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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.

Do You Know Your Movement Vital Signs?

Most people think of heart rate or blood pressure when they think of vital signs. It is common to
use numbers to quantify health and risk of disease. The American Heart Association
encourages people to “know their numbers” referring to blood pressure, blood cholesterol, blood
glucose, and weight. However, research is now showing the importance of moving properly for
health. Let’s take a look at some of the numbers you can use to quantify your movement health:

Walking Speed

Walking speed has been called the “sixth vital sign” in medical literature recently. It is easy to
measure, and takes into account strength, balance, coordination, confidence, cardiovascular
fitness, tolerance to activity, and a whole host of other factors. It has also been shown to be
predictive of future hospitalizations, functional decline, and overall mortality. Normal walking
speed is considered to be 1.2 to 1.4 meters per second.

Push Ups

Push ups are popular to build strength, but a recent study found that they can show us a lot
about your heart too. Researchers found that men who could do 40 or more consecutive push
ups were at a 96% lower risk for cardiovascular disease than were men who could do less than
10. The push up test was also more useful in predicting future cardiovascular disease than
aerobic capacity measured on a treadmill.

Grip Strength

Hand grip strength has been shown to be strongly correlated with health. The stronger your
hand grip is, the less likely you are to suffer from cardiovascular disease, respiratory disease,
COPD, and all types of cancer. In the study, muscle weakness was defined as grip strength <26
kg for men and <16 kg for women. Grip strength below these numbers was highly correlated
with an increase in disease.

Standing From the Floor

If you can’t easily get down on the floor and back up your health might be in trouble, according
to a study that looked at more than 2,000 people. The study asked people to go from standing
to sitting on the floor and back up with as little support as needed. They found that if you need to
use more than one hand to get up and down from the floor that you were 2 to 5 times more
likely to die in the next 7 years than someone who can do it with just one hand, or even better,
no hands at all.

Moving well is obviously important to overall health and longer life. These tests can give a
snapshot of how you’re doing. If you’re having trouble with any of them, considering seeing a
movement specialist – your physical therapist.

Are You A Passive Patient or an Active Consumer of Healthcare?

Think about the last time you made a big purchase, say $1,000 or more. Did you go out and buy
the first thing you saw? Take one recommendation from somebody? Or did you research it,
learn some things, compare it to other options, and select something that was right for you?
Most people tend to be educated and research large purchases like cars, televisions, or the
newest iphone. So why do we so often fail to do this with healthcare?

By becoming more educated healthcare consumers we can go from passive patients who take
the first recommendation that comes from a practitioner to an active consumer who weighs
options and makes choices. Here are some questions to talk through with your practitioner the
next time a healthcare decision comes up.

What are the benefits or expected results?

When a treatment or procedure is recommended, the patient often assumes that it will make
them “better.” But what the patient expects and what the healthcare provider expects are often
two different things. For example, a patient having back surgery expects to be pain free after
surgery. The surgeon probably doesn’t expect that to happen. Outcomes from back surgeries
are terrible. A large study of 1450 patients in the Ohio worker’s comp system showed that after
2 years 26% of patients who had surgery returned to work. Compare that to 67% of patients
who didn’t have surgery. There was also a 41% increase in the use of painkillers in the surgical group.

What are the risks and downsides?

Patients want to hear about the benefits of a treatment, but they often don’t ask or care about
the risks. To be an educated consumer, you need to. If one treatment has a 3% edge over
another, but has a high risk of making you itchy or causing frequent headaches, do you want it?
Going back to the back surgery study from before, the researchers found a 1 in 4 chance of a
repeat surgery and a 1 in 3 chance of a major complication. With surgery you risk infection,
blood clots, complications with anesthesia, and a whole host of other things. These risks need
compared with other treatments. In the case of back pain, physical therapy is a valid alternative
with a much lower risk profile. You might have some soreness with physical therapy, you might
sweat some and be challenged with exercise, but the risks of PT compared to surgery are minimal.

What are the alternatives?

Don’t feel bad asking about alternative treatments. If you were looking at a certain car you
wouldn’t go out and just buy it. You’d at least consider the competitors and probably even test
drive them. You should at least look at the other options in healthcare too. Maybe the first
recommendation that your practitioner makes is the right one for you, but if you don’t consider
the alternatives you’ll never really know.

Why this treatment over the other ones?

This is the question where the rubber meets the road. You’ve learned about all the options, now
you can see if your practitioner is balancing the risks and benefits to make the right choice for
you. Staying with the back pain example, research shows that more than 40% of people who
seek care for back pain will not receive a treatment of known effectiveness. Back pain is also
the #1 reason for opioid prescriptions, despite a 2016 recommendation from the CDC to avoid
prescribing opioids for back pain, and opt for non-drug treatments like physical therapy. By
asking for the rationale and carefully weighing options, you can avoid being one of the people
who gets an ineffective treatment.

