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5 Common Myths About Physical Therapy – Debunked!

5 Common Myths About Physical Therapy – Debunked! 1920 1080 ResilientRx

Physical therapy is an integral part of healthcare that helps millions of people recover from injuries, manage chronic conditions, and improve their overall quality of life. However, misconceptions about physical therapy are surprisingly common. These misunderstandings can prevent people from seeking treatment that could significantly benefit their health and well-being.

In this article, we’ll address five common myths about physical therapy and provide the facts you need to make informed decisions about your health care.

Myth 1: Physical therapy is only for injuries or accidents

One of the most persistent myths about physical therapy is that it’s only necessary after an injury or accident. While it’s true that physical therapists often treat acute injuries, their expertise extends far beyond that.

Physical therapy is beneficial for a wide range of conditions, including:

  • Chronic pain management: Conditions like arthritis, fibromyalgia, and chronic back pain can be effectively managed with physical therapy techniques.
  • Neurological disorders: Patients with conditions such as Parkinson’s disease, multiple sclerosis, or those recovering from strokes can benefit from specialized physical therapy programs.
  • Balance and fall prevention: Especially important for older adults, physical therapy can improve balance, coordination, and strength to prevent falls.
  • Prenatal and postpartum care: Physical therapists can help women prepare for childbirth and recover afterwards.
  • Sports performance: Athletes use physical therapy not just for injury recovery, but also to enhance performance and prevent future injuries.

Physical therapists are movement experts who can help you improve your physical function, whether you’re recovering from an injury or simply aiming to enhance your overall wellness.

Myth 2: Physical therapy is painful

“No pain, no gain” is not the motto of physical therapy. While it’s true that you might experience some discomfort during your recovery process, the goal of physical therapy is to reduce pain, not cause it.

Physical therapists are trained to work within your pain tolerance. They will push you to make progress, but not at the expense of causing undue pain or discomfort. If an exercise or treatment is painful, your therapist will modify it or try a different approach.

Moreover, many physical therapy treatments are designed specifically to alleviate pain. Techniques such as manual therapy, electrical stimulation, and dry needling can provide immediate pain relief while other interventions like exercise work to address the root cause of the pain.

Myth 3: Surgery is always better than physical therapy

While surgery is sometimes necessary, it’s not always the best first-line treatment. In many cases, physical therapy can be just as effective as surgery, with the added benefits of being non-invasive and having fewer associated risks. 

For example, studies have shown that physical therapy can be as effective as surgery for certain types of knee osteoarthritis and meniscal tears. It’s also been proven effective for low back pain, rotator cuff tears, and carpal tunnel syndrome, among other conditions. Check out our blog on meniscus recovery HERE.

Even when surgery is necessary, physical therapy plays a crucial role in the recovery process. Pre-surgical physical therapy (also referred to as “prehab”) can help you enter surgery stronger and better prepared, potentially improving your outcomes. Post-surgical therapy is often essential for regaining strength, mobility, and function.

Myth 4: You need a referral from a doctor to see a physical therapist

In many states, you can now see a physical therapist directly without a physician’s referral. This is known as direct access, and it allows patients to seek physical therapy treatment without the delay of waiting for a doctor’s appointment and referral.

Direct access to physical therapy can lead to:

  • Faster treatment and recovery
  • Lower overall healthcare costs
  • Reduced use of opioids and other pain medications
  • Fewer unnecessary diagnostic imaging tests

For those of us in Texas, patients can see a physical therapist for 10-15 consecutive business days without a referral. However, it’s important to note that some insurance plans may still require a physician’s referral for coverage. Always check with your insurance provider about their specific requirements.

Myth 5: Physical therapy is just exercise; I can do it on my own

Paging Dr. Google and Dr. Youtube! While the internet contains a wealth of potentially good resources, it can often provide you with conflicting, inaccurate, or downright false information at times. While exercise is indeed a component of many physical therapy treatment plans, it’s far from the whole picture. Physical therapists are highly trained healthcare professionals with extensive knowledge of anatomy, physiology, and the complexities of human movement.

