Physical Therapists are the people to see for movement disorders

I had a very frustrating week by way of numerous messages coming at me that people really don't understand the benefit of working with a physical therapist (PT). There were multiple times when an MD reportedly said that they would decide if someone was in need of a PT and that they would first prescribe exercises for their client. In one case, the physician said there were good enough exercises on You Tube for a client with vertigo symptoms. (Side note: 1st there are multiple reasons someone can experience vertigo and not one specific exercise routine is right for all of them. 2nd anyone who is experiencing vertigo symptoms knows they cannot feasibly look at a computer screen without wanting to vomit let alone search for a video to do their exercises).

I heard a wife say that her husband with a neurological dysfunction was just going to go work with a personal trainer vs a PT because said trainer knew the muscle that was weak and was just as knowledgeable as a PT. I have the utmost respect for most personal trainers and strength coaches and am constantly seeking more knowledge from my colleagues who have knowledge in strength training and fitness. However, our education is different and we do focus on different things. This particular person needs work on walking and correcting movement beyond what he will receive in a gym setting.

I heard someone who had major surgery say they didn't want to go to outpatient PT after their home care because she thought just getting independent in her home would get her back to a normal level of function.

PT's who are practicing these days have anywhere from 4-7 years of education in the field of physical therapy. The majority of PT's now have a doctorate degree in physical therapy. They may have an undergraduate degree in some sort of movement field (Kinesiology-the study of movement; Exercise Physiology-the study of the underlying mechanisms of physical activity). I myself have both degrees directly in Physical Therapy (because that is how it was set up 30 years ago).

PT's have extensive knowledge of the musculoskeletal and neurological systems. We are able to diagnose and treat movement disorders. We are educated on our limitations and do not diagnose medical problems. We refer out if someone does not have a movement disorder, if there appears to be an underlying medical reason for their movement disorder or if they are not improving with what appeared to be a movement disorder.

We evaluate gait and safety. We prescribe movement corrective strategies that allow better function. We know how to regress a movement to allow gradual return to a higher level of movement.

We are NOT medical doctors. We do not prescribe medicine. We are NOT personal trainers/strength coaches with our PT degrees, though some PT's do further education to be able to include more fitness into their treatment bag. We are NOT massage therapist though we do have a baseline knowledge of therapeutic massage (again, some PT's go for further education to do more advanced soft tissue and lymph work). We are NOT chiropractors, even though we have knowledge of how to mobilize a joint it takes further education on how to safely manipulate a joint.

I believe there is a place for us all to work together. I think someone who is not moving well needs to be evaluated and perhaps treated by a PT. I think there are times when further work up is needed. I think there are times when surgery is needed. I think there are times when someone is moving optimally but needs to get stronger or leaner to move better. I believe there are times when people need the calming hands of a massage therapist or skilled hands of a chiropractor to correct an alignment dysfunction. I think there are times when accupuncture can facilitate improvement in dysfunction. I believe a nutritionist is important to general healthcare to prevent a lot of movement dysfunctions.

I am tired of healthcare being driven by the insurance companies who think there is a one size fits all model and don't want to pay for restorative, preventative and maintenance care. I am floored that physicians say they won't refer to PT in order to save a buck because they will get more in their pocket if they cut outside costs. There is no incentive to give a PT more money if we actually correct a mobility issue and prevent an unnecessary surgery or use of long term pain medication.

I truly believe in a collaborative model where an MD/Nurse Practioner, a PT, a Chiropractor, an Accupuncturist, a Massage Therapist, and a Personal Trainer/Strength Coach all work together to provide their clients with the best HEALTH care possible. This is my vision and mission.

Tidd-bit of the day: A reminder of postural health

I now travel by car for my work as a home care physical therapist. I carry a bag full of necessary equipment. These two activities play a toll on my postural health.

 I was recently reminded, by a 90 year old patient of mine, how important it is to alternate the shoulders that I carry my bag on. This was an incredible observation and reminder for us all.

I think kids today are more aware that it is important to carry your backpack on both shoulders. It wasn't the norm when I was growing up.

I think both men and women need to be reminded to carry their bags (laptops/purses/groceries etc) on alternating sides to avoid overuse of one side. Stop wearing your shoulders as earings and you may be able to decrease neck pain and shoulder pain. If you're in the car like I am, check yourself at the wheel to avoid hunching forward all day long. Alternate your positions by sitting up tall and then sitting back into the seat. Shift your bottom side to side. Rotate your upper body back and forth, and again, drop those stressed shoulders out of your ears while taking a relaxing, slow deep breath.

Posture isn't static. Our bodies want and need to move. Change position frequently and work toward balance. I'm willing to bet this will help you to reduce some pain and stiffness in your own life.