For those of you who have been to physical therapy...

[CJ2008]

Can you tell me what you thought made a really good physical therapist experience versus an average or so-so one?

Also, did you always see the same therapist?
Did the therapist work with just you during the scheduled time, or did they have other clients too?

Not sure what is common / to be expected so trying to get some different experiences.

 

[Karl_K]

It has always been one on one during the scheduled appointment. Always the same.
Some stand over you while your doing the exercises some stand off and watch.
It depends on the therapist.
Different treatments will require hands on of course.
I can say that I haven't had a bad one.

What separates a good one from a so-so one?
Good one, caring, compassionate but drives you a bit.
so-so/bad, acts like they are just putting in time and could care less.
I haven't had a bad one but have seen them in action.

 

[Austina]

I always made my appointments with the same person on a one to one basis, then she could track my progress. I don't know if I was just lucky, but I liked her the minute I met her (she was recommended by a friend).

For me being comfortable with her was important, as you are often in a state of undress (depending on the area they're working on), so the surroundings were important too.

If you can get a recommendation from someone who has already used their services, then I would say that's the way to go.

If you have a session and you really don't gel with the person, find someone else. Good luck.

 

[Karl_K]

If they are not a bit pushy/driving that is not a good thing and some people do not like being pushed/driven.

 

[PierreBear]

HI CJ! This is a tricky question for me as I'm a bit skeptical of some treatments and am still trying to figure out who is the best person/treatment when I do have an injury. I always want to treat the problem and not the symptom of the problem. I have been to a few physical therapist and this is just my opinion. They have a good understanding of body parts and giving you the right exercises to strengthen the weakened part in your body. However, once you know what to practice at home, I always felt like I didn't need to continue going to the sessions. unless you need someone to push you to do it. It's a bit like going to the gym to do your own workouts or hiring a personal training to make sure you do it.

They should work one on one with you. From what I've seen they can work in various facilities from hospitals, sport clinics, and even home health care. When I was going through an IT band injury, I've been to two physical therapists. It was general the same structure where they first use deep tissue pressure points/massage etc to try and remove the scar tissue that was built up. Then they gave me exercises to strengthen my glutes. It was weak glutes that was the culprit and since I started to do those workouts, I haven't had the issue. However, if I had just gotten a deep tissue massage as a form of treatment, well it would just be more of addressing the symptom and would have had to pay a recurring fee. Hope that makes sense and good luck with physical therapy!

 

[CJ2008]

It has always been one on one during the scheduled appointment. Always the same.
Some stand over you while your doing the exercises some stand off and watch.
It depends on the therapist.
Different treatments will require hands on of course.
I can say that I haven't had a bad one.

What separates a good one from a so-so one?
Good one, caring, compassionate but drives you a bit.
so-so/bad, acts like they are just putting in time and could care less.
I haven't had a bad one but have seen them in action.

Thanks Karl. I really appreciate it.

 

[CJ2008]

I always made my appointments with the same person on a one to one basis, then she could track my progress. I don't know if I was just lucky, but I liked her the minute I met her (she was recommended by a friend).

For me being comfortable with her was important, as you are often in a state of undress (depending on the area they're working on), so the surroundings were important too.

If you can get a recommendation from someone who has already used their services, then I would say that's the way to go.

If you have a session and you really don't gel with the person, find someone else. Good luck.

Hi Austina! Hi Dottie!

Funny you mention the surroundings...many of these places look completely open so you have to feel comfortable discussing your issues while other people can hear you. And yes I imagine if you have to be kind of undressed then even more important that you feel comfortable.

I always ask for referrals from as many people I can think of that I *think* might value what I do. But what I've found is that it's so subjective. And honestly I think I am kind of picky. So that always gives me a place to start but in the end many times I end up just doing my own research and finding someone that way.

Thanks so much Austina.

 

[CJ2008]

If they are not a bit pushy/driving that is not a good thing and some people do not like being pushed/driven.

It's such a fine line I think. You need to have someone that knows when to push you but at the same time respect your limits, especially if you're the type of person who knows their body and when something doesn't feel right.

Thanks Karl.