A physical therapy session might include:

  • Manual therapy: Hands-on techniques to mobilize joints and soft tissues
  • Specialized equipment: From simple resistance bands to kettlebells, barbells, or machines  – PTs may utilize a variety of tools to help retrain movement patterns, build strength, and alleviate pain.
  • Education: Teaching you about your condition and how to manage it. This is a HUGE component of PT and vital for optimal patient outcomes.
  • Functional training: Exercises and activities specifically designed to help you return to your daily activities, work, or sport

Moreover, the exercises prescribed by a physical therapist are tailored to your specific condition, abilities, and goals. Your physical therapist will also monitor your progress, adjust your treatment plan as needed, and ensure you’re performing exercises correctly to maximize benefits and minimize the risk of further injury.

Conclusion

Physical therapy is a dynamic and diverse field of healthcare that offers far more than many people realize. By debunking these common myths, we hope to encourage more people to explore how physical therapy might benefit their health and quality of life.

Whether you’re dealing with an injury, managing a chronic condition, or simply want to move and feel better, consider consulting with a physical therapist. With their expertise in human movement and function, physical therapists can provide personalized care to help you achieve your health and fitness goals safely and effectively.

Remember, your journey to better health and improved physical function doesn’t have to be painful or automatically involve surgery. Physical therapy offers a path to wellness that’s accessible, effective, and tailored to your individual needs.

Whether you’re on your healing journey with new or old aches, pains, injuries or surgery, we’re here to help! Book with us today to help you reach your goals and improve your quality of life!

Getting The Spring Back In Your Step: Understanding & Treating Achilles Tendinitis (AKA Tendinopathy)

Getting The Spring Back In Your Step: Understanding & Treating Achilles Tendinitis (AKA Tendinopathy) 280 474 ResilientRx

Achilles tendinitis refers to painful overuse injury of the tendon that connects your heel to your calf muscles. It impacts numerous people – from athletes in running and jumping sports, to individuals who lead less active lifestyles. The pain and stiffness can greatly impact basic quality of life including activities like walking, exercise, and going up and down stairs. 

Before we dive into common treatments for this issue, it’s worth discussing exactly what it is, right down to how clinicians define and classify it. Having a better understanding of the diagnosis makes for more effective treatment approaches. We’ll start with the changing terminology – it turns out that “tendinitis” doesn’t quite capture what’s happening since the underlying issue is not quite black & white. Without further adieu, let’s break down the evolving terminology and science-backed treatment approaches:

What’s Up with the Changing Terminology?

Let’s first describe the key differences between tendinitis, tendinosis and tendinopathy, because these terms are NOT interchangeable. 

  • Tendinitis has historically been used to describe inflammation of a tendon, with treatments focused on reducing that inflammation. 
  • Tendinosis refers to more degenerative changes and microtears of the tendon, without inflammation present.
  • Tendinopathy is the most broad term that encompasses all tendon disorders, including inflammatory and degenerative features. It can involve inflammatory elements right after injury, but typically it’s more to do with dysfunctional healing and tissue remodeling over time. 

What we have a better understanding of now is that there is a spectrum of issues that can impact tendons, many of which are improper remodeling or healing of the tissue, as opposed to simply inflammation. Treatments (as discussed later) should focus more on remodeling and regeneration of the tendon rather than simply reducing inflammation. We need to get that tissue strong and resilient again!

What Causes Achilles Tendon Issues?

Simply put, it’s an overuse injury from repetitive strain. Micro-tears in the tendon outpace the tendon’s ability to repair itself properly, thus resulting in pain and dysfunction. Things like calf tightness, overpronation, sudden jumps in activity (i.e. couch to 5k), and poor leg strength may contribute over time. 

Most patients do not experience a single event or injury, but rather smaller insults over time. Pain can set in over days to weeks, and may worsen depending upon the person’s activity. So oftentimes a cycle of rest or stopping activity completely followed by resuming activities without the proper interventions in between causes people to stay in this unfortunate pain cycle. Complete rest actually increases tendon dysfunction!

Pain usually goes through a “warm-up phenomenon.” This means that pain can improve with exercise/activity a bit, only to return with a vengeance later on or the next day. This is where a structured program and guidance from an expert clinician is crucial. 

