October is National Physical Therapy month, a time of the year when physical therapists like Gopal T. Raghunath, PT MS, DPT, CSCS of Buffalo Grove Physical Therapy & Sports Rehabilitation, P.C. celebrate their profession while educating others about the role physical therapy plays in improving the health and vitality of their patients — and of health care in general.
In doing so, Dr. Raghunath points out that while physical therapy’s roles are both broad and diverse, several misconceptions still exist about what physical therapy is, what it isn’t, and the various ways it can help people improve the health and lives of people of all stages in life.
“When a lot of people think about physical therapy, they think rehabilitation. But that’s just a part of what we do,” said Dr. Raghunath, owner/clinic director of Buffalo Grove Physical Therapy & Sports Rehabilitation. “Physical therapists can improve the lives of people of all ages dealing with a number of common ailments … even people dealing with no ailments at all.”
According to the American Physical Therapy Association (APTA), physical therapists (PTs) are highly educated and licensed health care professionals who can help patients reduce pain and improve or restore mobility. Sure, this includes those who’ve suffered musculoskeletal injuries, Dr. Raghunath says, but it’s much more than that.
Here five common misconceptions about physical therapy:
I need to be injured to see a physical therapist.
Post-injury and post-surgical rehabilitation is just a sliver of what they do. It’s common for a physical therapist to treat other common ailments like balance issues, headaches, pelvic pain, chronic pain, incontinence, and basic joint and muscle pain. They also work with clients
on injury prevention and athletic enhancement.
It’s going to hurt!
Physical therapists don’t subscribe to the philosophy of “no pain, no gain.” In fact, they’re specifically trained to work within your pain threshold to ensure your gains in movement and strength are safe and incremental.
Surgery and/or medication are better options.
Both have their place, but multiple studies have shown that physical therapy is more effective and safer than such common options as prescription painkillers and common surgeries for lumbar spinal stenosis, degenerative disk disease, and even meniscus tears.
PT is expensive.
Physical therapy is a real bargain when compared with surgery. But more than that, studies have shown that for the treatment of one of the most common ailments, non-specific back pain, patients can save up to 60 percent on their medical bills if they visit a physical therapist early in their treatment.
I can’t see a PT without a prescription or referral.
According to the APTA, this myth is shared by 70% of health care consumers. The truth is all 50 states allow patients to be evaluated by a PT without a physician referral, and all but Michigan allow some form of treatment or intervention without a referral or prescription.
To learn more about how physical therapy can benefit a particular ailment or condition, or for an injury, pain or movement evaluation, contact the physical therapy team at Buffalo Grove Physical Therapy & Sports Rehabilitation at (847) 520-3382.
The better your strength and range of motion are before orthopedic surgery (e.g., joint replacement surgery), the better off you’ll be after. That’s the philosophy behind prehabilitation, says physical therapist Gopal T. Raghunath, PT MS, DPT, CSCS, of Buffalo Grove Physical Therapy & Sports Rehabilitation, P.C.
“The aim of prehabilitation is to optimize an individual’s strength, mobility and overall functional capacity prior to an anticipated orthopedic procedure through a comprehensive, therapeutic exercise program,” Dr. Raghunath said. “This not only prepares the body for the stress of actual surgery, but also for the post-operative rehabilitation program to follow in an effort to maximize the success of the patient’s recovery.”
Researchers have supported this claim. A study published in the October 2014 edition of the Journal of Bone & Joint Surgery determined that physical therapy before joint replacement surgery – a prehabilitation program – can reduce the need for post-operative care by nearly 30 percent, saving the patient both time and money.
The American Academy of Orthopedic Surgeons (AAOS) states that approximately 700,000 total knee replacement and 300,000 total hip replacement surgeries are performed each year in the U.S.
“When an individual has reached the point where he or she needs joint replacement surgery, their body compensates in direct relation to his or her impairments,” Dr. Raghunath said. “Moreover, these dysfunctional patterns can have a snowball effect on the entire system, resulting in whole-body weakness and poor mobility, all of which can and should be addressed through prehabilitation.”
According to Dr. Raghunath, an effective prehabilitation program consists of therapeutic exercise that includes cardiorespiratory conditioning as well as progressive resistance and flexibility training, all with an emphasis on replicating daily functional tasks. The goal is to help the patient combat the effects of inactivity.
Additionally, prehabilitation provides physical therapists the opportunity to prepare patients mentally and emotionally for their surgery and postoperative rehab, educating them about what to expect immediately after the procedure and coaching them on exercises they will need to know during post-operative rehabilitation.
“Patients often approach the unknown journey toward surgery and post-surgery with a certain level of anxiety, understandably so,” said Dr. Raghunath. “Fortunately, educating patients through our knowledge is one of our strengths as clinicians, which in turn helps alleviate this anxiety.”
Dr. Raghunath says that in order to optimize the benefits of prehabilitation, the program should include two to three sessions per week beginning six to eight weeks before surgery. To learn more about the benefits of prehabilitation, those facing the potential for joint replacement should consult their physicians as well as their physical therapist.
