|By kenr |
Jan 22, 2014
For sure (like any other profession) some Physical Therapists are much better than others. I'd suggest ... try a first session with more than one.
. (unfortunately the best PT I found for elbow is just a little too far to visit more than once from Queens).
A few non-expert thoughts ...
(a) If you're good at modifying/constructing mechanical devices (and purchasing basic parts for them ... foam pads, weights, pulleys, elastic and non-elastic cords, bars -- then you likely can do lots of the exercises at home.
So then you're free to choose a PT who's most expert about your injury and your recovery style, rather than one who is close enough for you to visit 3 times a week.
(b) sometimes the PT (or MD) will give over-conservative guidelines because they are afraid of getting sued.
- because you will be performing exercises at home outside their supervision, so they're afraid you might mis-perform and injure yourself worse.
- also sometimes the PT is constrained by limitations in the prescription from the MD.
- especially they are afraid to put some things in writing.
- maybe after several sessions, an experienced PT might give you some verbal hints.
- Another reason some PT rehab guidelines might be conservative is ...
(Z) For many injuries and many important questions you have about the best PT rehab strategy ...
choosing the best PT professional is not critical, because ...
No one really knows the answer.
. . ("really knows" in the sense that there is well-controlled scientific study that addresses the question).
(c) scientific study to compare rehab strategies is tricky, because ...
- accurately measuring soft tissue injuries is tricky -- and there's a range of severity.
- the anatomical structure of the arm varies among different humans.
- athletic people might have developed some key aspects of their anatomy more or different from others.
- some people (especially busy people with full-time jobs) might not be interested enduring the hassles of participating in a well-controlled study.
- So it takes serious work to assemble a population of patients with similar injury severity and anatomy and athleticism (and compliance).
- Then there's a fundamental conflict between getting a large enough population count to achieve statistical signifcance - versus - a population with similar basic characteristics.
- Therefore it might not be straightforward to find a published PT rehab study which is both statistically significant _and_ specifically relevant to your key characteristics.
(d) much of the rehab exercises are more under control of the patient, not the therapist -- so "compliance" is a big concern . . .
- so the quality of performance of a rehab strategy varies widely -- or it is expensive to monitor it closely.
- (? key part of succeeding in PT as a business is herding numbers of unmotivated patients thru a rehab program, week after week ?).
- successful rehab strategies can take a long time, so monitoring compliance gets even more expensive.
- then actually comparing two strategies is almost twice as expensive as that.
(e) payback? -- There's not mucy monetary reward for demonstrating that one PT rehab method is better than another. Unlike discovering a new drug, or patenting a new medical device.
- anyway many patients are not sufficiently motivated (? or competent ?) to comply well with a better strategy even if were proven.
- Therefore, there is not sufficient funding or high motivation for researchers to perform careful well-controlled scientific studies for your characteristics and your injury.
(z) Conclusion: For many injuries and many important questions you have about the best PT rehab strategy ...
No one really knows the answer.
So ... check lots of sources ... keep monitoring your progress ... measure as best you can ... re-asking the questions.
And don't injure yourself further. Because in many cases your body will somehow heal itself without your mind knowing the right strategy.