Finding the "Why" in Physical Therapy is the Most Important Part

The most common question I get from patients that I have seen over the past 24+ years is “What can be done to help me heal faster from my injury?”

I love this question as it feeds into idea of the patient taking control and ownership of their health.  This hastened healing sought from physical therapy often involves (but certainly not limited to) intervention such as manual therapy (i.e. massage, myofascial release, manipulation or even Dry Needling), or a specific therapeutic exercise given (i.e. stretch or strengthening exercise). 


Historically I have found this approach undoubtedly has helped patients recover from injury.  


Get to the “Why”

The above thought process albeit quite effective really only addresses a portion of healing process. In my opinion, this often times can be disguised as treating more of the “symptom” vs. the “problem or cause” of the injury. 


We as physical therapist often fall victim to this as often it works and the patient’s symptoms improve and feel better.  The problem with not getting to the “why” is the injury may manifest again later as the patient may fall back into their movement patterns of daily life and the cycle of pain and dysfunction resumes. 


Determining the “why” is what makes physical therapy such a vital and integral part of our health care system and a very underrated and underacknowledged skilled physical therapists possess.  With our knowledge of how the body moves and how neuromuscularly it integrates patterns to move with and without injury, PTs serve as detectives to discover the underlying cause of how a particular injury happened in the first place.  



Sometimes Less is More

As PTs spend more time with each of our patients, we learn more of how the patient moves and responds to stress. In my experience, especially over the last half of my career, discovering the “why” has also shined light on discovering what the patient should stop doing vs. do more of. 


For example, someone with chronic neck pain that spends 8-10 hrs/day sitting at her computer does benefit from PT treatments such as manual therapy and a home stretching program.  But to truly allow her overused muscular system to recover, she may need better ergonomic strategies such as raising her monitor or using a standing desk option to do less sitting.  Less is more!   Muscular/soft tissue pain, more often than not, is caused by doing too much of something, which overtaxes the neuromuscular system. 


Overall, our job as PTs is to to find the "why". 


-- Jerret Hopstad, MPT, OCS


Posted by isabellesiegrist at 9/20/2022 1:03:00 PM
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