arthritis Archives - Freedom Physical Therapy

Relief Through Movement

Physical Therapy for Chronic Pain

Chronic pain can be a debilitating condition, limiting your mobility and impacting your daily life. The CDC estimates that around 50 million Americans experience chronic pain, and 17 million have substantial reductions in activity because of pain. Beyond limiting activity or your ability to work, chronic pain has been linked to depression, Alzheimer’s disease, and substance abuse.

Chronic pain is complex. There’s no single intervention to treat it, but physical therapy should be part of the mix. Here’s why:

How PT Approaches Pain:
Physical therapy often provides relief that’s just as effective as medication but without the potential side effects. Here’s a breakdown of how PT tackles pain and its effectiveness:

Identify the Root Cause: PT goes a step further than medication that masks pain. Therapists assess your posture, muscle strength, flexibility, and joint mechanics to pinpoint the source of your discomfort.

Address the Underlying Issues: Based on the evaluation, PT focuses on strengthening weak muscles that support your joints, improving flexibility for a better range of motion, and correcting any imbalances or postural problems that might contribute to pain.

Use A Multi-Faceted Approach: A PT treatment plan will be customized based on the evaluation. In addition to therapeutic exercise, a PT might use various techniques. Examples include:
• Manual Therapy: PTs use massage, joint mobilization, and trigger point therapy to address muscle tension, improve circulation, and alleviate pain.
• Modalities: Techniques like ultrasound, heat therapy, or electrical stimulation can reduce inflammation, promote healing, and manage pain.
• Aquatic Therapy: A warm, therapeutic pool supports your body and joints while offering gentle resistance. This can often make it easier to start moving again after being in pain for an extended time.

Educate and Empower Patients: PTs equip you with the knowledge and tools to manage your pain independently. This might include learning a new exercise routine, how to modify activities, or how to modify your daily schedule when you’re feeling better (or worse) than normal.

It’s also becoming increasingly likely that you’ll learn how pain works. Research shows that combining pain education with physical therapy is an effective treatment.

If you’re struggling with chronic pain, call your physical therapist. They might have the key that will unlock a pain-free life.

References:
1. Chronic Pain Among Adults — United States, 2019–2021 | MMWR (cdc.gov)
2. The impact of combining pain education strategies with physical therapy interventions for patients with chronic pain: A systematic review and meta-analysis of randomized controlled trials, Physiotherapy Theory and Practice, 37:4, 461-472 DOI: 10.1080/09593985.2019.1633714
3. Preferred Communication Strategies Used by Physical Therapists in Chronic Pain Rehabilitation: A Qualitative Systematic Review and Meta-Synthesis, Physical Therapy, Volume 102, Issue 9, September 2022, pzac081 Preferred Communication Strategies Used by Physical Therapists in Chronic Pain Rehabilitation: A Qualitative Systematic Review and Meta-Synthesis – PubMed (nih.gov)
4. The Influence of Cognitive Behavioral Therapy on Pain, Quality of Life, and Depression in Patients Receiving Physical Therapy for Chronic Low Back Pain: A Systematic Review https://onlinelibrary.wiley.com/doi/abs/10.1016/j.pmrj.2018.09.029

PTs Fuel Healthy Movement With Nutrition

Physical therapy and nutrition are often seen as separate, but the truth is, they are deeply
intertwined. To get the most out of PT, especially after an injury or surgery, integrating both is
crucial. Here’s why:

Food Fuels The Body
During recovery from an injury or surgery, your body is working to heal itself. The activities and
exercises you’re doing in PT are designed to help it along. To take advantage of all the work
you and your body are putting in, proper nutrition is critical.
Protein provides the building blocks for tissue repair and muscle growth. Carbohydrates provide
energy and help support your immune system. Your body also needs healthy fats to regulate
inflammation and to build certain cells. Being short on any of these critical components will slow
your recovery down.
You also need enough micronutrients, like vitamins and minerals. For example, vitamin C is
needed to make collagen, which goes into bones, skin, and connective tissue. Vitamin D helps
your body absorb calcium, which is important for healing fractures, or surgeries involving bones.
Iron helps your blood cells carry oxygen throughout your body, which is needed for healing in
general. Again, being low on any of these micronutrients will affect your healing.

