During every eval, I find it worth asking why people are coming to physical therapy. Most say, they want to get back to [x] or they can’t do [Y] without severe pain. But every so often people come through the doors that don’t quite have the right motivations. Here are my top three, and unfortunately, top three most common, wrong reasons people come to physical therapy.
1. My spouse is coming– Okay, your spouse happens to have a laundry list of symptoms and conditions. I get it. People might even treat them differently because they are in pain. You might even have a little back pain. But when I ask you why you are coming to PT and you say “because my [spouse] comes,” you can just leave and stop wasting my time. Does the pain you have stop you from doing any functional activities? No. Does the your pain stop you from sleeping/working/exercising? No/No/No. And then the litany of Outcomes Measures basically say there is no existing disfunction. I have plenty of people who need my services because they can’t work, have difficulty taking care of themselves or their children, or they cannot perform the activities they once enjoyed doing, so because your spouse is coming to PT you’re not allowing those in need to truly get the care they deserve.
2. Well, I sprained my ankle three months ago and it’s feeling much better, but I’d like to work on my sagging triceps. Are you kidding me? How did you even get a prescription for physical therapy in the first place? “I’m not motivated enough to workout on my own, but when my insurance will cover a DOCTOR of Physical Therapy to “train me” I’m all about working out. But please don’t give me any home exercises because I will not do them,” is all I really hear when people say that. Another equivalent of this is,”yeah my shoulder sorta hurts, but can we get rid of these [person grabs their love handles]”.
3. My doctor said you’d get me better. There’s no better way to dis-empower a patient than to tell them that they have no control of their rehabilitation. And yet, before even coming through the door, MDs have already set that up by telling their patients that a physical therapist will make them better. Doctors, please try this approach for all physical therapists’ sake. “Yes Ms. Jones, I understand you’re having back pain. I’d like you to go see Mike, a physical therapist, who will work with you to reduce your back pain, increase your activity level and the quality of that movement, and even help you return to some, if not all, of those activities you loved to do up until a few months ago. It will take lots of hard work and will take time, but ultimately, if you are consistent, you will most likely feel better”.
Physical therapy is not just glorified personal training. We as a profession are here to advance people’s functionality, decrease pain, and improve peoples’ quality of life. We are not here to tighten people’s sagging areas unless it’s a “side effect” of gaining muscle in needed areas to improve function, we are not here to provide social hour for you because your spouse also comes, and we are not here to provide passive treatments without patient involvement (see my hummers article).