It’s common to think physical therapy is only for post-operative rehabilitation. The truth is, “probably greater than half of our therapy patients haven’t even had surgery,” says Dr. Peter Theut of the OAM Total Joint Center. “Sometimes, just what patients need is physical therapy.” The ultimate goal of physical therapy is to restore normal, pain-free function — that is, to restore an injured joint’s range of motion and strength. But remember, joint strength is not synonymous with major muscle strength. “People think because they’re active, they don’t need physical therapy. When in fact, it’s quite different,” says Dr. Theut. “You may be strong, but you could be doing activities that place a lot of strain on your joints and muscles, causing pain.” Strengthening the muscles around joints is far more specialized than lifting weights. Depending on the injury, physical therapists may manually manipulate the joint or use various modalities — or methods of treatment — to strengthen muscles, relieve pain or diminish swelling. Here are common modalities used:
Ultrasounds – Ultrasonic waves, administered directly on the skin, help to increase blood flow and reduce pain from swelling.
Heat/cold packs – Heat increases range of motion by loosening up a joint. Cold is used to diminish swelling and pain.
Traction – Often used for back and spine problems; the traction method stretches the spine and takes pressure off the nerve.
Lontophoresis/phonophoresis – Iontophoresis is when a topical steroid (anti-inflammatory) cream is applied to the skin with a low-level electrical current to drive in the cream. Phonophoresis is the same technique, using ultrasonic waves instead. As a shoulder and knee specialist, Dr. Theut’s patients almost always require physical therapy after surgery. “Within the realm of shoulder problems, therapy is very, very important,” he says. Going without therapy — especially post-op — is a vicious, worsening cycle downward. “What typically happens is the shoulder becomes stiff. Because it’s stiff, it becomes painful. Because it’s painful, people don’t like to move the shoulder, which makes it stiffer,” says Dr. Theut. “A therapist can be absolutely essential in preventing, or if it’s already occurred, treating the pain and stiffness.” After 2–3 months of physical therapy with OAM, patients may be transferred for treatment at the OAM Work Center where they will undergo specialized preparation for returning to work. “The goal is to get them back to work without restriction. The Work Center team evaluates exactly what motions the patients need to do at work and literally mimics them in therapy,” Dr. Theut explains. “The patient is monitored in a safe setting until they can return to work safely.” As a surgeon, Dr. Theut entrusts his patients regularly and undoubtedly to the OAM physical therapists. “Whether working on a shoulder, hip, knee, or hand, I have 100% faith in all of our therapists. They’re trained superbly and very skilled in restoring function.”