Preparing for Your Visit With a Physical Therapist

Preparing for Your Visit With a Physical Therapist

Physical therapists are highly educated, licensed health care professionals who help patients improve or restore mobility, and in many cases helping patients reduce pain, and avoid the need for surgery and the long-term use of prescription medications and their side effects.

Physical therapists examine, evaluate, and treat patients whose conditions limit their ability to move and function in daily life. Your physical therapist’s overall goal is to maintain, restore, or improve your mobility and help reduce your pain.

In most states, you can make an appointment with a physical therapist without a physician referral. Whether this is your first visit or you’ve been treated by a physical therapist in the past, there are things you can do to make your visit as successful as possible.

Before Your Visit:

Make a list of any questions that you might have, so that you can make the best use of your time with your physical therapist.

Write down any symptoms you’ve been having and for how long. If you have more than one symptom, begin with the one that is the most bothersome to you.

Make specific notes about your symptoms. For example, is your pain or other symptom:

  • Better or worse with certain activities or movements or with certain positions, such as sitting or standing?
  • More noticeable at certain times of day?
  • Relieved or made worse by resting?

Write down key information about your medical history, even if it seems unrelated to the condition for which you are seeing the physical therapist.

Make a list of all prescription and over-the-counter medications, vitamins, and supplements that you are taking.

Make a note of any important personal information, including recent stressful events in your life.

Write down and describe any injuries, incidents, or environmental factors that you believe might have contributed to your condition.

Make a list of any medical conditions of your parents or siblings.

Consider taking a family member or trusted friend along to help you remember details from your own health history and to take notes about what is discussed during your visit.

Make sure you can see and hear as well as possible. If you wear glasses, take them with you. If you use a hearing aid, make certain that it is working well, and wear it. Tell your physical therapist and clinic staff if you have a hard time seeing or hearing. For example, you may want to say, “I have difficulty hearing. It’s helpful to me when you speak slowly.”

If available, bring any lab or diagnostic reports from other health care professionals who have treated you for your current condition.

Bring a list of the names of your physician and other health care professionals that you would like your physical therapist to contact regarding your evaluation and your progress.

When you call to make your appointment, ask whether you should wear or bring a certain type of clothingwhen you come for your first visit. You may want to avoid tight or formal clothes, in case the therapist wants you to engage in activities during the first session.

What to Expect During Your First Visit:

Your physical therapist will begin by asking you lots of questions about your health and about the specific condition you want the physical therapist to treat. Detailed information about you and your condition will help the physical therapist determine whether you are likely to benefit from physical therapy and which treatments are most likely to help you.

Your physical therapist will perform a detailed examination. Depending on your symptoms and condition, the physical therapist might evaluate your strength, flexibility, balance, coordination, posture, and heart and respiration rates. Your physical therapist might use his or her hands to examine or “palpate” the affected area or to perform a detailed examination of the mobility of your joints, muscles, and other tissues.

Your physical therapist also might evaluate:

  • How you walk (“gait)
  • How you get up from a lying position or get in and out of a chair (“functional activities”)
  • How you use your body for certain activities, such as bending and lifting (“body mechanics”).

Your physical therapist might ask you specific questions about your home or work environment, your health habits and activity level, and your leisure and recreational interests so that the therapist can help you become as active and independent as possible.

Your physical therapist will work with you to determine your goals for physical therapy and will begin to develop a plan for your treatment. In many cases, the physical therapist will make a diagnosis and begin treatment almost immediately.

One of the main goals of treatment is almost always to improve your ability to do your daily tasks and activities. To reach this goal, the physical therapist may need to focus on pain, swelling, weakness, or limited motion. Your physical therapist will constantly assess your response to each treatment and will make adjustments as needed.

In most cases, an important aspect of your physical therapy treatment will be education. Your physical therapist might teach you special exercises to do at home. You might learn new and different ways to perform your activities at work and home. These new techniques can help minimize pain, lessen strain, avoid re-injury, and speed your recovery.

