Every day we have patients come into the office with different diagnoses and impairments that impact their lives. Oftentimes, people come to us after being failed by many medical/health care professionals or after insurance stops covering care. These patients come to us frustrated and misinformed, thinking they will never fully recover. They believe that their treatment to this point has “helped,” but in reality, they are still in pain and not close to their functional goals.
The truth is, a majority of the time, when patients come to us in this position (with complaints of pain or dysfunction at a specific site on the body) things are not always what they seem. Almost every time we find that complaints of pain or dysfunction are only a symptom stemming and the actual root cause is usually stemming from above and/ or below the site of pain.
The most recent example that has come into the clinic is a patient who suffered from two tibial plateau fractures. Since his initial injury, he has seen a variety of doctors, has had two separate surgeries performed, and has been in physical therapy for more than12 months of combined treatment. Post-surgery rehab focused on improving the range of motion of the knee and restoring as much strength in the leg as possible. The care plan for treating a post-surgery tibial plateau fracture was seemingly correct…If the pain the patient was having was actually stemming from the fracture.
When this patient first came to us, he had maxed out all previous strength assessments (i.e., straight leg raise, leg press, and knee extensions) but struggled with basic tasks such as squatting, stair negotiation, and prolonged walking due to pain. The patient continued to struggle with pain in the knee daily. What this patient's previous therapists failed to realize was the pain at the knee and his continued struggle were stemming from nerves in his lower back.
We determined this by actually listening to the client's story and problems, which didn’t make sense for the pain coming from the knee. Following this up with a comprehensive assessment, we determined the root cause to be irritated nerves in the low back. We started treating the lower back by figuring out what that patient was sensitive to, which lead g to the knee pain disappearing. Squatting, walking, and negotiating stairs all improved, and the patient felt like he was finally making a breakthrough.
Although this patient did not get the full care he needed from his previous provider, this isn’t their fault. This is actually the sad reality of our healthcare system. As a patient, typically, your care is in the hands of insurance companies and healthcare providers that are not only overworked and burnt out but trained to treat symptoms and not the source. Typical physical therapy clinics require therapists to meet high productivity standards, meaning they are told to see each patient a certain number of times, regardless of what the patient actually needs, and that they have to see 2,3,4 or even more patients at once Most clinics and clinicians lack the time and the expertise to truly identify and treat the source of the problem rather than the symptoms, leading to poor results for patients, if any at all.
So, to take care of YOUR recovery, here are a couple tips for success:
Find a provider that works WITH you and understands your goals. Find someone who knows how to do a proper assessment. If they only look at your knee for knee pain, run the other way.
Make sure you understand what you’re sensitive to, your expectations for recovery, and the plan to reach your functional goals. Make sure you completely understand the game plan for your recovery and that it makes sense. Too many Physical Therapists just make up mumbo jumbo that you don’t understand because they don’t actually know or have a plan.
Constantly communicate and set performance goals that correlate with your long-term goal. The more you collaborate the better. This means your therapist needs time to spend with you, and you shouldn’t have to jump through hoops to communicate with them.
If you’re sick of getting the runaround and want to see if we might be a good fit, click here to schedule a free phone consultation with our team.