What’s it cost?

This last question is becoming more important as patients bear an increasing share of the cost
of healthcare. Even if you don’t have a high deductible plan or hefty co-pays, by being
financially responsible today, you’ll probably see smaller price increases in your premiums down
the road. That back surgery that we’ve been talking about? It’ll likely cost between $60,000 and
$80,000. So if we put the whole picture together, a patient who takes the first recommendation
for surgery will have a $60,000 procedure that leads to a higher risk of disability, and a higher
risk of long term painkiller use, while risking infection, and blood clots. Don’t forget the 25%
chance that you’ll get to do it all again in a repeat surgery. Seems like a bad deal. An educated
consumer would learn that physical therapy is a viable alternative to surgery with comparable
outcomes, much less risk and lower cost. In fact, a large study of 122,723 subjects showed that
people with back pain who got physical therapy in the first 14 days lowered their healthcare
costs by 60%. It’s easy to see why bargain shoppers love PT!

Life is a Movement Journey, Here’s How PT Can Help

Now that spring has arrived, temperatures are starting to rise in many parts of the country. And
that means the transition from heating our homes to cooling our homes is right around the
corner. No matter what method you use to cool your home during the warm spring and summer
months (central air conditioning, window units, or fans and dehumidifiers), each spring you cross
your fingers that your approach still works. If not, you might be calling an expert for a tune-up,
or in extreme circumstances, you might need a complete overhaul.

Just like an AC system that has probably been dormant for many months of the year, a body
that hasn’t been physically engaged on a regular basis may have trouble getting started again.
And yet, this time of year, the warm temps draw many people to city and suburban streets,
tracks and trails, ready to take that first run of the season. A good percentage of these spring
runners haven’t kept up their strides throughout the winter. It should come as no surprise that a
4-mile run for a previously inactive person is going to stir up a few aches and pains.

Especially as we age, our ability to move undergoes changes. But whether we’re talking about a
college student or a retiree, returning to an activity without proper planning is a recipe for
disaster. That’s where physical therapy comes in. Physical therapists are trained to treat injuries
and ease pain, but they can also help their patients prevent injuries and safely prepare to
participate in new activities.

Think of physical therapists as “movement consultants” who can ensure that your body is
physically ready to tackle a new challenge—or resume a favorite leisure activity. Here’s another
example to illustrate what we’re talking about: Let’s say that you play in an adult soccer league
and you’re preparing to play in your first game of the season in a few weeks. You probably hung
up your cleats when the last season ended months ago, but expect to pick up just where you left
off. But it’s simply too much to ask for your 2019 debut on the field to be on the same level as
the last game of the previous season, when you likely had reached peak performance.

This is a good time for your PT to step in and help you shake off the rust. The rehab professional
can customize an exercise plan to help you slowly return to sport and avoid an injury that could
sideline you for the whole season. Or like cleaning the filters before firing up your air
conditioner for the first time this year, the rehab expert can help to ensure that your body is
prepared to return to its former activity level following a hiatus.

80% of Americans Experience Back Pain, But 100% of PTs Know How to Prevent It

Got back pain? You’re not alone. Eighty percent of Americans suffer from low back and neck pain at some point in their lives. Let that sink in. With such great odds that you—or someone close to you—will one day become a statistic, wouldn’t it make sense to arm yourself with preventive strategies and knowledge? Physical therapy is a good place to start.
By performing a thorough evaluation, a physical therapist can identify the muscular, postural and skeletal limitations that could one day lead to an episode of back pain. As part of the assessment, she will observe as you perform a series of exercises and then gather an account of your daily activity level and environmental factors like operating machinery or working at a desk 40 hours a week.
The PT will then use all of this knowledge to design a personalized exercise program and teach you a few APT-approved strategies to prevent back pain:
Use good body positioning at work, home and during recreational activities.
Keep the load close to your body during lifting.
Ask for help before lifting heavy objects.
Maintain a regular physical fitness regimen— staying active can help to prevent injuries.

