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When’s the right time to see a PT?

July 16, 2019 By Gregory Synnestvedt PT, DPT Leave a Comment

Time to see a Physical Therapist, PT?
By Dr. Greg Synnestvedt PT DPT

Have you ever had physical therapy? Some people picture typical physical therapy as the rehabilitative process that a person goes through after joint replacement surgery. While this is one important time to participate in therapy, most people in a physical therapy clinic are coming for very common pains. The most common areas people seek PT for are 1) low back pain 2) shoulder pain and 3) knee pain. There are also people who are not in any pain at all (lucky them!) but want to improve their balance, walking, mobility, or ability to do daily tasks.

When is the right time to see a physical therapist? If you are trying other treatments for an ache or pain, it is worth seeing a physical therapist to get their opinion before going to other specialists. A recent study found that seeing a physical therapist first for low back pain reduced the overall healthcare costs and also reduced the chances of opioid prescription down the road. Whoever you see first in the healthcare system has a large impact on your path through the system—this is not the way it should be, but this is how it is. You can see a physical therapist with a direct access license for 30 days before requiring a referral from your physician, and this could give you enough time to see that you will be okay without an injection, procedure, or expensive MRI right off the bat. If your physical therapist thinks that your situation requires your physician’s attention, they will refer you to the physician for consultation.

A similar study to the one mentioned above found that early physical therapy for people with neck pain reduced the rate of imaging, opioid prescriptions, and overall costs. Early was defined as people who saw a physical therapist within 3 months. If you have an issue for more than a few weeks that isn’t getting better, it could be useful to consider trying PT.
As patients, we usually seek the “silver bullet” treatment, though this rarely exists. Ture healing and improving are nearly always processes involving time and effort. Take, for example, knee pain from arthritis, which is a very common problem. The clinical practice guidelines put out by the Academy of Orthopedic Surgeons recommends physical therapy as a primary treatment for knee arthritis, with strong evidence. Despite this recommendation, non-recommended treatments such as hyaluronic acid injections, corticosteroid injections, and opioids remain among the most commonly utilized treatments for patients in the year leading up to joint replacement (Bedard et al., 2017). This study estimated a 45% healthcare savings if only the recommended treatments were used. This is not to say that injection is never useful, but that it is worth trying physical therapy.
As a patient, you are your best advocate. If you have a joint or muscle pain or difficulty moving, ask your doctor for a referral to physical therapy and see what PT can do for you.

Bedard, Nicholas A., et al. “The AAHKS Clinical Research Award: what are the costs of knee osteoarthritis in the year prior to total knee arthroplasty?.” The Journal of arthroplasty32.9 (2017): S8-S10.
1: Frogner BK, Harwood K, Andrilla CHA, Schwartz M, Pines JM. Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Health Serv Res. 2018 Dec;53(6):4629-4646. DOI: 10.1111/1475-6773.12984.
Epub 2018 May 23. PubMed PMID: 29790166; PubMed Central PMCID: PMC6232429.

Horn, Maggie E., and Julie M. Fritz. “Timing of physical therapy consultation on 1-year healthcare utilization and costs in patients seeking care for neck pain: a retrospective cohort.” BMC health services research 18.1 (2018): 887.
Study: Seeing a PT First for LBP Lowers Overall Costs, Reduces Chances of Later Opioid Prescription

https://www.apta.org/PTinMotion/News/2018/05/24/PTFirstForLBP/

Study: Early Physical Therapy for Neck Pain Associated With Lower Imaging Rates, Opioid Prescriptions, and Overall Cost
https://www.apta.org/PTinMotion/News/2018/12/04/EarlyPTNeckPain/

Hips Don’t Lie About Causing Knee Pain

November 6, 2017 By Kelsey Krebs Hanlon, PT, DPT Leave a Comment

When you come to Physical Therapy for knee pain, you may be surprised that your therapist spends just as much time evaluating your hips. This can be confusing for many patients, as they wonder why their therapist is so focused on strengthening their hip muscles when they do not have any hip pain.

