Let’s face it, we want everything to work in a set time period. Those time periods are now, and yesterday. When it comes to PT, the best therapists are not only trying to heal what your primary issue is, but also trying to correct the movement patterns that have gotten you into your situation in the first place. If going to PT every year for the same issue is what floats your boat then you’ll make a lot of physical therapy conglomerates happy. If what you’re looking for is long term solutions, read on to see what goes into a PT prognosis.
When you first see your PT, you should be having a conversation about your goals, what you would consider a successful round of treatment. Now, if your injury is not due to an accident or one incident then it is potentially due to your biomechanics (how your body moves due to muscle and joints length, strength, and coordination). Your PT should be able to describe to you three things. What tissue giving you the pain, what mechanics got you into this situation, and what the two of you can do about it. Often times, getting you out of pain can be a relatively quick process, however it would be a mistake to stop going to PT if the cause of the issue is movement. To illustrate this let’s talk about a patient with neck pain.
This particular patient is a 40 year old male who hurt his shoulder 15 years before. Since then, he has carried his shoulder higher which is likely a compensation that he developed during the time it was injured. Carrying his shoulder higher has resulted in his neck pain and could eventually result in more serious issues. To treat his neck pain and make if feel better may take 2-3 weeks, but he may be instructed to continue if he wishes to resolve this issue for good.
There are a few different components to fixing the movement for good. Many of these components are directly dependent on how good the patient is at performing their exercises. One is the time it takes to lengthen the muscles that may be contributing to this faulty pattern (2-5 weeks). The second component is the time it takes with habitual practice to be able to perform a movement correctly (2-5 weeks). Then is the amount of time it takes to train that position and load it to become strong (6-8 weeks). Some of these time components overlap, but generally the strength phase cannot come until the movement pattern is correct.
So the best case scenario for this individual could be that they start the range of motion phase at the beginning of treatment while treating the neck. Then they start the coordination phase in week 1-2 to get the movement pattern down. This means that somewhere in week 3-6 we get to start strengthening.
Now, some of you may be thinking “That’s a lot of Physical Therapy!” and the answer is…not necessarily. With good PT intervention you should have a good understanding of how to perform your exercises, and the exercises should somewhat replicate the treatment. Once you are in a strength phase your PT should be able to see you once every 2-3 weeks to assess progress and alter your strength program and instruct you on how to progress over the next phase. This way you’re not attending just to do the same thing you do every time. Each session should be meaningful and progressive.
At the end of the day, we didn’t even touch on one big component, time of injury. The longer someone waits before going to PT, the longer the course of care may have to be due to worsening tissue health and worsening movement patterns. Seek a good PT early for your pain and you’ll ensure yourself much more activity over your lifetime.
National averages across many of these conditions are 9-12 visits.
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Averaging the above stats across all conditions equals 5.0 at DPT.