Your Weight Affects Your Health
Being overweight directly affects your health. It puts you at higher risk for cardiovascular
disease, stroke, osteoarthritis, back pain, diabetes, sleep apnea, and more. All of these are
conditions that you might see a PT directly for, or that will impact your healing. Eating a healthy
diet is the most effective way to reduce body weight. Combining a healthy diet with exercise is
even better for your health.
As an example, an 18-month study of 450 people with knee osteoarthritis showed that the group
that lost weight through a diet and exercised had less pain, better walking speed, and lower joint
forces in their knees than groups who either only lost weight, or only exercised.

How can a physical therapist help with nutrition?
While PTs are not authorized to provide individual diet plans or medical nutritional advice, they
can still help with your nutrition.

• PTs can screen for potential nutritional deficiencies or imbalances that may impact your
progress in PT or your overall health. This might involve screening for malnutrition,
sarcopenia (muscle loss), or assessing dietary habits affecting energy levels, healing, or
muscle building.
• Your PT can educate you on the importance of nutrition for various aspects of
rehabilitation and recovery. This includes explaining how specific nutrients like protein,
vitamins, and minerals contribute to tissue repair, muscle building, energy production,
and pain management.
• They can offer general guidance on healthy eating patterns, portion control, and
choosing nutrient-rich foods to support reaching your specific physical therapy goals.
• PTs recognize that overall health and well-being involve various factors, including proper
nutrition. They can encourage you to adopt healthy lifestyle habits that include a
balanced diet alongside regular exercise and proper sleep hygiene.

Finally, your PT can recognize when your nutrition needs exceed what they are able to provide.
In that case, they can refer you to and collaborate with a registered dietician or other qualified
healthcare professional for help in dealing with complex nutritional needs or recommending
specific dietary changes.

By combining the power of physical therapy and nutrition, you can achieve your
recovery goals faster and feel your best!

References:
1. Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and
Clinical Outcomes Among Overweight and Obese Adults With Knee
Osteoarthritis: The IDEA Randomized Clinical Trial Effects of Intensive Diet and
Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes Among
Overweight and Obese Adults With Knee Osteoarthritis: The IDEA Randomized
Clinical Trial | Obesity | JAMA | JAMA Network
2. Ottawa Panel Evidence-Based Clinical Practice Guidelines for the Management
of Osteoarthritis in Adults Who Are Obese or Overweight Ottawa Panel
Evidence-Based Clinical Practice Guidelines for the Management of
Osteoarthritis in Adults Who Are Obese or Overweight | Physical Therapy |
Oxford Academic (oup.com)
3. Strategies for optimizing nutrition and weight reduction in physical therapy
practice: The evidence Strategies for optimizing nutrition and weight reduction in
physical therapy practice: The evidence: Physiotherapy Theory and Practice: Vol
25, No 5-6 (tandfonline.com)
4. Body mass index and risk of knee osteoarthritis: systematic review and metaanalysis of prospective studies Body mass index and risk of knee osteoarthritis:
systematic review and meta-analysis of prospective studies – PMC (nih.gov)
5. Nutrition: A Portion of PT’s Menu of Services Nutrition: A Portion of PTs’ Menu of
Services | APTA
6. Considerations for PT’s Role in Nutrition Considerations Related to the PT’s Role
in Nutrition and Diet | APTA
7. Nutrition and PT a Powerful Combination – Nutrition and Physical Therapy: A
Powerful Combination | APTA

Movement is Medicine: Physical Therapy and Arthritis

May is National Arthritis Month. Arthritis may seem relatively benign – everyone knows someone who has arthritis. But here are some numbers that help put the problem of arthritis into perspective:

• Arthritis is the leading cause of disability.
• Arthritis affects 1 in 5 adults and 300,000 children
• 1/3 of working-age people with arthritis have some kind of limitation in their ability to work
• Arthritis costs $156 billion each year in medical expenses and lost wages
• Nearly 1 million hospitalizations happen each year due to arthritis

It’s a serious condition, and a serious problem. The good news is that physical therapy is one of the most effective treatments for arthritis.