If your car has one tire that keeps becoming worn, it does not help much to continue changing that tire if you do not address the underlying imbalance/alignment issue in your car. This is also true for your body: altered biomechanics in one are can often lead to the manifestation of pain in a completely different body part. Only focusing on the painful site can lead to reinjury or future injury in other areas.

The hip muscles, particularly the hip extensors and abductors (the ones that let you lift your leg out to the side and out behind you), are essential for maintaining good alignment at the knee joint. Weakness in these muscles can cause abnormal stress on the knees and lead to pain. Often times strengthening these muscle groups are as important if not more important than actually strengthening the muscles of the knee.

A basic way to begin to strengthen these muscles is to stand at a counter and kick your leg straight out to the side, making sure to keep your toes pointed straight forward and to keep your pelvis and trunk still. You should feel the muscle on the side of your leg working after multiple repetitions, and you may even feel the muscles on the side of the led that you are standing on working as well. After that activity you can kick your leg straight backward, making sure to avoid rotating your pelvis. You should feel the muscles in your buttocks working after multiple repetitions.

Start with 2 sets of repetitions, 1-2X daily and work your way up from there.

As always, if you are having knee pain that interferes with your function, talk with your doctor about making an appointment with a physical therapist who can evaluate and identify which areas of your body may be causing the pain.

Contact WWSPT to schedule a Physical Therapy evaluation.

Vestibular Therapy:

I was very pleased with the Vestibular Therapy that I received. I went from being dizzy to moving with ease in two visits. The entire staff At Wendy Webb Shoenewald Physical Therapy was very helpful and kind. Thank you!

CS.

BPPV:

Wendy,

I needed to come in for rehab for BPPV for the second time in as many years. It is a pretty disconcerting thing to have to deal with but I have had great care both times. Most recently with Jenna who, in addition to being quite knowledgeable in understanding the nuances of this condition and the treatment of it, had excellent “bedside manner” in keeping me calm and informed about what she was doing with each procedure. I had to come in three times dealing with this episode and feel very relieved and confident moving forward with my life.

Thanks so much.
MS

PT Treatment:

When I came to WWSPT I had difficulty walking, balance problems, a great deal of pain and very little hope. I was told I could be helped. Wendy had a plan, some things made no sense to me and were painful. Wendy encouraged me to work through the discomfort and soon I was doing better. Everyone in this practice is so pleasant and helpful providing a positive atmosphere for all their patients! I would recommend this practice to others.

D.L

PT Treatment:

Specific, tailored physical therapy is a key intervention to slow the progress of Parkinson’s Disease. Kelsey and Hannah are very experienced in this area and have been wonderful to work with. In particular, Hannah’s group PD classes are motivating and full of camaraderie.

JH.

PT Treatment:

All of the staff including the office are very knowledgeable and friendly. I would highly recommend Wendy Webb Schoenewald Physical Therapy. Kelsey was always on time to see me and willing to accommodate my time needs-even on a short notice. I cannot praise this dynamic team and their entire practice enough.

Best Regards,
NM

Parkinson’s Disease:

I want to write today to tell what a positive experience I had at WWS PT. The staff is very supportive, friendly and knowledgeable. The staff answering the phone gave all the necessary information needed and had other staff members answer other questions as well. Kelsey, the PT therapist, was excellent and supportive. She made things challenging but fun and provided information as requested by me. Other staff members (Hannah and Anne) were available to assist me and give me more information for continue support. WWS PT is a great group to work with. Thank you for all your help.

Knee Injury & Joint Rehab:

Words cannot adequately express my gratitude and appreciation for helping me walk pain free and regain the range of motion in my knee. Four years after knee replacement surgery I began experiencing pain in the knee joint and soon discovered I had lost 20+ degrees in my range of motion. The structural integrity of the knee was confirmed and PT was offered but there was not much hope for improvement. Wendy immediately assessed what she felt caused the pain and issues with my range of motion. Over successive weeks new and more intense exercises were introduced. The information she relayed regarding how muscles in one area affect other joints was extremely crucial to understanding my problem and ensuring a positive recovery. Self-awareness is critical to success. The entire staff is helpful, friendly and professional. To say that Wendy is an exceptional physical therapist is only part of the picture. She goes above and beyond the norm, helping make mobility a reality by imparting to her clients both the tools and the confidence to achieve their goal.