Those who experience back, hip, and knee pain while walking, running, working, or exercising may find that the source of their discomfort resides much lower in their bodies – perhaps in their feet, said Gopal T. Raghunath, PT MS, DPT, CSCS, owner/clinic director of Buffalo Grove Physical Therapy & Sports Rehabilitation, P.C.
Made up of 26 bones, 33 joints and more than 100 muscles, tendons and ligaments, the feet are complex structures designed for shock absorption and propulsion. Any functional deficiencies within the feet can negatively affect muscles and joints up through the legs and into the back.
“Pain in the spine, hips, and knees can often be caused by an ailment in the foot, resulting in gait abnormalities,” said Dr. Raghunath. “When dealing with such issues, you have to take into consideration the entire kinetic chain, from the feet up through the body. Assessing how your body moves globally, starting with the feet, is often key in identifying the underlying causes of pain and dysfunction in other parts of the body.”
Such assessments may find your feet to be the cause of these dysfunctions, or they may determine your feet are innocent bystanders (so to speak) in a more complex chain of movement-related deficiencies.
For instance, an improper step brought on by issues in strength, balance, flexibility, gait or improper footwear, Dr. Raghunath said, can lead to painful foot conditions such as plantar fasciitis, Achilles tendonitis and bunions, to name just a few. Such conditions, along with the issues that caused them, can justifiably create back, hip, and knee problems.
“It’s common to take our feet for granted – that is, until they start to hurt,” Dr. Raghunath said. “It’s at this point when the rest of our bodies are most susceptible to injury because, to compensate for the pain and possibly a lack of flexibility or proper movement, more of the impact and stress normally absorbed by the feet is transferred up throughout our kinetic chain.”
Dr. Raghunath suggests stopping such potential chain reactions, before a chronic condition is manifested. As a physical therapist, he is able to analyze a person’s foot type and gait, then suggest footwear specifically designed for the shape of his or her feet. Physical therapists are also trained to identify deficiencies in strength, flexibility, balance and musculoskeletal makeup that may affect the feet.
“By achieving the right balance between flexibility and strength, plus wearing shoes that are appropriate for your foot type, your feet will feel great,” Dr. Raghunath said. “And of course, the rest of your body will benefit, as well.”
In light of the Centers for Disease Control & Prevention’s (CDC) mid-March release of new guidelines questioning the safety and effectiveness of subscription opioid use for the treatment of chronic pain, Buffalo Grove physical therapist Gopal T. Raghunath, PT MS, DPT, CSCS points out that physical therapy has long been considered a safer, cheaper and more effective treatment for such conditions.
In fact, the CDC report itself lists physical therapy and exercise as options for managing chronic pain that “may actually work better” than oft abused opiate painkillers like Vicodin and OxyContin – and with fewer risks and side effects.
“Given the potential harmful long-term side effects of opiates, I would certainly prefer progressive exercise and movement therapy,” said Dr.
Raghunath, owner and clinical director of Buffalo Grove Physical Therapy & Sports Rehabilitation, P.C. “Exercise, when prescribed in appropriate therapeutic doses, not only helps improve strength, flexibility and cardiorespiratory endurance, but also stimulates endorphin production to bring about feelings of well-bearing and reduce pain, thereby making it ‘wonder drug’ itself.”
An often debilitating condition that can lead to fatigue, depression and anxiety, chronic pain is defined as persistent pain that continues for months – even years.
The country’s top federal health agency, the CDC established its new guidelines based on research and trends that suggest the risk of opiate drugs far outweigh the benefits in most people. Such drugs are addicting and often overused and abused, stated the CDC, contributing to the death of nearly 20,000 Americans in 2014 alone.
“We know of no other medication routinely used for a nonfatal condition that kills patients so frequently,” said CDC Director Thomas Friedman in a recent USA Today article. “We hope to see fewer deaths from opiates. That’s the bottom line.”
In contrast, several studies over the years points to movement, exercise and individualized physical therapy as effective options for treating chronic pain. A report about chronic pain released by the National Institutes of Health in January of 2015, in fact, specifically mentions physical therapy as a key, non-pharmaceutical option for treating, managing and even ending chronic pain.
“Despite what is commonly done in current clinical practice, there appear to be few data to support the long-term use of opioids for chronic pain management,” states the report titled “The Role of Opioids in the Treatment of Chronic Pain.”
“Chronic pain can indeed be physically and emotionally depleting,” said Dr. Raghunath. “However, it can be treated safely and effectively with physical therapy. Regular exercise performed in appropriate increments is a lifestyle choice that empowers individuals to establish and maintain control of their health and their lives.”
From education, strength and flexibility training and manual therapy, to posture awareness and body mechanics instruction, physical therapists are licensed and trained to identify the causes of chronic pain, then establish an individualized treatment plan for alleviating and possibly eliminating the pain.