Think PT is just for rehab after an accident or injury? It's time to discover the many ways these body experts can come to your rescue.
Physical therapy can help with everything from balance issues to strength, mobility, and overall fitness-all crucial factors as we age. Yet plenty of people who stand to benefit fail to take advantage.
“I think we have a bit of a PR problem,” says Mary Morrison, P.T., a physical therapist specializing in geriatrics at the Cleveland Clinic.
For instance, many people think you have to be in pain before you visit a therapist. In fact, physical therapy (PT) can help prevent falls, injury, and even chronic disease. For those who already have a chronic disease, it can help slow the progression.
Even people who do have pain may dismiss or minimize their discomfort rather than seek a PT’s guidance to fix it, adds Mark Milligan P.T., D.P.T., director of physical therapy at Vori Health, a virtual holistic health provider that incorporates physical therapy as part of an integrated approach to treating muscle and joint pain.
If any of the scenarios below sounds like you, an evaluation with a physical therapist might be in order.
Reason #1: Your Body Aches
Bad back? Sore shoulder? Bum knee? A physical therapist may be able to ease your pain.
“One of the myths of aging is that pain is normal,” says Alice Bell, P.T., a certified specialist in geriatric physical therapy and spokesperson for the American Physical Therapy Association.
The truth is musculoskeletal pain-the kind resulting from overuse, poor posture, or an injury to your muscles, joints, or tendons-can usually be reduced or eliminated by physical therapy. These can include shoulder impingement, sprains, tendonitis, and back, hip, neck, or knee pain.
Even if you classify your body aches as moderate or mildly annoying, you can benefit from PT, adds Milligan. A therapist can teach you specific exercises and stretches that can minimize and even prevent pain.
More important, working with a PT can help you maintain your strength and muscle mass by keeping you active.
"When your body is in pain for any length of time and you avoid movement, that means you're not using muscles in your body appropriately," Milligan explains. "That exercise avoidance can cause a lot of muscle weakness, which can set you up for more problems down the road."
By analyzing your movements, a physical therapist can identify the root cause of your pain, and recommend strengthening and flexibility exercises to help you heal.
If you have shoulder problems, for example, exercises that strengthen the rotator cuff and scapular muscles—like shoulder blade squeezes—can help pull your shoulder back into proper alignment.
A therapist can also teach you how to break up static patterns that lead to pain. One of Bell's patients-a woman with neck and shoulder pain-was an avid knitter who would sit in the same position for hours working on a project. Bell taught her how to shift positions, hold her projects differently, and take breaks throughout the day.
If you have pain that does not improve in two weeks, consider seeking a physical therapist's help, says Morrison. You may see improvement in as little as one to two sessions, adds Bell.
Reason #2: You’re Doing Less of the Things You Love
One in four Americans ages 65 and older take a tumble each year, making falls the leading cause of injury among this age group. But the worst part is that many are avoidable.
We all lose strength, power, and muscle mass-and have a slower reaction time-with age, increasing the risk of falls, says Morrison. Often the warning signs are there, but can be so gradual you don't notice them. One red flag: You've stopped engaging in a favorite activity in the past year, or you do it less often than you used to, says Bell.
"I have patients come to me and say they used to golf 18 holes and now they're golfing nine," says Bell. "Or they used to ride a bike and now they're barely getting on it. Or they find it more difficult to play with the grandkids."
These trends can be clues that your muscles are getting weaker, even if you don't really notice a difference day to day. That puts you at greater risk of a fall.
Seeking a PT's guidance can help. Here's what to expect: After asking about your history-with an ear toward any telling changes in recent months-a physical therapist gives you some standard assessment tests to gauge your strength, power, flexibility, and balance. The PT may also check your blood pressure for any changes that might contribute to falls.
Together you come up with a plan that fits your life, and includes three types of exercise: aerobic, strength, and balance moves.
And if you’ve already had a fall? A good first step is telling your doctor about any falls, especially if you were injured. Your doctor will want to make sure there are no underlying medical issues, such as blood pressure problems or medication side effects that led to your fall.
As part of your follow-up care, physical therapy can still help. In fact, science shows that PT has the greatest impact in high-risk groups: those over 80 who've had a previous fall.
“It’s almost like the frailer a person is, the more quickly we see positive change with a plan that pushes them but doesn’t over-push,” says Bell. “I see patients who start to improve in as little as a week or two.”
Reason #3: You’re Prepping for Elective Surgery
Most people know a PT can help you recover from surgery, but physical therapy can help you prepare for it too.
"The term we use is 'prehab,'" says Bell. That's "prehabilitation"-a proactive approach that positions you for a smooth and speedy recovery. If you're planning to have spine surgery, or a hip or knee replacement, prehab will likely help.
Studies show that the more you know about the surgery and recovery process beforehand, the better you'll fare. In fact, prehab may reduce your number of post-op therapy visits by 30 percent.
For example, a PT can teach you rehab moves ahead of time, so you know what they’re supposed to feel like and which muscles they should activate.
Your therapist can also teach you to use adaptive equipment you’ll need post-op, like a walker, cane, or crutches, or devices that assist with dressing or bathing.
“After surgery, people have a whole bunch of instructions to follow,” says Bell. Learning as much info as you can ahead of time can make that process a lot less overwhelming.
