What is a physical therapist?

A physical therapist is a specialist trained to work with a patient to restore their activity, strength, and motion following an injury or surgery. Physical therapy (PT) can teach patients specific exercises, stretches, and techniques, and use specialized equipment to address problems that cannot be managed without PT training.

Why is physical therapy important?

Physical therapy is important in orthopedics for two primary reasons:

• First, orthopedic patients typically have a deficiency that needs to be addressed. For example, patients with carpal tunnel syndrome may have weakness of specific hand muscles that require targeted exercises. Or knee conditions such as chondromalacia may be due in part to muscle imbalance around the knee joint. A physical therapist can teach exercises that specifically target these muscles to improve function and decrease problems.

• Second, physical therapists are knowledgeable about surgical procedures, treatment goals, musculoskeletal anatomy, and can tailor their efforts to improve the well-being of the patient. After a procedure such as a hip replacement or ACL reconstruction, it is important that therapy is guided by the surgical procedure. Some surgery places limits on weight-bearing and range of motion; a therapist is knowledgeable of these limits and can help ensure a successful outcome.

Many orthopedic problems can be managed without a physical therapist. Often some simple exercises or stretches may help improve a patient situation. However, there are many complicated conditions that a physical therapist is specially trained to treat.

What are some important things a therapist does?
Physical therapists have many rehab tools available, some specific aspects of physical therapy which you may encounter include:

• Stretching
  Stretching is vital to maintain good range of motion around a joint. If a patient has stiff joints, normal activities such as opening a jar or climbing stairs can be severely affected. By proper stretching, these functions can be preserved. After an injury or surgery, scar tissue forms, and soft-tissue contracts; this is when stretching is most important.

• Strengthening
  Strengthening exercises are performed to help the patient improve the function of their muscles. The goal is to improve strength, increase endurance, and maintain or improve range of motion. Common types of strength training include:
  • Closed Chain
    The closed chain exercises are performed with the foot locked in position on the ground--for example a leg squat. These exercises a performed to help balance the muscle strength. By performing closed chain exercises, the weak muscle (e.g. the quadriceps) and its antagonist (e.g. the hamstrings), will both be exercised and balanced. Open chain exercises, such as a leg extension, do not balance the muscles this way.
  • Proprioceptive
    Proprioception is the sense of knowing where a body part is in space. This can be a difficult concept to grasp until you lose it, because so much proprioception occurs without out conscious thought. When you lose proprioception of, for example, an ankle joint after a sprain, patients often complain of an unstable sensation of the joint. Proprioception training reteaches your body to control the position of an injured joint.

• Ice and Heat Therapy
  Ice and heat are useful to warm up and cool off muscles. In addition, these modalities can stimulate blood flow and decrease swelling. These can be important aspects of the therapeutic process.

• Ultrasound
  Ultrasound uses high frequency sound waves (not within the range we can hear) to stimulate the deep tissues within the body. By passing an ultrasound probe over the body, deep tissues are stimulated by the vibration of the sound wave. This leads to warming and increased blood flow to these tissues.

• Electrical Stimulation
  Electrical stimulation is a therapy that is not well understood. By passing an electrical current to an affected area, nerve conduction within the region is altered, which can in turn alter muscle contractility. Patients often experience diminished pain after this type of treatment.