 

[Ally T]

Many moons ago (it'll be 11 years this Oct) I had a break to my C7 vertebrae. When the section of bone was smashed off, it took with it some tissue & there was a lot of nerve damage. They eventually found the missing pieces of bone 3 vertebrae lower down my spine.

After a healing period, I was referred to a Physio on the NHS (I'm in the U.K.) & it was a bit of a disaster. Ever single session, it was a different therapist & we were back to square one, spending half of the session discussing the injury & treatment so far to alleviate the muscle & nerve damage. And they always wanted to "try something new" or take a completely different approach. It was a painful old nightmare.

Eventually I booked myself in with a private Physio, who was & still is a practitioner for Everton Football Club. His shift pattern allows him the luxury of private patients one day each week. He was amazing. He got to the root of the tangle very gently over time, took off where he finished last on each new week, was gentle & the progress was marked & fantastic. He has been worth every penny. Sure the treatment was painful & at home exercises tough, but we got there. My constant headaches & muscle spasms have almost entirely gone, so much so that I now notice any pain, rather than pain being the normal & only noticing the times when there wasn't any pain. And I can deal with it by simply upping my evening brief Physio routine, that takes about 60 seconds to complete before I fall into bed.

I still see him periodically for various running injuries, of which there have been many. He has kept this old body ticking over for a long time & I am always confident in his abilities.

Continuity of practitioner has been key for me. That man knows how my body works better than I do, and I don't mean that to sound weird or sexual! Which also reminds me that Physiotherapy can be very intimate depending on the issue. Make sure you are comfortable & at ease with that person. And good luck!

 

[CJ2008]

HI CJ! This is a tricky question for me as I'm a bit skeptical of some treatments and am still trying to figure out who is the best person/treatment when I do have an injury. I always want to treat the problem and not the symptom of the problem. I have been to a few physical therapist and this is just my opinion. They have a good understanding of body parts and giving you the right exercises to strengthen the weakened part in your body. However, once you know what to practice at home, I always felt like I didn't need to continue going to the sessions. unless you need someone to push you to do it. It's a bit like going to the gym to do your own workouts or hiring a personal training to make sure you do it.

They should work one on one with you. From what I've seen they can work in various facilities from hospitals, sport clinics, and even home health care. When I was going through an IT band injury, I've been to two physical therapists. It was general the same structure where they first use deep tissue pressure points/massage etc to try and remove the scar tissue that was built up. Then they gave me exercises to strengthen my glutes. It was weak glutes that was the culprit and since I started to do those workouts, I haven't had the issue. However, if I had just gotten a deep tissue massage as a form of treatment, well it would just be more of addressing the symptom and would have had to pay a recurring fee. Hope that makes sense and good luck with physical therapy!

Right. If the exercises are addressing the underlying issue and you're motivated enough to do them on your own then I could see that. At the same time if you find someone really good sometimes they'll catch things in your form that you may not even be aware of. I think it depends on so many variables whether going is worth it, and of course money is always one of those variables.

And yes, I totally get what you're saying about for example doing only massage, etc. It really is about getting to the bottom of the issue and that can have many roots/causes.

Thanks PierreBear!

 

[CJ2008]

Many moons ago (it'll be 11 years this Oct) I had a break to my C7 vertebrae. When the section of bone was smashed off, it took with it some tissue & there was a lot of nerve damage. They eventually found the missing pieces of bone 3 vertebrae lower down my spine.

After a healing period, I was referred to a Physio on the NHS (I'm in the U.K.) & it was a bit of a disaster. Ever single session, it was a different therapist & we were back to square one, spending half of the session discussing the injury & treatment so far to alleviate the muscle & nerve damage. And they always wanted to "try something new" or take a completely different approach. It was a painful old nightmare.

Eventually I booked myself in with a private Physio, who was & still is a practitioner for Everton Football Club. His shift pattern allows him the luxury of private patients one day each week. He was amazing. He got to the root of the tangle very gently over time, took off where he finished last on each new week, was gentle & the progress was marked & fantastic. He has been worth every penny. Sure the treatment was painful & at home exercises tough, but we got there. My constant headaches & muscle spasms have almost entirely gone, so much so that I now notice any pain, rather than pain being the normal & only noticing the times when there wasn't any pain. And I can deal with it by simply upping my evening brief Physio routine, that takes about 60 seconds to complete before I fall into bed.