What's more, improving your strength and range of motion before surgery, and maybe even reducing your pain, means you'll have a better baseline to start from in recovery. In one small study of older adults scheduled for hip replacement, those who took in-home training improved their leg strength and walking speed more than those who skipped the prehab.
Reason #4: You’re Managing a Health Problem
For people with chronic pain or a chronic disease—such as arthritis, osteoporosis, heart disease, diabetes, Parkinson’s, or cancer—exercise can be an important part of your overall treatment.
It not only helps boost your mood, but it may even help manage symptoms and improve your overall health. Exercise can also increase muscle strength and endurance, making daily tasks easier to perform and fighting disease-related declines, says Milligan.
But working out with a chronic disease can be challenging. A physical therapist can help you modify moves accordingly.
Morrison teaches arthritis patients to lift weights within a partial range of motion—like partial weighted leg raises with the knee slightly bent, for example—so they can still lift heavy-enough loads without joint pain.
And because osteoporosis and Parkinson’s put you at risk for kyphosis, or an excessive curvature of the upper back, Morrison teaches patients the proper way to bend forward to avoid rounding the back.
Working with a therapist after a heart problem or stroke can help you return to your usual roles much faster.
And for those with cardiovascular risk factors like high blood pressure, high cholesterol, or diabetes, regular PT visits can improve your blood pressure, weight, and quality of life after just one year.
Many physical therapists are even trained in psychological techniques for managing chronic pain.
"There can be a lot of fear and anxiety surrounding pain," says Morrison. To help you deal with that, therapists offer education designed to reset your expectations, and may teach relaxation techniques like deep breathing as well.
“Patients with chronic pain rarely feel worse after exercising,even if they come in feeling poorly,” Morrison says.
The bottom line: If you’ve been diagnosed with a chronic condition, consider making a physical therapist part of your health care team.
Reason #5: You’re New to Exercise
It’s never too late to start exercising. But it is important to educate yourself on the proper way to do it first—key for injury prevention and sticking with your program.
“We see a lot of people who start exercise without a good strategy or without factoring in their chronic issues or environment,” says Bell. “They may get frustrated because either they’re not doing enough, or they’re doing too much, and they get soreness and fatigue and just stop.”
For instance, beginner exercisers often have muscle imbalances due to weak muscles that aren’t able to do their job properly. What happens: Other muscles compensate, and overly tight muscles can pull your bones out of alignment. The fix is to strengthen the weak muscles, Morrison says.
A PT will also monitor your heart rate and blood pressure responses to exercise, and advise you on just how hard you should be working.
"Older people tend to underexercise," says Morrison. "They don't push themselves." A PT can teach you how to find your exercise sweet spot, so you get the full benefit from your program.
Reason #6: You Want to Prevent a Fall
One out of four older Americans falls every year, reports the Centers for Disease Control and Prevention. In fact, the CDC says an older adult falls every second of every day.
Vori Health’s Milligan says physical therapists can help keep you from becoming another fall statistic by setting you up with a balance training program that includes learning how to fall appropriately and get up safely from falls.
"For patients who are at a high risk of falling, we can work to improve their balance but also incorporate lessons on how to fall and how to get up," he says. Vori Health physical therapists can also provide digital home assessments to identify trip hazards and help patients and caregivers find solutions.
Reason #7: You’re Dealing With Incontinence
More than 50 percent of older adults experience urinary incontinence, reports the CDC. Milligan says physical therapy should be one of the treatments considered.
“I think that is arguably one of the largest untapped markets of physical therapy,” he says.
A physical therapist can guide you through exercises to strengthen your pelvic floor muscles and improve pelvic floor muscle function to reduce surprising leaks. Milligan says physical therapy can also help patients who are recovering from prostate cancer surgery or who have some degree of pelvic organ prolapse.
What to Know Before You Visit a Physical Therapist
Ready to call a PT? Here’s how to prepare for your appointment.
Check your health coverage. If you have Medicare Part B or a Medicare Advantage Plan, you may need a doctor, physician’s assistant, or nurse practitioner to sign off on a PT program. Other health coverage may not require a doctor’s referral to visit a PT, so be sure to check.
Find the right therapist for you. Check with your health plan or medicare.gov to find available professionals. Plus, the American Physical Therapy Association has a provider search tool that lets you look for different specialties like geriatrics, orthopedic, and neurologic: choosept.com/findapt.
Have any instructions from your doctor available to share. If you have a chronic condition, previous injury, or are currently receiving treatment or taking medications, sharing this information with your physical therapist can help you get the best care. And after you start PT, it’s helpful to share that info back with your doctors.
Think about your goals. Do you want to be able to bend down to feed your dog? Or walk to the mailbox without pain? Or just generally keep yourself healthy and active? Sharing your ultimate goal with your therapist allows them to design a program that helps you achieve exactly what you want.
Ask about timing your visits. The frequency of your PT visits and how long you stay in physical therapy depend on your unique needs.
Higher-risk folks may see a therapist two or three times a week for a few months, while lower-risk patients might need just a few sessions before they feel confident enough to keep up with the program on their own, Bell says.
Either way, it's often a good idea to follow up with your PT every year, just so she can see how you're doing, says Morrison. In general, building a relationship with your PT is smart. That way, you know just who to turn to in the event of future issues.
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