The Benefits of Physical Therapy for Managing Arthritis Symptoms

Arthritis comes in 2 forms: osteoarthritis and rheumatoid arthritis. Osteoarthritis occurs because of wear and tear on the joints over time. Rheumatoid arthritis is an inflammatory, autoimmune disease. It occurs because of the immune system attacking the joint lining. Physical therapy can reduce joint pain, improve mobility, and help to prevent further damage to the joints. Using individualized exercises, physical therapists help people manage their condition and reduce discomfort. Physical therapists often combine advice on lifestyle modifications with exercise to maximize improvement. Let’s look at the types of exercise that can help manage arthritis symptoms next.

Range of Motion Exercises

These gently move affected joints through their entire range of motion. This can help reduce stiffness and improve mobility. Examples would include things like gentle stretching, tai chi, or gentle yoga.

Aerobic Exercise

Aerobic exercise creates repeated motion, moving the synovial fluid in the joints. It also increases blood flow and releases endorphins which reduce pain. Aerobic exercise also helps to control weight. Weight loss is proven to reduce the stress on your joints, which can reduce pain. Aerobic exercise for people with arthritis should be low impact. This would include things like walking, cycling, or swimming.

Strength Training

Strength training is an important part of managing arthritis. It decreases pain, improves strength, and function. Stronger muscles around the affected joints provide better support and protection.

Aquatic Exercise

Exercising in a therapeutic pool can be a great way for people with arthritis to get started. The buoyancy of the water helps to relieve some of the body’s pressure on the joints. The water pressure also provides compression on the joints. This offers some stability and pain relief. The movement of your body through the water creates resistance for your muscles. This allows them to get stronger in a protective environment.

Education

Besides designing a custom exercise program, a physical therapist will educate people with arthritis on lifestyle modifications to help mange their symptoms. Some suggestions might include weight loss, getting enough sleep, eating a healthy diet, and managing stress. A PT can also modify daily activities to help protect joints affected by arthritis. This can slow down or prevent progression of symptoms.

Physical therapy is a safe and effective treatment for arthritis. Current clinical guidelines for treating arthritis include strong recommendations for exercise and other physical therapy treatments. If you’re one of the 53 million Americans with arthritis, give your PT a call. They’re a great provider to help you reduce pain, manage your symptoms, and move better.

References:

1) Research (peer-reviewed)
a) Knee osteoarthritis: key treatments and implications for physical therapy- https://www.sciencedirect.com/science/article/abs/pii/S1413355520302434
b) Osteoarthritis Management: Updated Guidelines from the American College of Rheumatology and Arthritis Foundation – https://www.aafp.org/pubs/afp/issues/2021/0115/p120.html
c) Physical therapy for patients with knee and hip osteoarthritis: supervised, active treatment is current best practice – https://sport-physiotherapie-halle41.ch/wp-content/uploads/2021/03/9-Physical-therapy-for-patients-with-knee-and-hip-osteoarthritis-2019.pdf
2) Articles and Content
a) May Is National Arthritis Awareness Month – News
b) Benefits of Exercise for Osteoarthritis | Arthritis FoundationHow Can Physical Therapy Help to Avoid Surgery? – Tucson Orthopaedic Institute

Physical Therapy Is For Everyone!

Physical therapists are highly trained health care professionals. They are experts in human movement who are trained to evaluate and treat all kinds of musculoskeletal issues with exercise and other techniques. Everyone moves and everyone can benefit from exercise, so physical therapists can help people through their entire lives!