Thanks for the mobility,
P B-D

Sports Injury & PT Treatment:

WWSPT has the best possible environment for recovery. This staff is full of the most positive and encouraging people I have ever met. They are the reason that I was able to get back on the soccer field as quickly as I did. It was the most beneficial experience I could have had thanks to Kelsey challenging me each day. I have so much respect for the staff at WWSPT and would recommend them in a heart beat.

PT Treatment:

Ralph was extremely pleased with the rehab treatment at WWSPT. Anne was so good at explaining everything to us. She was also patient and kind. I feel that Ralph has made progress and is more confident now. (He also liked the PT who worked with him when Anne was on vacation.) It has been a positive experience for us!

Thank you so much.
RL

Orthopedic Treatment:<

Kelsey did a great job helping me recover from lower back surgery (laminectomy). All of the exercises that she recommended were very effective. She was especially good at loosening up my lower back when I started therapy.

I have been to other facilities in the past and would recommend this one first.

PT Treatment:

The atmosphere at WWSPT is joyful and encouraging. Kelsey was my therapist — she is professional but also personable. I have and will continue to recommend WWS Physical Therapy & Vestibular Rehabilitation to anyone who needs therapy.

Vestibular Rehabilitation:

Viviann, my therapist at WWSPT, helped me make it through an incredible journey. After a serious head injury, with Viviann’s guidance as well as my relentless practicing at home, I was able to achieve my treatment goals. My progress happened one day and one exercise at a time. It is now 17 months after the accident and I am doing great! The facility, the staff, and the encouragement were first rate!

Many thanks!
B

Vestibular Rehabilitation:

I made amazing progress with my treatment in a short period of time.

Thank you Palak!
GG.

Orthopedic Treatment:

I am happy to write about my experiences at WWSPT, because I’ve seen a great deal of improvement. In the decades since my injury, I have been to many physical therapy centers but never had such significant and measurable improvement. Wendy and Viviann addressed my injury rehabilitation needs with specific targeted exercises and tools and gave me lots of individual attention.

Thank You!
JM

PT Treatment:

I have been treated at WWSPT on two separate occasions for periods of up to 8 weeks. On both occasions, physical therapy was required to treat a relatively rare disease-related condition.

The staff is great at WWSPT. Each person that takes your call or greets you upon arrival is warm and friendly and makes you feel comfortable and ‘at home’. Appointments are made easily and care is taken to accommodate the patient’s schedule as much as possible.

I have been fortunate to work with Anne Haneman, PT, both during my prior treatment as well as my current PT. Anne is a very smart, very knowledgeable, and very kind person. She continually does a great deal of research to learn more about my condition and find ways to provide me with effective treatment options to do both at their facility and to practice at home. She is great to work with which takes the stress out of the entire process. I love that she is genuinely happy to see my progress. She loves what she does and it shows.

Thank you.
M L
Buckingham, PA

Orthopedic Rehabilitation:

In 2013, I was in physical therapy with Viviann for 5 months, 3 times a week, and she was just fabulous. Tendons above my knee had ruptured; I was in a cast for 2 months. Once the cast came off, it turns out your knee no longer bends AT ALL. And Viviann’s task was to bend my knee a little bit at a time. She would bend it until it hurt, and then briefly push it just a bit further. She had a lot of experience with this, and I very much trusted her. She also was warm and had a sense of humor, and I really felt I lucked out with such a kind and knowledgeable therapist. We of course also had other exercises. And the whole place was nice – the day my knee finally bent enough to go all the way in a circle on the stationary bike, the room cheered.

Smiles,
CD

Orthopedic Rehabilitation:

Although my trials regarding my numerous surgical procedures MAY seem extreme to the point of being laughable, I have faced each of them with the confidence that in my wellness toolbox, I have one of the best rehabilitation practices in our area, to rely on to see the job through to a terrific result.

