you think I think I should get an x-ray first?
These are good questions! And the concerns are valid!
Most patients who seek physical therapy for the first time are unaware of the laws that pertain to physical therapists treating patients and the extensive training we undertake.
In the state of New Jersey, where I practice, we have direct access.
This means a prescription from a medical physician is not needed to start physical/vestibular therapy.
During the evaluation and treatments, we perform thorough assessments in which we are monitoring the progress of your condition and screening for any red flags related that would give us concern about anything more serious that could be going on.
And, here’s the best part- it's all without the extra time and cost of fancy imaging studies, x-rays, or pills!
If we feel like there are inconsistencies and areas of concern, or even things that we feel need another opinion, we will of course refer you to a physician or medical provider that can further evaluate and provide insights.
So now, with all that new knowledge you have, I want you to reflect on something...
Why do you feel you NEED a prescription, MRI, or x-ray?
I totally understand why patients are often searching for a diagnosis, and I think for all of us we want to know what to call “the thing” that is causing us to feel so terribly and seeing that in an image makes us, in some way, think it'll make us feel better about it.
Here is a quick example to demonstrate my point...
I remember in high school I was dealing with chronic hip pain.
You see, I fell off a jungle gym when I was about 5 years old and have struggled with hip pain on and off since. This left me unable to sit and get through my classes and play sports in high school without this constant nagging pain that was really debilitating for me.
Once I finally saw a physician, I was told to go to physical therapy.
If I was being totally honest with you, this is not what I wanted to hear and I felt to
tally defeated (I actually left the orthopedic's office crying) and I never understood why I was being told to go to physical therapy.
So I didn’t (hey like I said, I’m being honest here).
I wanted to be told,
“you have ABC condition, the remedy is XYZ “quick fix solution ``".
It wasn’t until years later when I was struggling to sit in my classes during my first few months of PT school that I actually decided to pursue real help for my hip (with physical therapy).
I made some good progress and learned a lot of things about my body and how it moved and functioned, but I was still sent for 2 different MRI’s and ran up quite the bill from the orthopedist for a struggling college student.
I went for the first MRI, but never went back for the second.
And here's what I came to realize and why I never went back...
Was anything more I was going to find out actually going to change my course of action?
No.
Was I going to have surgery?
No.
Was I going to resort to being anti-inflammatories and pills my whole life?
No.
So why was finding out the “thing” so important to me anyways? I eventually knew how to manage my pain, alleviate and manage my symptoms on my own, but I still struggled with wanting the tangible diagnosis.
I think when we are in pain or struggling with a condition that we can’t touch or feel we seek to name it. And by naming it we feel like we have control over it. But actually, it doesn’t need a name to start controlling it.
So what is actually wrong with my hip? Labral tear? Acetabular impingement? Femoral acetabular retroversion? Sacroiliac joint dysfunction?
Do any of these crazy sounding conditions really matter towards making me feel better?
Again, No.
At the end of the day (knowing what I know now), I have muscle imbalance in my lower back and hip. This causes some areas to be tight, and others to be weak. As long as I continue to exercise (and practice what I preach) I feel great. When I slip up (because I’m human, just like the rest of you), that’s when I notice it and I know that I need to get myself back on track again.
So what's my point here?
We can spend months, or even years (in my case) trying to find the “diagnosis” or “pill” or any quick fix for our condition. But really, you can start taking an active approach to your wellness, starting now! I wish I did when I was so young and before my college years.
But any lifestyle changes you make (even before a diagnosis) will be better to improve your overall health, no matter what the condition.
So why continue to live in fear of your symptoms? Starting treatment now can only help you take control of your life, it’s not going to make things worse, it’s going to make you better!
Here are a few examples...
Evidence supports having physical therapy weeks (and even up to 1 year) before having a total knee replacement. Why?
Because we can start addressing some of the issues that have led to the need for the knee replacement in the first place like strength, body mechanics, soft tissue flexibility and joint mobility.
Evidence supports that those who participate in physical therapy before having this surgery have better outcomes in the end and some even put off having the surgery all together.
So why don’t we take this approach with other conditions of our life?
When I see clients who are suffering from dizziness, they often want to “wait and see”.
Wait for the MRI, VEMP, VNG, and see what these studies will reveal.
But, will this information drastically change the course of your rehabilitation?
The hard truth is...
No, probably not.
If we feel like it’s best to wait for treatment until we have some more information, we will be honest and tell you that.
But for most, passively waiting won't get you to feeling better. But treatment can be effective NOW, because unlike others in healthcare, we treat you, your goals, your complaints, your struggles, NOT your diagnosis or imaging.
Each of us is unique, our personal and family histories are unique, our symptoms are unique and our bodies are unique, and therefore you deserve an individualized solution with a treatment plan that is unique to you.
Don’t settle for anything less than what you deserve!