Doesn anyone else think physical therapy is a complete joke and waste of time?

I've done it both ways, both on injury and post-surgical and I have to say with a good physical therapist I've had very successful results with a reduced recovery time.

I may have been lucky as far as therapists are concerned, and I'd agree that the quality of the therapist would have a lot to do with the progress. I didn't have the advantage of the "hot 25 year old" for mental rehabilitation and I can definitely say the therapy wasn't pain free, but it worked.

I would theorize that some therapists worry too much of any pain, and like training, recovery isn't necessarily a pain-free exercise. Someone that recognizes that pain is part of it and instructs you how to identify "good pain" vs "bad pain" would be key. So I'd gauge that on if your PT says "none of this is going to hurt" they're likely lying or just going through the motions.

I have had some bad luck with some massage therapists that just do the "rub rub" and basically back off any time you flinch. Find people that are familiar with sports therapy or massage and run away from those that advertise "relaxation".

Your information about PT education is terribly misinformed. Currently, a PT degree is either a Master's or Doctorate (not a PhD) degree. To apply, you need 4 year baccalaureate, typically a B.S. in a desired science field or major. After you are accepted to PT school, it is another 3 years of full time graduate school before you are granted a certificate to sit for the boards. You are then required to take the national exam in order to practice.

While it may be a "jock major" at some undergraduate schools, it is usually a pre-medical degree for anyone else who does not go to a university that offers PT as a major.

It is also quite competitive to get in to PT school. The PT school I graduated from recently had over 500 applicants with only 35 seats available. PT classes are typically very small compared to MD classes.

I'm not sure why you are under the impression it is "easy" to get into this profession. Maybe if you had 3 years of full time PT school, you would understand it is anything but possible to "cruise through" demanding course work and clinical affiliations.

Modalities can be a great adjunct when used appropriately and when medically necessary. Ultrasound is probably the most ineffective modality out there, even if used every day. But, depending on the goal of your PT, a modality can be effective in its designed purpose: Primarily to alleviate symptoms. Modalities are typically not a curative form of treatment, but can be a valuable supplement to an exercise program regardless of the frequency they are utilized.

That being said, you are absolutely correct in stating that there are many bad PTs in the field. However, the same can be said for many medical professionals out there. It is all about doing your own research and finding the PT who will work best with you and your background.

I think physical therapy is a jock major at most if not ALL undergraduate schools. I remember back in HS where the seniors for each team filled out exit surveys on what they planned to major in college. Every year nearly the entire football team (who also tended to be the dumbest kids) listed PT as their intended study. I think it arises from the fact that most of the jocks at the gym see this in-shape 25yr old guy (usually a former fball or bball player) taking fat slobs through stretching and think "hey I could do this myself." Matter of fact as a teenager I could probably do it as well.

Physical Therapist wrote:

Your information about PT education is terribly misinformed. Currently, a PT degree is either a Master's or Doctorate (not a PhD) degree.

apparently a PhD is different from a doctorate now.

Just you most likely.

I am a runner and a PT. I train well over a hundred miles a week and run well under a 3 hour marathon. I also am aware that there are bad PTs out there. But, there are many more good ones. The education and the training is far more intense then it use to be. I want to address a few things:

?apparently a PhD is different from a doctorate now.

- A PhD is a teaching doctorate degree; while a DPT is a clinical doctorate degree. It is amazing how many people are naive to the difference.

Science based? I think the difference is that there is now high quality science based research out there on how to treat and identify different symptoms and diagnoses. We are not relying on case-studies and low quality "expert opinion" it is now based on high quality: systematic reviews and randomized control trials that have narrow confidence intervals. The practice of physical therapy is evolving to be very focused on being an evidence based profession. If your clinician is practicing appropriately and utilizing this evidence then you are in good hands vs the clinician who is all about massage, hot packs and ultrasound.

?leg length discrepancy only by x-ray? You sir are an idiot. Unless you are an obese beast, it is quite easy and reliable to find true leg lengths and functional leg lengths by palpating and measuring the same land marks that are used in the x-ray.

