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  • Dr. Piotr Solowiej PT, DPT

5 Physical Therapy Misconceptions

Physical therapy - pain - problem solving

I know what you may be thinking: "Why would I go and pay a PT, to tell me things that I already know?"

Well, my friends, as a physical therapist, the job is to enhance the life of the person you are working with. So if you're in pain, or can't participate in activities as well as you would like to, physical therapy can help.

However, not many people know that. One of the biggest problems the profession has is that there is poor public awareness about the benefits of physical therapy. Here are 5 common misconceptions about the profession, as well as the debunking on why they are wrong:

1) They're just going to tell me to sit up straight.

'Good' posture is a man made construct. What qualifies as good? The common answer is often some form of 'neutral' spine. But what does that even really mean? There is no universal gold standard for a 'neutral' spine. It a subjective feeling of 'neutral.' Posture can certainly play a relevant role in terms of someones pain. There are even categories of pain presentations that are classified as postural. However, outside of those, you may be surprised to hear that for most patients I recommend all kinds of variable postures. Even those that are often considered 'bad.' For more on my thoughts on posture specifically, check out this post.

2) They're just going to tell me to stop doing my exercise routine/sport.

If something hurts when you move or exercise, that doesn't necessarily mean you have to stop that activity. But you may have to modify it in some way. Also its a sign that your body clearly doesn't like something about what it going on and you should figure out why the pain is occurring. It doesn't take a scholar to say "if it hurts, just don't do it." That's such garbage advice and doesn't help anything. No assessment, and more importantly no understanding of why the problem is happening. If a true impairment is the cause for your pain, then it will be back there when you go back to the activity after resting. From the viewpoint of a physical therapist, pain during a movement is a piece of information. Given your history with the problem and objective findings during tests and measures, an assessment is made as to why that symptoms is occurring. After problem solving a personalized plan is made to intervene, aiming to alleviate symptoms and improve your participation in the target activity.

3) I already exercise. Doing more isn't going to help.

Sometimes, less is more. Maybe the reason you are hurting is because you are doing too much of a certain movement, or mode of exercise. Again, the answer here is not to stop that activity. Maybe it just needs to be temporarily modified. Or maybe the answer is temporary or relative rest. Or maybe there's an underlying musculoskeletal impairment (weakness, stiffness) that negatively affects your ability to move comfortably, and once addressed the problem disappears....No way of knowing for sure without an assessment. If you're hurting and haven't been able to fix the problem on your own, talk to a professional!

4) I'm in pain so I shouldn't move, because it will get worse.

This sort of mindset can lead to a vicious cycle. I was recently reading a book which cited a perfect summary of the consequences of this sort of thinking, made by physical therapist Erik Meira. Erik says: "Pain will make one fearful of movement, which leads to less movement, which leads to more pain, and more fear, etc." I couldn't have said it better myself. So I won't. Read Erik's full blog post about positive feedback loops here.

5) I've tried PT before: it didn't help then so it won't help now.

Physical therapy can't help everyone, that is true. But even though your pain may be in the same location as in previous history, the cause or mechanism can be totally different. Also, all physical therapists are independently licensed practitioners. That means we all learn the same basic knowledge, but practice in our own individual manner. Some therapists may also be pressured to adhere to certain workplace/company rules that can affect the effectiveness of your care. If therapy didn't work for you in the past, then maybe the therapist or the clinic was not a good fit for you. Be smart and shop around around when searching for a physical therapist. Call the clinic. Ask to speak to a therapist directly. See if they are a good fit for your needs.


Hope you learned some new things reading that. If you agree or disagree I'd love to hear about it. Drop a comment below and we can discuss!

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