Your physical therapist will evaluate your need for special equipment, such as special footwear, splints, or crutches. If the evaluation indicates that you are at risk for falling, your physical therapist might recommend simple equipment to help make your home a safer place for you. The therapist will know what equipment you need and can either get it for you or tell you where you can find it. If you do need special equipment, your physical therapist can show you how to use it properly.

Your physical therapist will communicate the important information from your examination to your physician and to other health care professionals at your request.

Your physical therapist will continually recheck your progress and work with you to plan for your discharge from physical therapy when you are ready. Make sure you talk with your physical therapist about what you should do after discharge if you have questions or if your symptoms or condition should worsen.

One of the top injuries in the workforce – Slips, Trips, and Falls

One of the top injuries in the workforce – Slips, Trips, and Falls

As the physical therapist at Spectrum Physical Therapy and in industrial settings, my staff and I treat patients for a variety of aches and pains—including injuries resulting from slips, trips, and falls. They happen at work. They happen at home. Regardless of where they occur, they’re preventable.

How do falls happen? Sixty-five percent of falls occur when a person slips or trips while on a single “level,” such as a sidewalk, according to U.S. Bureau of Labor Statistics. The remaining 35 percent are falls from height. To understand what contributes to slips, trips, and falls so we can better avoid them and the injuries that often follow, it helps to understand what causes a slip or trip.

Slips: Where there is too little friction or traction between footwear and a walking surface, people slip. Sounds simple enough, yet there are many common causes:

  • Wet or oily surfaces
  • Shoes with a small sole surface, high heels, or leather bottoms instead of rubber bottoms
  • Ice, snow, or rain
  • Loose, unanchored rugs or mats
  • Flooring or other walking surfaces that don’t have the same traction in all areas

 

Trips: When your foot hits something, you may lose your balance and possibly fall. Common causes are:

  • Blocked view
  • Poor lighting
  • Clutter
  • Wrinkled carpet
  • Uncovered cables
  • Bottom drawers left open
  • Uneven steps, thresholds, or walking surfaces

So, what’s the best way to prevent falls due to slips and trips? Good housekeeping, quality walking surfaces, proper footwear, appropriate walking pace, and awareness of one’s surroundings are important steps to prevent falls.

Let’s get into some detail.

Housekeeping

Good housekeeping is the first and the most important activity that helps prevent falls due to slips and trips. Good housekeeping includes:

  • Cleaning spills immediately
  • Marking spills and wet areas
  • Mopping or sweeping debris from floors
  • Removing obstacles from walkways and always keeping them free of clutter
  • Securing (tacking, taping, etc.) mats, rugs, wires, and carpets that do not lay flat
  • Always closing file cabinets or storage drawers
  • Covering cables that cross walkways
  • Keeping working areas and walkways well lit
  • Replacing used light bulbs and faulty switches

Without good housekeeping practices, any other preventive measures such as sophisticated flooring, specialty footwear, or training on techniques will never be effective. Learn more about good housekeeping practices.

Flooring

Changing or modifying walking surfaces is the next step to preventing slips and trips. Recoating or replacing floors; installing mats, pressure-sensitive abrasive strips, or abrasive-filled paint-on coating; and metal or synthetic decking can improve safety and reduce risk. It’s important to remember that high-tech flooring requires good housekeeping as much as any other flooring.

Footwear

In workspaces where floors may be oily or wet or where workers spend considerable time outdoors, prevention of fall accidents should focus on proper footwear. Since there’s no footwear with the right anti-slip properties for every condition, consulting a manufacturers’ guidance is recommended. When there’s snow or ice, for example, wear wide-based rubber-soled shoes—not high heels or leather-bottomed shoes, which are slippery and have little surface to provide traction. Properly-fitted footwear increases comfort and helps prevent feet from getting tired, which, in turn, improves safety.

Tactics

What if you need to cross a wet floor? What can you do to reduce the risk of slipping?

  • Take your time and pay attention to where you’re going.
  • Walk slowly.
  • Adjust your stride to a length and pace that’s suitable for the walking surface—that means taking smaller steps when the surface is slippery.
  • Walk with your feet pointed slightly outward—or, as some people say, “Walk like a duck!”
  • Make wide turns at corners.