?Not stretching or strengthening right muscles? There are normally biomechanical abnormalicies that form over-time; from sitting in front of a computer or papers at your desk 40hrs/wk to running 50,000 miles over the past 10 years. Therefore, we will focus on these (which lead to injuries and may be at fault for your slow return); it will take a while to fix these since they are forming over many years or miles; but stick to the plan and you will reap the benefits.

As for a quick fix, physical therapy is not always the answer. Too many people are looking for the quick-fix, often times it takes 6-8 weeks for you to heal (but listen to a PT and you won't have to go through that 6-8 weeks again in 6 months).

I personally love working with runners. I have not dealt with the claims of PT2, "one more thing: runners are usually our most pain in the ass- high maintenance- know it all- stubborn patients. I can think of very few runners I've worked with who have been a joy to treat.", I usually have respect from my runners. Runners are well educated/informed and motivated. The biggest pain in the ass patients are those that roll their eyes at me because I look ten years younger than my age, don't have a BMI over 30 and smell a little more pleasant than an ash-tray.

I have rambled on for too long. Hopefully, my post will provide some insight into physical therapy (if you take the time to read it, sorry). I appoligize in advance for some potentially offensive points. There are many more things I would like to reply to, but will hold on. Hopefully there aren't too many spelling errors and run-ons for you grammar police.

Sorry, I did not clarify.

The "D" in DPT stands for a clinical doctorate and is not equivalent to a PhD, which is a scholastic degree that allows the recipient the opportunity to teach at a university.

The clinical doctorate title usually (but not always) includes more clinical experience, pharmacology, and differential diagnosis courses than the PT Master's program. Although there are a handful of Masters programs left in the U.S., most are in the process of transitioning over to the DPT.

by using the internet and the wealth of information you can rehab yourself. I haven't found PT's to be very helpful, and the ones I have seen have either made things worse or believe orthotics is the answer for everything.

legally blonde wrote:

by using the internet and the wealth of information you can rehab yourself. I haven't found PT's to be very helpful, and the ones I have seen have either made things worse or believe orthotics is the answer for everything.

This is the problem that I am talking about with pain in the ass patients who are runners. This is what I see with our pain in the ass high maintenance patients:

Runner has injury

Runner does not want to go to doctor because doctor will tell them to simply stop running and pain will go away

Runner goes online to diagnose and self treat

Problem does not go away

Runner goes back to doctor and gets referral to PT

Runner attends PT but already has pre-conceived ideas about what is wrong with them, how to treat it, and how the PT doesn't know squat

Runner continues to do whatever they think will work based of what Joe Blow says on the internet

I must also say that with some typical running injuries, the problem is not where the pain is, it's somewhere else. This is the reason you can't go online and self diagnose and treat. If you have knee pain and go to a "bad" PT, they will treat your knee pain. If you have knee pain and go to a "good" PT, they will investigate other possibilities of a cause, watch you run on a treadmill, test your hip strength, etc. If you go to a PT for a running related pain with no direct cause of injury and they go straight to treating it without testing other areas, I would go for a 2nd opinion.

Like most have said, there are different kinds of PTs.

Like it or not, even with the years of serious education, diagnosis is based on guesses. They never really know what's wrong with you until the treatment starts working and works to solve the problem. Even then, you don't know if it was the PT's treatment or just time. As one PT mentioned, it takes 6-8 weeks for it to start working. Hmmmm.... sounds just like the same amount you'd start to get better if you hadn't gone at all.

My one PT experience I thought I had shin splints and was also told by the PT that I had shin splints, was given all kinds of exercises, warm-ups for running. I had to figure out on my own that I actually had a stress fracture and those exercises were making it worse. But, I wouldn't give up finding another one for another problem.

I like going because I like the laser therapy. It seems to work for me. That's less to do with the PT than where they work.