Lifestyle can play a big role in back pain. In fact, inactivity and incorrect body mechanics while participating in certain activities are two of the biggest contributors to back pain. In addition to the strategies listed above, it’s also helpful to pay attention to little things throughout your day. That could add up to bigger problems down the line. Let’s go back to that desk job for a minute: How often do you get up to walk, stretch and move throughout the day? A good rule of thumb is to stand up or move every 30 minutes. You may get bonus points with your boss, too, as your productivity soars due to the increased activity.
While low back pain rarely becomes serious or life-threatening, it can be quite painful and interfere with our daily lives. Working with a physical therapist can help patients identify the factors that might contribute to back pain and help to develop a prevention plan. But the healthcare professionals are also a great place to turn when you’re seeking treatment for back pain or hoping to prevent a recurrence.
With such good odds that you could one day become a low back pain statistic, why not do everything in your power today to change your trajectory? Seems like another good reason to find an activity (or better yet, two or three activities) that you enjoy, make it a regular part of your day and stick to it!

Patients Reap the Benefits of Playing a More Active Role in Physical Therapy

Patients can no longer be passive players in the game of health. Studies show that informed patients are not only more engaged during physical therapy but also reap the benefits in overall health and well-being.

Those who understand why they’ve been referred to physical therapy, are actively engaged in the process, and develop useful self-management skills are more likely to achieve lasting results. With a few pointers, building one’s health literacy doesn’t have to be an overwhelming prospect.

To get the most out of your rehabilitation, it’s important to keep an open line of communication with your physical therapist. Your physical therapist is a wealth of knowledge and is there to help you regain mobility and relieve pain. The interaction should be positive, informative, and collaborative. Here are a few questions to ask your physical therapist so you may understand the rehab approach and how it impacts your injury or illness:
 Why have I lost function/why do I hurt?
Your physical therapist has been trained to determine why a particular injury causes a loss of mobility or interferes with your ability to complete a task. It’s helpful for patients to gather information and understand the body’s mechanics as it relates to an individual injury.
 Did my lifestyle contribute to this issue?
Your physical therapist will gather information about your lifestyle in order to identify habits that might be contributing to the problem. Perhaps the patient needs to wear shoes with support and limit time in flip flops. Or maybe the patient is experiencing low back pain due to poor posture at work.
 How will physical therapy help me?
Physical therapists work with patients to devise an individualized and concrete care plan. You should feel comfortable asking your physical therapist why a specific goal has been chosen, how it will help you, and what you personally need to do to succeed.
 What can I do to make sure I get better?
Showing up for appointments is only half the battle. Being ready to participate and understanding what you should be doing in between appointments is critical. You should be prepared to carry over goals at home and make modifications to habits at home and work to change contributing behavior.

It’s important that you feel comfortable asking your physical therapist questions and continue to understand how you can contribute to your care plan. Advocating for your own care and maximizing educational opportunities will give you the confidence and tools to succeed in physical therapy and beyond.

Yearly Physical Therapy Visits are Just as Important as Annual Cholesterol Tests

You know the drill: During your annual visit, your primary care physician will order a cholesterol test. Combined with an assessment of health measures such as diet and exercise, the results of the cholesterol test will provide your physician with the information she needs to make a recommendation. If the results are positive, you might hear: “You’re doing great, keep doing what you’ve been doing!” If the results are unfavorable, then you’re more likely to be told: “I’d like you to walk for 20 additional minutes each day and eat cholesterol-lowering foods like oatmeal.”

Over time, high cholesterol can cause fatty deposits to form in your arteries, putting you in a high-risk category for heart disease and stroke. Similarly, the cumulative effects of poor posture or a muscular imbalance, for example, can take a toll on your body and inhibit your ability to move properly. That’s where a physical therapist comes in: Annual PT “checkups” can catch the musculoskeletal problems that put you at risk for injury or limit your ability to function down the
line.

One of the best tools in a PT’s prevention arsenal is the movement screen. By analyzing your fundamental movements with a movement screen developed for their own practice or one that requires certification such as the Functional Movement Screen (FMS™), PTs can get a clear picture of what the future will bring for you. Based on the information gathered, a physical therapist can help you safely reach your fitness goals and teach preventive strategies that can be
incorporated into your daily life.

Of course, it’s best to schedule your checkup before you’re experiencing a problem. That way, your physical therapist can establish a baseline based on your functional level at that time and use it to identify changes during subsequent annual visits. The effects of poor posture or a muscular imbalance may not be immediately apparent to you, but they will be to your PT.

An annual “checkup” gives your PT an inside look at your musculoskeletal system, which is comprised of your muscles, bones, cartilage, tendons, ligaments, joints and other connective tissues. It’s important that these essential internal structures are working together to support, stabilize and move your body.

Just as taking an annual trek to the primary care physician helps to monitor your cholesterol levels—and prevent heart disease—yearly physical therapy appointments allow your PT to identify and address any changes in the way you move before they become something more.

Call today to set up your appointment with one of the best physical therapists in town!