What is physical therapy, exactly? Who should try it? How much will it cost? We answer all the pressing questions on the treatment you need to know more about
By Emily Abbate, GQ
A weird thing happens when we get really invested in a sport, like running or skateboarding or intramural basketball or goat yoga: Eventually, in some way or another, we get injured. Research indicates that between 40 and 50 percent of runners deal with injuries each year, and between 19 and 74 percent of CrossFitters, too. And when average Joes and extraordinary athletes alike get benched, they often turn to the same person: a physical therapist.
I did so in late 2015 when - in the midst of working through a newfound passion for barbell work - I attempted one too many overhead squat snatches, which triggered some nagging arthritis in my lower back. It was painful and debilitating enough that I knew I needed to seek out treatment. But after a decidedly underwhelming visit to a physical therapist, I couldn’t begin to understand why anyone would pay big money for someone to, basically, stretch them out.
After I voiced my woes to a wise friend, though, they suggested that I try a new therapist - one who had a lot of cool tools, sage advice, and helpful insight on how to fix my problem. Within three visits, I felt a dramatic amount of tension release from my lower back. I was also hooked for good. And if nagging maladies are preventing you from jogging or ollie-ing or dribbling or, uh, goat yoga-ing as much as you'd like, we're here to help you find the help you need.
A weird thing happens when we get really invested in a sport, like running or skateboarding or intramural basketball or goat yoga: Eventually, in some way or another, we get injured. Research indicates that between 40 and 50 percent of runners deal with injuries each year, and between 19 and 74 percent of CrossFitters, too. And when average Joes and extraordinary athletes alike get benched, they often turn to the same person: a physical therapist.
I did so in late 2015 when - in the midst of working through a newfound passion for barbell work - I attempted one too many overhead squat snatches, which triggered some nagging arthritis in my lower back. It was painful and debilitating enough that I knew I needed to seek out treatment. But after a decidedly underwhelming visit to a physical therapist, I couldn’t begin to understand why anyone would pay big money for someone to, basically, stretch them out.
After I voiced my woes to a wise friend, though, they suggested that I try a new therapist - one who had a lot of cool tools, sage advice, and helpful insight on how to fix my problem. Within three visits, I felt a dramatic amount of tension release from my lower back. I was also hooked for good. And if nagging maladies are preventing you from jogging or ollie-ing or dribbling or, uh, goat yoga-ing as much as you'd like, we're here to help you find the help you need.
What is a physical therapist, and what kind of schooling do they go through?
A physical therapist is a doctor of physical therapy. PTs earn their four-year undergraduate degrees and then complete a postgraduate degree that takes about three more years - so seven years in total. After that, each aspiring PT must take and pass the National Physical Therapy Examination (NPTE) administered by the Federation of State Boards of Physical Therapy (FSBPT) to become licensed. You can check a PT's active certifications on individual states' licensure websites.
What happens at physical therapy?
As with first dates, this differs on a case-by-case basis. During your first visit, they should do a total-body movement screen with you and inquire about your injury history - beyond whatever specific ailment brought you into the office. Then a PT can go through various techniques with you to help address any lingering issues. Have a wonky squat that’s causing ankle pain? Or a tight hamstring that makes your deadlifting a nightmare? Your PT has got you covered.
“You should be getting an individualised program designed off of personal assessments,” says Corinne Croce, DPT and co-founder of Body Evolved in New York City. “Appointments that follow that first assessment allow for focused care and efficient progression.” These can include everything from hands-on treatments like active release therapy to corrective exercises to neuromuscular retraining to good old-fashioned strength and conditioning. A battery of gadgets, including muscle stim machines, Graston instruments, and compression boots, may be involved at some point.
Most importantly, a PT should be constantly re-examining your strength, range of motion, and pain levels to decide whether the chosen technique is leading to the desired outcome. “If you are not progressing under the current plan, the answer is rarely to continue with more of the same,” says Cameron Yuen, DPT, of New York City's Bespoke Treatments. “A therapist should have multiple approaches and techniques available to ensure that your progress does not stall.”