Physical Therapy for Children

Physical therapists start treating some people very shortly after birth. Common reasons a baby might need PT include torticollis and cerebral palsy. Torticollis is a postural issue caused by a tight neck muscle. Babies with torticollis hold their heads tipped to one side. Cerebral palsy is a neurological disorder that causes difficulty with movement and coordination.

As children get older, some have trouble hitting their motor milestones – think of these as the “firsts” – sitting up, rolling over, crawling, standing, and walking. Physical therapists can help here too, using their expertise to help develop motor skills and coordination to get these children back on track.

Physical Therapy for Adolescents

In adolescents, sports injuries become more common. Whether it’s an ankle sprain, or an ACL surgery, a PT can help. The rapid growth in adolescents can cause issues too. Things like growth plate fractures, growing pains, Osgood-Schlatter’s disease, and Sever’s disease are all common in adolescence and are related to the changes the body is going through.

Physical Therapy for Adults

As adults, a lot of us will have back pain – studies say up to 80% of us. Physical therapy is one of the first treatments recommended for back pain. Physical therapists also see adults for injuries – maybe from weekend warrior type sports injuries, overuse, or from an accident at work. Some adults also start to show symptoms of diseases like multiple sclerosis, or myositis which also benefit from physical therapy.

Physical Therapy for Older Adults

Later in life, people tend to have more health issues that impact their ability to move. Things like arthritis, joint replacements, strokes, and heart attacks are all things a PT can help with. Physical therapists also help people age better – keeping them moving with exercise programs that help reduce falls, or helping them make adaptations and modifications to keep them in their homes safely.

Movement is a constant in life. As movement experts, PTs can help people of any age. Some specialize in treating pediatric patients, and some specialize in treating geriatric patients, but all PTs have the expertise to help people move better.

References

https://www.cdc.gov/ncbddd/cp/facts.html
PT for pediatric ataxia – https://pubmed.ncbi.nlm.nih.gov/31392562/
Adult in workplace – https://pubmed.ncbi.nlm.nih.gov/32270086/
Adult myopathy (an example of something treated for adults, not geriatrics necessarily) – https://pubmed.ncbi.nlm.nih.gov/31115788/
The Role of a Physical Therapist in Healthy Aging – https://www.ncoa.org/article/the-role-of-a-physical-therapist-in-healthy-aging
How Physical Therapists Can View Normal Versus Abnormal Aging – https://www.foxrehab.org/pt-impact-older-adults-optimal-function/

What Physical Therapy Can Do For Arthritis

Arthritis is a chronic condition that causes inflammation of the joints. It can cause pain, stiffness, and swelling. The hips, knees, hands, and spine are the most commonly affected joints. Arthritis is not a single disease but an umbrella term that includes a variety of different types. Some of the more common examples are osteoarthritis, rheumatoid arthritis, gout, psoriatic arthritis and ankylosing spondylitis.

While physical therapy might not be the first treatment you think of for arthritis, it probably should be. A lot of people with arthritis choose to use medication to manage their pain, stop activities that hurt, and wait for things to get bad enough to have a joint replacement. But this isn’t a great plan – all medications have side effects, even over the counter ones. Reducing activity leads to muscle atrophy and even stiffer joints. Even though joint replacement surgery usually has good outcomes, it does come with its own set of risks and a painful recovery.

Physical therapy has been extensively researched as a treatment for arthritis, and demonstrates good outcomes. Physical therapists typically start with exercise as the base for arthritis treatment. Exercise helps to regain lost joint motion, decrease feelings of stiffness, and strengthen muscles surrounding the affected joint. These benefits are all somewhat obvious. What surprises many people is that exercise has been shown to be as effective as medication for pain relief in many types of arthritis, without the side effects.

