I work for two DPTs who are trying to change the way people view musculoskeletal disease. I have spent countless hours in the last year trying to catch up for all of the time I misspent doodling and sighing loudly through science and health classes. I read blogs and articles about the benefits of physical therapy, what’s new in physical therapy, and the struggles of rehabilitation post-injury. And I watch over Twitter conversations that include #solvePT, #bizPT, and of course, #GetPT1st.
As of right now, I’ve never actually been to physical therapy. But if I was experiencing back (or knee, or shoulder, or pelvic, etc.) pain in the time before I started working for Strive Labs, I would not have even considered physical therapy first.
Knowing what I know now, the rationale doesn’t make any sense. If something was wrong with my brain (no comments, please), I would seek the counsel of a neurologist. If something was wrong with my feet, a podiatrist. It makes perfect sense to see a musculoskeletal specialist for a musculoskeletal problem.
So why wouldn’t I, the average healthcare consumer, get PT first?
1) I flat out didn’t know it was an option:
My first step would probably be to my PCP. Or possibly an unplanned ER visit. Physical therapy would be so far off of my radar. If I was hurting or feeling bad in any other way I would go to my doctor, so why would this experience be any different? There’s a small chance that if I had back pain I would seek a chiropractor (because they’ve branded themselves well as “the back people”), but even then, in a non-emergent circumstance I would likely seek a doctor I already know and trust. I only thought of PT as something people did after surgery, not before.
2) Cons of word-of-mouth:
My family and friends who have required physical therapy have had a mixed bag of experiences. Most of them have this in common: their initial experience was bad. They felt unheard, they felt that the treatment wasn’t working, that it was a bad match between themselves and their therapist. And also, hello—they were in pain. Pain only exacerbates those negative experiences.
Fear not, PTs reading this right now, some of these people eventually found a PT that they ended up trusting implicitly, and they were able heal and be pain free. But some of the most important people in my life are still in pain, post-PT. This is not the fault of the therapist. And it’s not because the therapy was futile. Every injury is unique. But if half of the people in my sphere of influence had a bad first experience, or had PT and still hurt…my motivation for seeking PT is low.
My point is this: when we (in the PT industry) talk about about physical therapy as a first course of action, it can feel so obvious that it becomes frustrating to see people not seeking PT initially.
It’s so easy now to see why getting PT first is such a great idea, why it makes so much sense and how much sheer evidence exists to support its efficacy. But when talking to people outside of the industry, there needs to be a clear breakdown of the benefits of getting PT first, and an understanding that it’s not as intuitive to the average person than we may think.