For example, if you have restricted shoulder movement, your PT might decide to try a joint or soft-tissue mobilisation technique, like massage. If there’s no change in your range of motion - or, even worse, an increase in pain - a prompt reassessment is in order.
“You should be getting an individualised program designed off of personal assessments,” says Corinne Croce, DPT and co-founder of Body Evolved in New York City. “Appointments that follow that first assessment allow for focused care and efficient progression.” These can include everything from hands-on treatments like active release therapy to corrective exercises to neuromuscular retraining to good old-fashioned strength and conditioning. A battery of gadgets, including muscle stim machines, Graston instruments, and compression boots, may be involved at some point.
Most importantly, a PT should be constantly re-examining your strength, range of motion, and pain levels to decide whether the chosen technique is leading to the desired outcome. “If you are not progressing under the current plan, the answer is rarely to continue with more of the same,” says Cameron Yuen, DPT, of New York City's Bespoke Treatments. “A therapist should have multiple approaches and techniques available to ensure that your progress does not stall.”
For example, if you have restricted shoulder movement, your PT might decide to try a joint or soft-tissue mobilisation technique, like massage. If there’s no change in your range of motion - or, even worse, an increase in pain - a prompt reassessment is in order.
What is the point of physical therapy, exactly?
“The goal of a good physical therapist will be to help with any sort of muscle-, joint-, or movement-related pain,” says Dan Giordano, DPT, CSCS, and co-founder of Bespoke Treatments, and to “map out a recovery plan that helps clients become more durable human beings.”
This toughen-up promise sounds appealing. Realising its benefits, though, will also require lots of hard work, both during your appointments and afterward. Oftentimes, PTs will give clients toys, like resistance bands, to complete some homework between two and four times per week.
It is also important to note that physical therapy isn’t just for athletes (or wannabe athletes) suffering from sports-specific injuries; it can also help with all the other little problems that may come up, says Croce. “Pre- and post-op rehab, acute injuries, chronic injuries, prevention, correcting movement dysfunctions, and overall physical health - a physical therapist should be able to help you maintain and even better the health of muscles and joints.”
This toughen-up promise sounds appealing. Realising its benefits, though, will also require lots of hard work, both during your appointments and afterward. Oftentimes, PTs will give clients toys, like resistance bands, to complete some homework between two and four times per week.
It is also important to note that physical therapy isn’t just for athletes (or wannabe athletes) suffering from sports-specific injuries; it can also help with all the other little problems that may come up, says Croce. “Pre- and post-op rehab, acute injuries, chronic injuries, prevention, correcting movement dysfunctions, and overall physical health - a physical therapist should be able to help you maintain and even better the health of muscles and joints.”
How much will this cost?
Some insurance providers include physical therapy as a part of their plan, enabling patients to fork over only a co-pay once they set foot in the office. (This is the stuff dreams are made of). Others may cover a portion of services, depending on things like your deductible and your doctor's in-network or out-of-network status. And as with most specialists, some offices only accept certain insurance plans - something to take into consideration when hunting for a new doc. Generally speaking, out-of-pocket fees can range anywhere from £75 to £350 per session.
When should a physical therapist refer me to someone else?
An important question, since this isn't cheap! First, if you need imaging services like MRIs or X-rays, or exhibit signs and symptoms of anything outside the scope of their practice - acute neurological injuries, for example - you'll need to head elsewhere. Don't worry, this will become apparent very quickly.
Otherwise, a PT should be able to help you in some capacity within two to three sessions, provided that you're working hard and doing your homework. “If that doesn’t happen, then we’ll typically refer someone to a doctor specialising in the specific area that’s bothering them for further examination,” says Giordano. If your PT doesn't do so, be sure to express your concern so that your treatment gets back on track. Those goat-yoga classes aren't going to take themselves.
Otherwise, a PT should be able to help you in some capacity within two to three sessions, provided that you're working hard and doing your homework. “If that doesn’t happen, then we’ll typically refer someone to a doctor specialising in the specific area that’s bothering them for further examination,” says Giordano. If your PT doesn't do so, be sure to express your concern so that your treatment gets back on track. Those goat-yoga classes aren't going to take themselves.