Physical therapy has more to offer people with arthritis than just exercise though. Education helps people understand their condition, what to expect, and how to manage it. As experts in human movement, physical therapists are especially good at helping people modify the way they perform certain tasks or activities to reduce strain on joints affected by arthritis. They can also suggest ways to modify the environment at work or home to reduce pain and improve function. They may also suggest things like braces, orthotics, or other devices that can help maintain mobility and reduce pain. On top of all of that, PT has been proven to be a cost effective treatment, too.

With so many techniques that are proven effective in helping people with arthritis, physical therapy is a recommended first line treatment for many types of arthritis. Now that you have a better understanding of what PT can do, hopefully you’ll think of PT first when you think of arthritis too.

References:
1. Research (peer-reviewed)
a. PT for juvenile RA – https://pubmed.ncbi.nlm.nih.gov/1946625/
b. PT for hip and knee OA – https://pubmed.ncbi.nlm.nih.gov/33034560/
c. Systematic Review for Juvenile RA – https://pubmed.ncbi.nlm.nih.gov/28729171/
2. Articles and Content
a. Effectiveness and Cost-Effectiveness of Physical Therapy for Knee Osteoarthritis- https://www.rheumatology.org/About-Us/Newsroom/Press-Releases/ID/718
b. Can physical therapy reduce arthritis pain? – https://www.medicalnewstoday.com/articles/physical-therapy-for-arthritis

Physical Therapy is a Tree With Many Branches

Starting a career in physical therapy is like climbing a tree. Everyone starts with the same trunk, but pretty quickly, you have to make some decisions about which way you’re going to go. What kind of people do you want to work with? Where do you want to practice? And how far up the tree do you want to climb? You’ll get to grow professionally – learning more, getting better clinically, and maybe even improving your sales and business skills, but that’s not all. Physical therapy gives you a chance to grow personally too.

Pick your people

You can pick the type of people you want to work with – sports physical therapists work with athletes, helping them recover from injuries and improve performance through exercise and hands-on techniques. Geriatric physical therapists work with elderly patients on mobility problems, pain or managing chronic conditions. Pediatric physical therapists work with infants and children providing developmental assessments and helping them improve their gross motor skills.

Pick your place

You can also pick where you work – there are physical therapy jobs in nursing homes, hospitals, outpatient clinics and schools. Physical therapists provide care wherever people need it. So far, we’ve only mentioned the more common places you’ll find PTs – if you want to specialize further, you may find yourself working only in the ICU with critical care patients, in a factory doing industrial rehabilitation and ergonomics, in a women’s health clinic, or even working in a preventative, public health role.

Grow professionally

Most physical therapy careers start in a general role, working with all types of different patients. If you work in a large health system, you may even rotate between settings. But as you find the type of people you like to work with and the setting you prefer, you have the option to improve your skills and focus on a specialty area of practice. Again, you have lots of options on how to do this. You could:
● Take an internship position or join a fellowship program
● Attend workshops or conferences
● Read journals and textbooks
● Collaborate with your colleagues and mentors
● Take courses in other areas of medicine
● Study abroad or take courses online

Grow personally

Your clinical skills aren’t the only thing a career in physical therapy can grow though – you’ll grow personally as well. You have to learn to have compassion and empathy when you work with ill or injured people. You have to work as a part of a team. You need sales skills – most people aren’t going to want to make changes in their routines, or do the exercises you prescribe at home. You’ll learn to work with people who have different opinions and different viewpoints from all kinds of cultures and backgrounds.

You may also have a chance to improve your business skills. You could advance out of the clinical setting and into a management role. Some PTs start their own practices, or a company in a field related to physical therapy like wellness, performance, injury prevention or population health for large corporations.

Wherever you start in physical therapy, you’ll have a lot of options on where you end up. Chances are you’ll explore more than one branch of the physical therapy tree. That’s OK, having the chance to grow and change is part of what makes PT so exciting!