I still see him periodically for various running injuries, of which there have been many. He has kept this old body ticking over for a long time & I am always confident in his abilities.

Continuity of practitioner has been key for me. That man knows how my body works better than I do, and I don't mean that to sound weird or sexual! Which also reminds me that Physiotherapy can be very intimate depending on the issue. Make sure you are comfortable & at ease with that person. And good luck!

Thanks Alex T!

So nice to read that you recovered from your injury, even though it was a hard and long road (and ouch about the missing pieces of bone ). And how awesome that you found that one person that not only knows what they're doing but that you also feel comfortable with them.

So far all of you have pointed to working with only one person to be key so I will keep that top of mind.

 

[Calliecake]

CJ, Didn't your doctor tell you who they recommend. I was told recently that I need physical therapy and my doctor recommended where I should go.

 

[CJ2008]

CJ, Didn't your doctor tell you who they recommend. I was told recently that I need physical therapy and my doctor recommended where I should go.

Hi Callie. I am looking into this on my own. But even if they had...I wouldn't necessarily go to who they recommend. I still want to understand what makes a good place for people so I can judge for myself, you know?

 

[Karl_K]

These days in the US its who your insurance will pay for more than anything.

 

[Karl_K]

It's such a fine line I think. You need to have someone that knows when to push you but at the same time respect your limits, especially if you're the type of person who knows their body and when something doesn't feel right.

Thanks Karl.

like anything else it boils down to communication.

 

[CJ2008]

like anything else it boils down to communication.

Yes. 100%.

 

[luv2sparkle]

I haven't spent any time with a therapist for myself, but I spent 2 years going to therapy every single day when my son was recovering from a brain injury. He had the same therapist 90 percent of the time. I think it is needed so trust is built up. The best therapists were the ones who didn't cut him any slack or feel bad for him but worked him hard. I would kind of feel bad because I knew it was painful at times but he wouldn't be doing as well if they didn't put him through the paces. Maybe that is different with the kind of therapy you need but in general, the tougher they are on you the farther you will get in recovery. They don't do you any favors being easy on you. I am not sure there is any kind of physical therapy that doesn't involve some degree of pain, but maybe that is just my experience as well. I watched many many people go through therapy during the time my son did, and it seemed to be the same for everyone.

 

[CJ2008]

I haven't spent any time with a therapist for myself, but I spent 2 years going to therapy every single day when my son was recovering from a brain injury. He had the same therapist 90 percent of the time. I think it is needed so trust is built up. The best therapists were the ones who didn't cut him any slack or feel bad for him but worked him hard. I would kind of feel bad because I knew it was painful at times but he wouldn't be doing as well if they didn't put him through the paces. Maybe that is different with the kind of therapy you need but in general, the tougher they are on you the farther you will get in recovery. They don't do you any favors being easy on you. I am not sure there is any kind of physical therapy that doesn't involve some degree of pain, but maybe that is just my experience as well. I watched many many people go through therapy during the time my son did, and it seemed to be the same for everyone.

Thanks for this perspective.

This might be a challenge for me, because I am of the basic mentality that pain is never good.

For example, I am not of the mentality that good stretching happens when you stretch to the point of pain (just to give an example).

So if there are instances where pain is necessary to progress to the next phase, that would need to be explained to me. There might be 2 kinds of pain, too...one being ok pain and one that means you're doing something that's going to make things worse.

So again it all boils down to trust and communication. The therapist would have to understand my basic philosophy and be willing to explain to me why in my case or particular exercise it doesn't apply. They'd have to explain a little bit to me about why this body part is going to feel a certain way and why it's OK. They'd have to be able to compromise, too - so if for example for a patient that just went along they went at 90% they'd have to go at 70% with me so that I could start to trust their advice and see that pain is indeed OK.

This would come over time and there would have to be good communication. A therapist would have to be willing to work with a patient who wants to understand why they're doing something which some therapists would probably find annoying.