How Does Physical Therapy Get You Back on Track?

Your physical therapist should develop a customized treatment plan aligned with current evidence-based clinical guidelines and your goals (We do at ResilientRx)! Properly dosed strength exercises, mobility training, biomechanical corrections, and guidance on gradual return to activity aim to spark tissue regeneration/remodeling while minimizing flare-ups. Guiding the optimal balance of rest and activity helps manage load demands. It’s an intricate puzzle tailored to each patient. It’s also important to note that rehab will not be PAIN-FREE. It’s actually safe to have mild levels of tendon pain lasting less than 24 hours after activity. We often use a simple scale to monitor pain levels, which helps to dose exercise appropriately and push things forward without compromising progress. Every patient will respond differently, so communication is key.

Here’s what the framework for achilles tendinopathy rehab looks like:

  • Early stage: hands-on modalities to calm symptoms such as soft tissue work/massage, joint mobilizations, dry needling and taping. Here we also introduce gentle strength and mobility exercises to start the tissue remodeling process
  • Mid stage: progressive loading via strength exercises to the gastroc and soleus (calf muscles). Isometric and eccentric exercises are advanced to further expose the tendon to more time under tension Stretching may be more tolerated in this phase compared to when symptoms are more acute. 
  • Late stage: we start to move more toward plyometrics exercise and sport-specific or functional training as needed, including more “traditional” strength training principles

The Bottom Line

Tendinopathy rehab is load-related and dose-dependent. We want the achilles tendon to tolerate higher loads over time, so this is a gradual process that requires patience and diligence. The unfortunate truth however, is that progress with Achilles tendinopathy is almost never linear. There will be ups, downs, and plateaus. Sometimes consistent strength training may need to be done for anywhere from 3-6 months before returning to plyometrics. Anti-inflammatories and complete rest are discouraged as this leads to further deconditioning, weakness, and more susceptibility to flare-ups. The good news is that over 75% of tendinopathy patients achieve resolution of symptoms through dedicated rehab and avoid surgery! It can be a long road for many of us, but we’re here for you!

Have you been struggling with Achilles tendinitis or chronic tendon pain in general? Schedule an appointment with one of our Doctors of Physical Therapy to get you back to doing the things you love! CLICK HERE or call 512-777-0330.

References:

1. Magnan B, Bondi M, Pierantoni S, Samaila E. The pathogenesis of Achilles tendinopathy: a systematic review. Foot Ankle Surg. 2014;20(3):154-159. doi:10.1016/j.fas.2014.03.002 

2. Morrissey D, Roskilly A, Twycross-Lewis R, et al. The treatment of mid-portion Achilles tendinopathy: a systematic review. J Foot Ankle Res. 2021;14(1):3. Published 2021 Jan 11. doi:10.1186/s13047-020-00440-5

3. van der Plas A, de Jonge S, de Vos RJ, et al. A 5-year follow-up study of Alfredson’s heel-drop exercise programme in chronic midportion Achilles tendinopathy. Br J Sports Med. 2012;46(3):214-218. doi:10.1136/bjsm.2010.083428

4. Rowe V, Hemmings S, Barton C, et al. Conservative management of midportion Achilles tendinopathy: a mixed methods study, integrating systematic review and clinical reasoning. Sports Med. 2012;42(11):941-967. doi:10.1007/BF03262301

5. Doral MN, Alam M, Bozkurt M, et al. Functional anatomy of the Achilles tendon. Knee Surg Sports Traumatol Arthrosc. 2010;18(5):638-643. doi:10.1007/s00167-010-1083-7

6. Alfredson H. Chronic midportion Achilles tendinopathy: an update on research and treatment. Clin Sports Med. 2003;22(4):727-741. doi:10.1016/s0278-5919(03)00034-7 

7. Padhiar N, Achana F, Davies A, et al. Eccentric exercises reduce the risk of Achilles tendon overuse injury: a systematic review and meta-analysis. Br J Sports Med. 2021;55(21):1180-1188. doi:10.1136/bjsports-2020-103426