What if there are obstacles in your way, or you simply can’t see your path very well?

  • Make sure lights are turned on.
  • Use a flashlight if you enter a dark room where there is no light.
  • Ensure that whatever you’re carrying or pushing does not prevent you from seeing obstructions, spills, etc.

There are many factors that increase your chances of falling. Fortunately, however, there are also many factors that can help you reduce that risk—if you pay attention and keep your head in the game. Think about the information in this article as you go about your normal activity around the Lab and print out this handy “Preventing Slips, Trip, and Falls” 1-Minute Safety Topic from the Safety Resources intranet.

Whether you’re navigating a stairwell or walking outside in snow or rain, by taking proper care you’ll reduce your risk for slips and trips, which will reduce your risk of a fall—and reduce your risk of injury. (Which may reduce the number of people who come to me for physical therapy, which is a good thing.)

Be safe and look out for each other’s safety, too.

Dr. Gary Welch, PT, CFCE, CFMT, CKTP, COMT

When swimmer’s shoulder grabs hold, local physical therapist keeps summer swimmers above water

When swimmer’s shoulder grabs hold, local physical therapist keeps summer swimmers above water
Child swimming in a pool

Child swimming in a pool.


Patchogue, NY (June 27, 2013) – With warmer summer days, approximately 80 percent of Americans will take to water-related activities with an expected 200,000 swimming-related injuries requiring medical attention. The most common swimming-related injury is swimmer’s shoulder.

“Among Olympic swimmers and recreational swimmers alike, the most common injury keeping swimmers out of the wahttpter is rotator cuff tendonitis, more frequently known as swimmer’s shoulder,” said Gary Welch, a physical therapist and owner of Spectrum Physical Therapy in Patchogue, and a member of the Private Practice Section of the American Physical Therapy Association. “In most instances, swimmer’s shoulder is preventable by strengthening muscle groups surrounding a weakened rotator cuff.”

Welch offers the following strengthening and stabilizing exercises to prevent or minimize the effects of swimmer’s shoulder:

1) External Rotation with Elastic Band – attach one end of an elastic band to a wall or door; pull the other end of the band away from the stomach with elbow bent at a 90-degree angle; right arm pulls rightward away from the stomach; left arm pulls leftward away from the stomach

2) Prone Horizontal Abduction – lay body face down on a bench or firm bed; with one arm draped downward to the side; lift straightened arm out to the side until the arm is parallel to the ground

3) Elbow Push-Ups – body in plank position – similar to conventional push-ups – except with toes, palms and elbows on the floor using only the shoulders to lower and push up

4) Rowing – sit on the floor with knees bent at 90-degrees; place elastic band on the underside of flexed feet; sitting with the torso tall and straight, pull the elbows back, stretching the band and squeezing the shoulder blades

5) Y-T-W on an Exercise Ball – lay facedown with chest on the exercise ball and body in plank position; outstretch arms in Y position; change to T position; pull elbows to sides to make W position.
Repeat these exercises 15-20 times or as tolerated. If you have a rotator cuff injury already, I recommend that you see your orthopedic or contact us for an appropriate evaluation, assessment, and treatment protocol.
You can contact us at (631) 456-5512

A 2012 study commissioned by the Center for Health Exercise and Sports Medicine in Melbourne, Australia found that 38 percent of participants reported significant pain causing modification or cessation of their training. The study observed 74 competitive swimmers ranging in age from 11 to 27, and performing a minimum of five swim practices per week, with 23 percent reporting significant pain lasting for two or more weeks.

About The Private Practice Section of the American Physical Therapy Association
Founded in 1956, the Private Practice Section of the American Physical Therapy Association champions the success of physical therapist-owned businesses. Our members are leaders and innovators in the health care system. The American Physical Therapy Association (APTA) represents more than 85,000 physical therapists, physical therapist assistants and students of physical therapy nationwide. For more information, please visit www.ppsapta.org.