 

[t-c]

Your PT pushing or not really depends on your injury. My longest stint in rehab (there were many when I was an athlete) was for a ligament tear in the knee. For that one, the PT actually made sure I didn't push myself to allow for complete healing and recovery. I was strapped to a machine that would lock up if I pushed too hard; I needed to use with the right amount of force for the leg lifts.

I had a couple of PT I usually worked with because I was there frequently. They were both well versed with my case. I would recommend sticking with one so he/she knows how much you can handle, how much you're improving, etc...You should feel comfortable communicating with your PT: if you feel any pain, tired, having a bad day, if you have any questions. Look for someone who jives with your personality: I personally didn't like one that was too cheery, but needed one who would buck me up when the inevitable frustration set in. You should be perfectly comfortable with your PT.

 

[CJ2008]

Your PT pushing or not really depends on your injury. My longest stint in rehab (there were many when I was an athlete) was for a ligament tear in the knee. For that one, the PT actually made sure I didn't push myself to allow for complete healing and recovery. I was strapped to a machine that would lock up if I pushed too hard; I needed to use with the right amount of force for the leg lifts.

I had a couple of PT I usually worked with because I was there frequently. They were both well versed with my case. I would recommend sticking with one so he/she knows how much you can handle, how much you're improving, etc...You should feel comfortable communicating with your PT: if you feel any pain, tired, having a bad day, if you have any questions. Look for someone who jives with your personality: I personally didn't like one that was too cheery, but needed one who would buck me up when the inevitable frustration set in. You should be perfectly comfortable with your PT.

Right. And as a patient you need to have trust in your therapist that they know when to push and not to. I guess you can find therapists that are too conservative and are afraid of pushing when really it would be the best thing, and on the other hand maybe some push too much because they're not as skilled or knowledgeable or patient / thorough enough to make sure they're taking everything into consideration.

I wouldn't mind working with two therapists max IF I felt they were both very well versed with my case and what I'm all about. That might even be the best of both worlds if you happen to be working with 2 people who have different strengths. And yes, definitely a personality that jives with yours is important otherwise things feel "off" and can feel draining. I don't like anybody who's too cheery especially in the morning

Thanks t-c.

 

[Missy]

CJ my experience was this. I had one Physical Therapist who I saw twice to three times a week and he worked with me one on one to start but then after a few weeks he was working with other patients during the same session but kept going from one to the other making sure we were all doing a good job.

It's the nature of the "business" as we all know. Healthcare is a business and it is all about numbers. The pressure to make money and see lots of patients no matter how good the therapist is. So if you can find someone who will work solely with you one on one that would be great but in my case it wasn't possible or practical and I was paying out of pocket after a few months since my health insurance company only covered my therapy for a few months though I had such major damage.

He pushed me but if I felt it was too much pain I told him and he eased up accordingly. We have to listen to our bodies no matter what the "experts" say and a good therapist will be in tuned to what you say too.

The good news is I worked hard during the sessions and at home every day as well and I did well. So as with everything in life it is about the effort you put into it as well as having the proper guidance. I have no doubt you will do well because you are motivated and I hope you find the right therapist for you. If at first you don't feel good about your therapist or feel a connection keep looking. Don't settle. The right therapist for you is out there.

Sending you healing vibes and good thoughts.

 

[blackprophet]

Most of this has been said but I'll summarize my thoughts:

- First appointment should be 80% assessment. Although they may know what your injury is, they should spend a lot of time understanding your specific mechanics and assessing exactly how the injury presents in your body. That is the foundation of a successful treatment plan.
- They will explain what they are doing and why. Everything. So you understand how what they are doing leads to you getting better. Sometimes you will need to treat the symptoms exclusively before they treat the cause. Sometimes you will need to be pushed into a pain threshold. Your treatment course should be clear and any deviations explained.
- They will push you if you need it. Getting better is hard work.
- They will know you and your case. Continuity is key.
- If Servicing you and other clients at the same time, it should be once you are well down the road of treatment. If you are going to be hooked up to a machine for 30 mins, and same for another patient, then it makes sense to work with both of you at the same time. If its within your first appointment, or you are doing a number of exercises that you need guidance on, they should give you the attention to ensure you are doing everything correctly. Form, in most exercises, is key, they should be correcting you, especially when you first start.
- Therapy is somewhat trial and error, so if you feel something isn't working for you say. The therapist should be able to explain how long until you should start to see results, or why you havent seen them yet. Or they should adjust accordingly. The best therapists I've seen use constant feedback as the data for their treatment plan.