Returning to Activity After a Pandemic

During the COVID-19 pandemic, activity levels dropped for a lot of people. Between stay at home orders, gym closures and working from home, people became more sedentary. On top of that, there were shortages of equipment like dumbbells and bicycles, making staying active at home difficult even if you wanted to.

But this summer, things look different; vaccines are widely available, restrictions are loosening and people are looking to get active and enjoy the warm weather. That’s all good news, but if you had a long break from activity, your body might not be ready to jump right back in. Here are a few tips to help you get more active without getting hurt:

Start slow
● If you’re a runner, think about a walk to run program
● If you’re a weight lifter, start with lighter weights and less reps.
● Whatever your activity of choice is, start with short periods of activity and gradually work your way back up.
Warm up and cool down
Warming up gets your heart and lungs ramped up and prepares your muscles and tendons for the increase in activity about to come. Include some light cardio like jogging, calisthenics, or cycling, followed by active stretching like butt kicks, high knees, or yoga.

Cooling down transitions your body back to a lower state of stress – it brings your heart rate and breathing down, decreases blood flow to your muscles and back to places like your digestive system, and helps you relax. It’s also a great place for static stretches if you need some work on your flexibility.

Take a day off
Rest days let your body recover and keep you from getting burned out. Not enough exercise isn’t good for you, but too much of a good thing can cause problems too.

Watch for early signs of injury
Some soreness for a few days after activity is normal, especially if you’ve had a long break. But there are a few common issues to watch out for as you return to activity:
● Swelling or bruising
● Joint pain, especially in the knees or shoulders
● Foot pain, which could be a sign of plantar fasciitis
● Muscle strains – particularly common in the hamstrings
● Sprains – most common in the ankle

Any of these issues justifies a call to your physical therapist. Getting checked out early can prevent an injury that derails your attempt to return to activity. PTs see all of the issues just mentioned on a regular basis and can help safely guide you back into a more active lifestyle.

In Person or Virtual PT? Maybe Both!

Virtual physical therapy has quickly moved from a niche offering to the mainstream. Having more options is great, but it can also complicate decision making. Having an understanding of the benefits of both can help make clear which one would best help you meet your goals.

In Person Physical Therapy

The main advantage of traditional “brick and mortar” PT is that the therapist is in the room with you. That means they can move around to see how you’re moving from different angles, physically adjust your position or movement as you exercise, and physically examine you – testing your strength, measuring your range of motion, etc. They can also use things like manual therapy, electrical stimulation or ultrasound when you’re in the clinic. In person PT may work best for:

● New patients – the ability to physically examine you makes it easier for your PT to accurately diagnose what’s going on
● Less active patients – if you’re not used to exercising and moving, having someone physically present to coach you along can be a big benefit
● People with complicated or chronic conditions – if your back has been hurting for the last 5 years and you’ve been ignoring it, providing a diagnosis and treating it totally virtually will be difficult for your PT
● Less motivated patients – virtual PT requires you to do most of your exercises by yourself. If you need someone watching over you to make sure you do them, in person PT might work better for you

Virtual PT

The main benefit of virtual PT is convenience. Because virtual PT relies on you doing most of your exercise and treatment on your own, appointments can be shorter. This also means that motivation is a prerequisite to choosing virtual PT. The fact that you don’t have to travel to the clinic makes it easier to squeeze a visit into a busy schedule. Virtual PT works well for:

● Athletes and others with good body awareness – being on your own for your home exercise program requires you to be in tune with your body and how it’s moving
● People with common athletic injuries – things like tendonitis, sprains, strains, plantar fasciitis, and overuse injuries are commonly treated by PTs. Because of that, there is a template for treatment that is easily adapted to individual needs.
● People who are comfortable with technology – you don’t have to be a technology whiz, but having some familiarity with skype, facetime, or zoom helps!
● Existing and returning patients – if your physical therapist knows you, it’s easier to treat you virtually.

