Physical Therapy: More Than Just Stretches

A few months ago I was at a family dinner and my sister-in-law was moving gingerly and grimacing in pain. I asked what was wrong and she responded that she had tweaked her back at work (she is a veterinarian) and was really struggling with daily movement and that lifting/bending at work were all but impossible.

She paused, then hesitantly asked, “Would you be willing to show me a few stretches that might help?”

She was hesitating because she didn’t want to ask me to work while I was “off the clock”- but we are never really off the clock, are we? Like most physical therapists, I can’t see someone who is in musculoskeletal pain and not put my hands on them (with permission, obviously!). So she and I moved into the living room, did an evaluation to ensure it was actually simple musculoskeletal pain, and then moved into some treatment. A couple of lumbopelvic manipulations and some soft tissue mobilization later, she was feeling normal. We discussed some pelvic girdle and core strengthening exercises, body mechanics during work, nutrition (the pelvic health therapist in me can’t help it), and, yes, some stretches, and then rejoined the family.

As I was thinking about this interaction, I realized (not for the first time!) how much I love having the knowledge and hand skills to provide immediate pain relief in these types of situations. An orthopedic surgeon, medical student, and former nurse were in attendance that day, and while they had some helpful information to share about back pain, I was the one who was able to do something in the moment to help her achieve meaningful change.

And then, as they often do, my thoughts diverted to how much I wish that our profession was better known and represented in the world. My sister-in-law, like many people, truly thought all I could offer her was stretching. Once we were finished, she exclaimed something along the lines of “Wow, you guys (physical therapists) need to shout what you can do from the rooftops! I had no idea how much you could do to help me!”

Now, let’s acknowledge the glaringly obvious: my own sister-in-law didn’t really know what I do for a living. Granted, I tend to keep work and family life relatively separate, but in some ways, maybe that is part of the problem. It’s true that therapists (I would definitely also include occupational and speech therapists in this category) are quite underrepresented in pop culture. It’s also true that our professional organizations tend to lack funding to have significant ad campaigns (imagine a beautiful commercial like those put out by drug companies…but without the quickly-passed-over side effects of significant injury and death at the end!) and representation.

Maybe education/advocacy needs to start with us-a grassroots effort to spread the word that we do so much more than just providing stretches (don’t get me wrong, I think mobility/flexibility are important and do often prescribe stretching as part of my care plan for a patient). We need to back up APTA’s national campaigns with real, on-the-ground presence in our communities, advocating for what we do.

Of course, we do advocate (hopefully!) one patient at a time by providing excellent care to those who walk in our doors. But that is clearly not enough—if it were, “try physical therapy” would be on everyone’s lips when discussions about musculoskeletal or neuromuscular dysfunction arise. We need to shift our thinking about how we represent our profession and ourselves. What are some ways we do that? I don’t know that I have all the answers, but some shifts I am personally making include:

Providing education and advocacy in my personal circles of influence. I am a mother of young children-this means I am in a lot of Facebook mom groups, chat with other parents at school pick up, and have quite a few medical visits (mostly well child checks thankfully!) as part of my daily life. I have started speaking up when parents talk about having pain, relatives with neuromotor dysfunction, leaking when they jump or cough, and so on…and I am trying to be very conscious of doing so in such a way that I am promoting rehabilitative therapies as professions, not necessarily myself specifically. I don’t think self promotion is wrong at all, but I also realistically can’t see the whole world and I want people to think therapy first, not just think of my name, when in need of care. And, yes, I am talking more about what I do when appropriate with family and friends.

Being more conscious of how I interact with others at marketing events. Of course I have always provided education at these events-but how much more powerful is it to provide free screenings when working an event for moms expecting babies vs just chatting about how therapy can help with pregnancy related back pain or incontinence? When I go to speak with physicians, I try hard to bring a fellow therapist so that we can demonstrate some of the things (outside of stretching!) that we do on each other-if that is not an option, I try to demonstrate on the physicians.