I wouldn't hesitate to switch therapists if I wasn't happy or I wasn't vibing with a therapist. When switiching, just have a good idea of what you have done so far, so the new therapist will be able to build off of that..

 

[mjr1]

I have spent a lot of time in PT recently (total knee replacement in March). As a distance runner I have used PTs quite a bit over the years.....I find the PT I have the most success with is one that is not only a PT but has certification for myofascial release as well as a number of other "hands on" techniques. She is a solo practitioner so I only see her and it is 1:1. She is much more hands on and uses massage therapy and stretching and alignment as well as strength training exercises and regular treatments like ultrasound and stim. She is very focused on what my body is telling her as she moves me in different positions and stretches me. Having a good working relationship with your therapist and a trust is super important. Different therapists will use different modalities and avenues to achieve the same goal successfully and the key is finding one that works with you to achieve your goal.

 

[CJ2008]

Most of this has been said but I'll summarize my thoughts:

- First appointment should be 80% assessment. Although they may know what your injury is, they should spend a lot of time understanding your specific mechanics and assessing exactly how the injury presents in your body. That is the foundation of a successful treatment plan.
- They will explain what they are doing and why. Everything. So you understand how what they are doing leads to you getting better. Sometimes you will need to treat the symptoms exclusively before they treat the cause. Sometimes you will need to be pushed into a pain threshold. Your treatment course should be clear and any deviations explained.
- They will push you if you need it. Getting better is hard work.
- They will know you and your case. Continuity is key.
- If Servicing you and other clients at the same time, it should be once you are well down the road of treatment. If you are going to be hooked up to a machine for 30 mins, and same for another patient, then it makes sense to work with both of you at the same time. If its within your first appointment, or you are doing a number of exercises that you need guidance on, they should give you the attention to ensure you are doing everything correctly. Form, in most exercises, is key, they should be correcting you, especially when you first start.
- Therapy is somewhat trial and error, so if you feel something isn't working for you say. The therapist should be able to explain how long until you should start to see results, or why you havent seen them yet. Or they should adjust accordingly. The best therapists I've seen use constant feedback as the data for their treatment plan.

I wouldn't hesitate to switch therapists if I wasn't happy or I wasn't vibing with a therapist. When switiching, just have a good idea of what you have done so far, so the new therapist will be able to build off of that..

This sounds like the ideal physical therapist. This makes perfect sense to me.

I hope I have enough luck to find someone/somewhere like this.

One thing I'm finding is that some receptionists - and even some of the PTs i've spoken to - find it somewhat curious/amusing that I am actually physically going to check out the facilities and asking questions beforehand.

One of the PTs I met with (who also happens to be the manager) said that they do "a lot of manual therapy" here - "a lot of places are just exercise exercise exercise."

The one little red flag this brought up for me is that I know manual/massage isn't covered by insurance. BUT - I am thinking they do the manual only IF the patient needs it.

 

[CJ2008]

I have spent a lot of time in PT recently (total knee replacement in March). As a distance runner I have used PTs quite a bit over the years.....I find the PT I have the most success with is one that is not only a PT but has certification for myofascial release as well as a number of other "hands on" techniques. She is a solo practitioner so I only see her and it is 1:1. She is much more hands on and uses massage therapy and stretching and alignment as well as strength training exercises and regular treatments like ultrasound and stim. She is very focused on what my body is telling her as she moves me in different positions and stretches me. Having a good working relationship with your therapist and a trust is super important. Different therapists will use different modalities and avenues to achieve the same goal successfully and the key is finding one that works with you to achieve your goal.

Oh. Funny you mention this about being more hands on, I just said something about that in the post above.

I can definitely see why massage would be beneficial depending on the injury. Sometimes people hold tension in certain areas, too, and I would think releasing that before doing exercises has to be a good thing.

Are you back to being able to run yet?

Do you pay for these sessions out of pocket or is it something your insurance covers.

