By Jane Cobler, PT, DPT
Just like there are many subspecialties in the field of medicine, so too are there in the field of physical therapy. You’ll see physical therapists working in all sorts of healthcare settings across all age groups – from the hospital, to schools, to private clinics and even in your home. In orthopedic medicine specifically, physical therapy is a particularly integrated component in your care. Physical therapists are especially well-suited to guide you through orthopedic recovery because much of the treatment is targeted at “re-balancing” your musculoskeletal system to better perform functions that matter to you.
Physical therapy as a profession is responsible for restoring function and improving patients’ quality of life in the home and community. Orthopedic medicine addresses issues as it relates to the musculoskeletal system (i.e. bone, muscle, joint, ligament, and tendon). These issues are commonly traumatic, degenerative, or over-use related, among other things. Treatment approaches in orthopedic medicine include both conservative management, including: medication, injection, splinting, and physical or occupational therapy, as well as more invasive solutions such as surgery.
When it comes to orthopedic injury, physical therapy can play a key role in both conservative and post-operative management to facilitate recovery and improved function. When patients experience an orthopedic injury, key elements of their musculoskeletal system are disrupted which can result in pain and ultimately limit an individual’s ability to perform even basic daily tasks.
Absent a medical emergency and depending upon the nature of the problem, your orthopedic physician may recommend a course of physical therapy as an early treatment option. Your physical therapist will perform a comprehensive evaluation, sourcing more detailed information on the exact underlying cause for your presenting complaint. The evaluation consists of taking measurements like range of motion, strength, balance, specific clinical tests, palpating (assessing by touch) musculoskeletal structures, assessing posture and watching you move. It’s also important to hear, in your words, the nature of the problem and how it impacts your daily life.
Your physical therapist will then develop a treatment plan based on these findings. Treatments typically consist of correcting the deficits identified during the initial evaluation, and are modified based on your subsequent responses. They will usually consist of specific exercise, hands-on manual treatments, and means to control inflammation and pain. Essentially, your physical therapist is trying to re-train your body to work better for you.
As such, the goals set by your physical therapist will always be related to a specific daily functional task you’ve identified as being limited with the expectation that, by meeting these goals, you will be able to notice improved ability to perform those tasks. Physical therapy will discontinue when either a) your goals have been met; b) you have reached a plateau or maximal medical improvement; or c) your condition does not improve. Typically you will go back to see your Orthopedist after finishing a course of treatment, where further care plans may be developed.
For patients who undergo orthopedic surgery, it’s highly likely that physical therapy will be a part of your post-operative recovery for similar reasons above. Once your issue has been “fixed” by your orthopedic surgeon, you will need to re-teach your body how to safely move and restore function. Your physical therapist works closely with your surgeon to ensure you are progressing as expected and protecting the healing process, advancing your rehab protocol and daily activities appropriately.
As you can see, physical therapy is often a vital component of orthopedic care management, both for conservative needs as well as post-operative recovery. Your physical therapist and orthopedic physician work closely together to help you get back to an improved quality of life.