You are mistaken if you think that PT's are a joke anymore. It is an exteremely difficult profession to get into. Like any other profession, there will be good and bad practitioners, but as someone with close knowledge of the field, getting a PhD in PT takes years of very difficult schooling. Pt is very important, but it is not made for healthy runners typically. It is mostly used for people recovering from surgeries, older individuals who have health problems, and pediatrics (children with disabilities). Think before you post bashing an entire, extremely important profession.

I have had two full knee replacement surgeries. My physical therapist is the reason why can now walk pain free after not walking for at least 5 years. I have never been through surgery for any type and I was terrified. My physical therapist was there every step of the way through my crying and numerous questions. He built confidence in me that I never knew I had. Physical therapy is not just a matter of moving joints, it saves lives like mine. There will never be a day in my life when I stand that I will not think of him. In return, I wrote a letter to the Director of his organization which is now circulating across the United States. Fot those who want to consider PT for a profession, do not be deterred by its challenges. Mine was truly a gift to me. For the rest of my life, it will be my honor to give recognition not only to a highly credentialed physical therapist but to the most honorable individual I have ever known.

yes, my Dad is willing to drive me all the way downtown St. Louis

Perhaps if you went to a PT you would not have nor continue to have these injuries. A PT doesnt just treat the injuries; a PT might help you discover your imbalances, weaknesses, laxity or tightness lie and lessen the chance of injuries.

I think PT started as a way to make sure people claiming worker's comp claims were doing SOMETHING to return to work, and if they weren't going to work they were going to have to comply with PT in order to continue to receive benefits.

It's a way to monitor them, and OK them to return to work.

I guess it helps you return to the sport faster after surgery or help you overcome an injury. You just need to make sure you have the right PT.

I use E-stim for at least 20 minutes a day, for I have been baptized in the name of the Big Twitch, the Little Twitch, and the Holy Ghost. Who , no doubt, is a Twitch, too.

I have never experienced any positive benefits from physical therapy, Physical therapy is nothing more than a new version of seeing a chiropractor. In most cases the first thing you r told is your insurance will only pay 4 x amount of visits. If the Dr. has written a prescription 4 5 visits the physical therapy team automatically contacts your Dr. and explains more visits r needed. The whole thing is a vicious circle

completely

Maybe it's different in the US, but physiotherapy in Commonwealth countries began after nurses treating bedbound polio patients noticed that taking limbs passively through range of motion drastically improved patient outcomes when learning to walk again. This catalysed the idea that movement could be applied as treatment, and could be prescribed by a professional with the appropriate training.

So in effect it evolved that nurses would gain extra training in anatomy and biomechanics (and lose training with pharmacology) and thus a new profession winked into existence.

I'm in a Masters program for physio and it seems to me a lot of the perceived problems with physio arise from the fact it is a relatively new profession, somewhat misbranded and a great many of the treatments are very difficult to amass quality evidence on. It's impossible to blind massage treatment, hence there isn't a lot of quality evidence. The same applies to sports taping. I've been a football trainer for six years and have done enough of both to know they work, but quality evidence is hard to come by. This is the nature of the treatments, compounded by the fact few physios want to go into research.

Patient compliance is a massive hurdle. It's hard enough for MDs to get patients to take meds, let alone exercises which may be boring, unpleasant, time-consuming and often not intuitively tied with the injury (hip work to correct knee or ankle dysfunction, for example). Massive problem, almost insurmountable.

Physio is also misbranded. Physio's core role is not to heal the essentially well, as with sportspeople battling aches and niggles. They take the profoundly ill, and help them live a normal life. At this, they excel. This is why physio isn't going anywhere. Working in the community with minor soft-tissue injury is essentially an adjunct to the core role, which is things like post-stroke rehab, or regaining function after major trauma like a car accident.

I also personally believe physios should be steered much more toward preventative medicine, especially in elder care. A hip fracture is a grim diagnosis for an 80yo osteoporitic woman with multiple pathologies. She will likely die in hospital. But preventing falls before they occur is the real key to improved quality of life.