What Physical Therapy Does
If you were to ask 10 patients what physical therapy does, you will likely get 10 different answers because physical therapy serves a wide range of uses depending on the person.
However, regardless of health condition, there are 5 things that effective physical therapy does: pain reduction, muscle strength improvement, flexibility enhancement, endurance development and mental enrichment.
Pain reduction is a hallmark of physical therapy, especially when you’re hurting from surgery or other acute event. Body positioning, cryotherapy, manual therapy, electrical stimulation and edema management are key in these situations and have been shown to be effective (Arch Phys Med Rehab 1997, 2005, 2009). However, in most cases, professionally-prescribed exercise therapy has been shown to be even more effective than passive modalities in reducing pain, especially in cases related to the spine, shoulder and knee (Physical Therapy 2001, 2008; New England J Med 2015; Med Sci Sp Exerc 2013).
Muscle strength is also a key benefit of physical therapy. For example, if you are recovering from a hip or knee replacement, research shows that intensive physical therapy after surgery is essential for positive long-term outcomes (Phys Med Rehab 2011; Arch Phys Med Rehab 2016). If your orthopedic surgeon says that you need a joint replacement, research suggests that attending 8 weeks of physical therapy focused on muscle strengthening may delay and/or prevent the need for hip or knee replacement (JOSPT 2009).
Gaining flexibility is another value of physical therapy, which is crucial if you have osteoarthritis in order to reduce joint forces with daily activities. For example, if you have osteoarthritis in your knee, lengthening your hamstrings (back of your thigh) and quadriceps (thigh) muscles may help reduce pain by increasing range of motion, which spreads forces across a greater surface area in the knee. This would be beneficial by reducing loads on knee cartilage.
Developing endurance is a crucial benefit of physical therapy for anyone with chronic disease, especially if you’re obese, opioid addicted due to chronic pain and/or dealing with heart disease. Endurance refers to your ability to sustain a level of exertion, such as walking or riding a bicycle, for at least 10 minutes. Improving your endurance can also reduce chronic pain and reduce the need for opioids by activating important nerve receptors that receive natural pain-reducing chemicals (Substance Abuse 2012).
Lastly, enriching mental state is another potential benefit of physical therapy. If you’re dealing with depression, bipolar disorder and/or anxiety, exercise-based physical therapy has been shown to be beneficial in its ability to reduce medication need while enhancing quality of life (J Neuropsych 2005). Unfortunately, the majority of physicians do not discuss exercise with their patients, so most patients needing exercise-based physical therapy are not referred (JAMA 1984; J General Internal Med 1993; Clinic J Sp Med 2000).
The aforementioned benefits of physical therapy should be communicated to your physician to ensure optimal care.
Of course, the catch is that you should see a physical therapist who is skilled in these areas to get the benefits. Many physical therapists choose to specialize in manual therapy (i.e., skilled hand techniques designed to reduce pain) instead of exercise. Consequently, exercise prescription skills are lacking, given that US PT schools do not currently offer standardized, peer-reviewed training in exercise therapy.