Both options have benefits and limitations. One or the other might be right for you and your needs, but they’re not mutually exclusive. Combining the two can work well for many people. Doing an in person visit for your initial evaluation and perhaps a follow up visit or two will let your therapist provide an accurate diagnosis and get you started on your exercise program. Once you’re comfortable with your exercise program, you can transition to virtual visits.

5 Reasons You Need a PT to Coordinate Your Fitness Regimen

Physical therapists aren’t just for people that are injured or have had surgery. Physical therapists can also help healthy people improve their fitness. Here are 5 reasons why you should consider seeing yours.

You Want a Baseline

When you see a physical therapist to improve your fitness, you’ll get an assessment of your strength, range of motion, posture and movement patterns. This not only helps your physical therapist design a customized program just for you, it gives them a baseline to compare things to in the future should you start having pain or suffer an injury.

You Want Expert Guidance

Sure, other professionals could help with your fitness routine, but the fitness industry is not well regulated. Some certifications just require an online course and paying a fee. There are no licenses or other requirements to use many titles. Becoming a physical therapist requires at least a bachelor’s degree and most PTs practicing today have a doctorate. Every PT has passed a national board exam and maintains a state license. That guarantees you that every physical therapist is a verified expert in human movement.

You Want to Prevent Injury

Physical therapists don’t just work to heal injuries, they are also experts in preventing them. After a thorough assessment, a PT can help you design a program that will not only help you reach your fitness goals, but that can address any issues that increase your risk for injury.

You Want Unbiased Advice

Yoga instructors will want you to do yoga. Personal trainers will want you to come to their gym. Pilates instructors will want you to do Pilates. Strength coaches will want you to strength train. A physical therapist doesn’t have a bias or vested interest as to what type of fitness regimen you choose. They are only interested in helping you reach your goals.

You Have a History

If you have some kind of history that affects your ability to exercise, a PT is the best person to help you design a fitness regimen. It doesn’t matter if it’s an old injury from athletics or work, back pain that comes up from time to time, COPD, arthritis or heart disease, a PT can help you safely work around it and meet your fitness goals.

PT Can Prevent Unnecessary Surgery

Recent research is showing that surgery might not be needed as often as we think. A large
review estimates that 10% to 20% of surgeries might be unnecessary and that in some
specialties such as cardiology and orthopedics, that number might be higher. The reasons for so
many unneeded surgeries being performed are varied, but the most common are that more
conservative options aren’t tried first, or lack of knowledge by the operating physician.

Physicians undergo long and rigorous training programs to become surgeons, but if they don’t
work hard to keep learning, their knowledge often stops growing when they leave residency.
Recent research is showing that certain common surgeries aren’t any better than a placebo.
Two such examples are kyphoplasty – a procedure for spinal compression fractures, and partial
meniscectomy – a procedure used to treat tears of the meniscus in the knee. If a surgeon hasn’t
continued to learn, they won’t know that these surgeries often don’t offer any more benefit than
a non-surgical treatment and will continue to perform them.

Every surgery, even “minor” ones carry risks. These include complications from anesthesia,
blood clots after surgery, delayed healing of the incision, infection, and unintended damage to
nerves or other organs near the surgical site. Some of these risks cause discomfort for a period
after surgery and go away, but others can result in permanent disability or even death. For some
patients and conditions, surgery is a great treatment option, but with all the associated risks,
when surgery can be avoided, it should be.

For musculoskeletal problems like back and joint pain, sprains, and strains, seeing your PT
before a surgeon can help keep you out of the operating room and get you back to life without
surgery. Studies have shown that physical therapy is just as good if not better than surgery for a
multitude of conditions and carries less risk. Some examples would include rotator cuff tears,
meniscal tears, spinal stenosis, low back pain, and osteoarthritis.

Physical therapy can’t fix every problem, and for some patients surgery is the best choice.
However, research is showing that surgery isn’t a cure-all, and is sometimes just a very
expensive and risky placebo. In most cases, starting with physical therapy is the right choice,
and for many patients, PT is the only treatment necessary.