I have had the chance to work with nearly every member on staff, for detached biceps, rotator cuff repair(s), Labrum repair, total left hip replacement, and total left knee replacement, and most recently, a shoulder procedure to stabilize the right shoulder capsule.

In each case I have remained encouraged that because of the talent present, the procedure has been understood, the plan for rehabilitation was based on a calculated approach, and the emphasis on home exercise to compliment that which was done at WWS, all worked together to restore me, to which I could never possibly fully express my gratitude.

T H

Positional Vertigo Treatment:

I never realized how Positional Vertigo impacted my daily life until it was gone! Yes gone! For Almost 9 years I adjusted many daily activities to avoid the sensation. My ENT referred me to WWS Vestibular Rehabilitation. After a few painless head maneuvers I feel much clearer, sleep through the night, and look forward to starting a yoga class.

Thank You! Thank You!
KZ
Doylestown, PA

Concussion Treatment:

The team at WWS Physical Therapy, in particular Kelsey and Vivian, were fantastic. They treated both my 9 year old daughter for a severe concussion as well as myself for lower back and leg pain. Everyone was courteous, professional and extremely knowledgeable. We appreciate their attention to our individual needs through our PT programs and definitely recommend them to others who are in need of physical therapy.

Thank you,
KG

Orthopedic Rehabilitation:

I have enjoyed a long term relationship with Wendy Schoenewald and her team of professional physical therapists. WWSPT treatment center is a calm environment of recovery and healing … allowing patients to return to health, function and one’s best life.

I refer to Wendy as my HDPT (Humpty-Dumpty) because she has done the impossible and “put me back together” after several orthopedic mishaps. Most recently, WWS has developed a challenging gym rehab program to strengthen the torn meniscus in both my knees in an effort to delay or prevent knee replacement surgery. Hannah and Jamie have worked tirelessly with me and produced excellent results – – I am very optimistic! WWSPT is clearly the best Physical Therapy practice in the region.

Thank You!
L.H

Orthopedic Rehabilitation:

Excellent results in reducing shoulder pain and increasing range of motion.

WL.

Orthopedic Rehabilitation:

I have been to WWSPT on 3 occasions. Twice after injuries and once after surgery. Treatment has always been excellent and in a very friendly atmosphere.

Thank you,
C.A.
1/15/2015

Vestibular, Balance and Healthy Aging:

I learned a lot and got a lot better. It exceeded my expectations. I even looked forward to going so early. Standing O for Wendy and Palak!

Thanks!
JB

Orthopedic Rehabilitation:

The entire staff at WWSPT is friendly, helpful and professional. Palak Mulji is an exceptional therapist whom I would highly recommend.

Thank you.
MT

Orthopedic Rehabilitation:

We had a very positive experience at WWSPT.
Joanne was very thorough, knowledgeable, experienced and supportive. She and Nick (my 11 year old) worked very well together.

Thank you!
CA.

Orthopedic Rehabilitation:

I worked with several therapists at WWSPT and they were all interested, helpful and accommodating.

Thanks.
LS

We strive to provide an environment of recovery and healing for our clients, to allow them to advance their health and return to function, recreation or sports. It is our belief that Physical Therapy is the initial link in the healthcare system for Musculoskeletal and Balance related issues and we are the true experts on exercise. We look forward to a long term relationship with our patients and their families over their life span and hope to become their practitioner of choice for acute musculoskeletal issues, neuromuscular issues as well as reoccurring events limiting their Wellness. We want to be a part of our patients Healthy living and Healthy aging.

When’s the right time to see a PT?

Hips Don’t Lie About Causing Knee Pain

Our Mission at WWSPT

WWSPT Mission 2.0

Contact WWS Physical Therapy

Ask About WWSPT Professional Associations

Our Mission at WWSPT

WWSPT Mission 2.0

Connect With WWSPT:

Contact WWS Physical Therapy

Ask About WWSPT Professional Associations