Physical Therapy Facilities: Physical Therapy With the Patient in Mind

can be very beneficial in the treatment of a variety of musculoskeletal disorders. Unfortunately it can also cause further injury or a delay in healing when the therapy is applied to according to a preconceived protocol rather than taking the patient’s individual circumstances into consideration.

While this may seem obvious that different patients may have different treatment needs, experience has shown that some physical therapy clinics utilize a “one-size-fits-all” approach to therapy. This approach appears to be especially common in larger physical therapy facilities in which a large part of the treatment is administered by assistants rather than by actual physical therapists.

A physical therapy assistant may not always have the training and experience to know when the usual treatment protocol is not appropriate for a given patient. This leads to the situation in which patients are put through therapies that not only fail to bring improvement, but can actually delay recovery and even cause further injury.

For instance, I had the occasion to treat a gentleman who presented with severe low back pain and sciatica who had been having physical therapy at a nearby facility. This patient had been diagnosed as having a ruptured disc in his lumbar spine and he could barely walk. The physical therapy assistants had been using the standard low back pain protocol used at the facility.

Unfortunately, their standard back pain protocol was completely inappropriate for a person with a ruptured disc. They were actually having this man do resistance training, despite the fact that he was literally screaming out in pain! Trying to be a compliant patient, he was actually attempting to do the weight-lifting they were asking him to do, and nobody seemed to be able to figure out (or perhaps simply didn’t care) why he was getting worse!

A good physical therapist will always consider the patient’s unique circumstances and develop a treatment program that is designed specifically for that patient. While general protocols can be helpful, strict adherence to a pre-set protocol is not always in the best interests of the patient.

In addition, while a physical therapist may delegate some treatment duties to assistants, the therapist must be sure that the assistants are properly trained and that the assistants maintain good communication with the patient and the physical therapist so that treatment can be adjusted if the need arises.

Dr. George Best is a chiropractor who works closely with physical therapists in the San Antonio, Texas area. The San Antonio Physical Therapy clinics he works with provide close personal supervision by experienced physical therapists.

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