Being more involved in physical therapist education at all levels. This is the future of our profession! I personally really enjoy teaching, so for me this looks like teaching CE locally and nationally as well as guest lecturing for entry level programs when the opportunity arises. I am not 100% clinical at this stage of my career, so I do not function as a clinical instructor when students rotate through my clinical, but I do meet with them to teach them some of the skills that will serve them well during their careers (the super boring ones, like how to read insurance benefits and document effectively). And I absolutely love having the opportunity to hire a new grad and mentor/teach them in their first year or few years out of school.

Being involved in the education of other medical professionals. This is a little “easier” for me because I work in a teaching hospital, and have a supportive department who helps in setting these opportunities up. It is truly amazing how little other healthcare professionals know about what we do, and having the opportunity to share that information with medical students, residents in many different specialties, and nurses at both the student and professional level is a privilege! Sometimes that is formal (lecturing to medical students or at Grand Rounds), sometimes it is informal (having residents come shadow at the clinic)—either way, it’s so awesome to be able to have some cross-disciplinary collaboration, and hopefully help make sure those up and coming professionals “think PT” early, not when they have exhausted all other options for their patients.

I would love to hear your thoughts—what are some ways that you can leverage your strengths and passions to advocate for our profession? Nothing is too big or too small—every effort counts, and it would be fantastic for us to all glean inspiration from one another!

3 responses to “Physical Therapy: More Than Just Stretches

  1. Jessie Podolak says:

    Jen,

    Thanks for this excellent post! I often wonder why many PTs feel uncomfortable standing up and saying, “We know AMAZING stuff and we can help!” Is it lack of confidence, confusion between humility and modesty, or simply a lack of know-how when it comes to advocating for our profession? I’m not sure what your PT school training entailed in terms of business, but my entry-level-program sure did NOT have a marketing component, and largely assumed referrals would flow freely from MDs. I’m assuming, little did my professors know over 20 years ago, that we would have direct access, an opioid crisis, and a DIRE NEED for PTs to let the public know what we have to offer!

    Recently, I attended our state’s Physical Therapy Legislative Day. Our state association and lobbyists teamed up to produce a very succinct document (a script of sorts) to share with our legislators. It outlined the various settings in which therapists worked, from prevention (Fit For Work type settings) to neuro, to pain, to post-op. There were at least 20 different settings highlighting the breadth of our knowledge and practice. We were encouraged simply to go through this document and inform them of all therapy has to offer, as well as let them know that if there were bills they were working on pertaining to these types of things, we are here to help. This was particularly useful for the students in attendance, who were quite nervous talking to their representatives and staffers.

    As I shared some of the content of the document with my representatives’ staffers, my passion regarding pain science, patient education, and working to fight the opioid epidemic came through. I followed up with an e-mail to one of my representatives who I learned has a specific interest in substance abuse. We are now chatting about having lunch, and he is curious about a PT perspective on a few Wisconsin health care bills in the queue.

    I share that simply to illustrate that even things that seem like they might be intimidating really aren’t that bad! Whether it’s our family and friends, as you eloquently described in your story, the general public, or our public officials, we are all just fellow human beings, and most folks are interested in learning how to navigate the confusing landscape of health in the U.S. We do have a lot to offer and could learn a bit from some of the other folks in the health care scene who have no problem shouting their value from the rooftops. ;-)

    Thanks for this great reminder!
    Jessie

    1. Jenn Stone says:

      Jessie,
      I completely agree. I got exactly zero marketing anything in PT school, even when it comes to marketing ourselves to our patients (to some degree we need to “sell” every patient that walks in the door on physical therapy). I only learned about it by necessity because I became a clinic director relatively early in my career, but had that not been the case, I think I still would be fairly uncomfortable with it! Many therapists I think feel guilty for “selling” what they can do, I’m not entirely sure why.
      I agree that many times these conversations don’t have to be intimidating! We can just let our passion flow. I also wonder if some of the issue is challenge with just being so busy in our day to day lives and practices that it is tough to do things like attend a capitol meeting or have lunch with a colleague in another profession.
      Either way, thanks for your perspective, it’s so true and valuable!

  2. Thank you as always for sharing your thoughts and experiences with us

Leave a Reply

Your email address will not be published. Required fields are marked *