 

[FeFeV]

Can you tell me what you thought made a really good physical therapist experience versus an average or so-so one?

Also, did you always see the same therapist?
Did the therapist work with just you during the scheduled time, or did they have other clients too?

Not sure what is common / to be expected so trying to get some different experiences.

I did PT for 10 months after being hit by an SUV as a jogger. My therapist was sweet, caring, firm and helped me reach goals that were important to my lifestyle. I always saw the same therapist and our time was one on one. She often gave me Biofreeze cream, bands, printed instructions and other components I could use at home to improve my condition. She also always called me the day after therapy to see if I was excessively sore or uncomfortable more than usual.

 

[FeFeV]

Thanks for this perspective.

This might be a challenge for me, because I am of the basic mentality that pain is never good.

For example, I am not of the mentality that good stretching happens when you stretch to the point of pain (just to give an example).

So if there are instances where pain is necessary to progress to the next phase, that would need to be explained to me. There might be 2 kinds of pain, too...one being ok pain and one that means you're doing something that's going to make things worse.

So again it all boils down to trust and communication. The therapist would have to understand my basic philosophy and be willing to explain to me why in my case or particular exercise it doesn't apply. They'd have to explain a little bit to me about why this body part is going to feel a certain way and why it's OK. They'd have to be able to compromise, too - so if for example for a patient that just went along they went at 90% they'd have to go at 70% with me so that I could start to trust their advice and see that pain is indeed OK.

This would come over time and there would have to be good communication. A therapist would have to be willing to work with a patient who wants to understand why they're doing something which some therapists would probably find annoying.

It's very important to do the things that are recommended by your therapist outside of the office visits. These at home exercises and stretches not only help your recovery but also minimize tons of pain and/or discomfort you may feel on therapy days.

 

[azstonie]

Hi CJ, lots of excellent experience and input already, but I'd like to chime in that when I broke my patella, my ortho surgeon was extremely clear/firm that "pain in PT is not good and can reinjure the knee and you start all over again. Pain is a sign that you're going/have gone too far."

The PT I had was not good. One of the main problem was that the facility was clearly a mill---way too many patients/clients booked at the same time. So I'm babying my poor knee as I do the workout, and stroke rehab patients are lumbering through the stations and I was really concerned that one of them would fall on me or crash into me (which I saw happen to another patient there). Too many people to safely work with/around. The facility was treating patients as well as offering its equipment to Joe Blow who wanted a workout out on them.

The therapist I saw was not attentive. He was busy chatting about his triathlons with the other therapists. He did not take good notes for the visits, only enough as required by insurance to be paid.

 

[CJ2008]

I did PT for 10 months after being hit by an SUV as a jogger. My therapist was sweet, caring, firm and helped me reach goals that were important to my lifestyle. I always saw the same therapist and our time was one on one. She often gave me Biofreeze cream, bands, printed instructions and other components I could use at home to improve my condition. She also always called me the day after therapy to see if I was excessively sore or uncomfortable more than usual.

That sounds like great communication.

And totally agree on following whatever advice / exercises they give you to do at home.

 

[CJ2008]

Hi CJ, lots of excellent experience and input already, but I'd like to chime in that when I broke my patella, my ortho surgeon was extremely clear/firm that "pain in PT is not good and can reinjure the knee and you start all over again. Pain is a sign that you're going/have gone too far."

The PT I had was not good. One of the main problem was that the facility was clearly a mill---way too many patients/clients booked at the same time. So I'm babying my poor knee as I do the workout, and stroke rehab patients are lumbering through the stations and I was really concerned that one of them would fall on me or crash into me (which I saw happen to another patient there). Too many people to safely work with/around. The facility was treating patients as well as offering its equipment to Joe Blow who wanted a workout out on them.

The therapist I saw was not attentive. He was busy chatting about his triathlons with the other therapists. He did not take good notes for the visits, only enough as required by insurance to be paid.

Kristie. Hi. How are you.

Funny you mentioned that. One of the places that I found has all kinds of services at one facility. When I called, their outgoing message said they offer blah blah blah and hair laser too (among other things I can't remember right now.)

They might be great, but that really turned me off, so I just hung up.

So what did you end up doing. Did you switch, or you just stuck it out?