Why have physical therapy

5 answers | Last updated: Sep 14, 2017
A fellow caregiver asked...

I suffered a fractured shoulder and went through PT for awhile. It seemed as though the therapist was trying to advance me faster than my body was willing to go. I sustained severe pulled muscles in a knee due to accidentally twisting it as I did some of the therapy. I discontinued therapy and never made an additional progress in my recovery. Why didn't I improve as I returned to my normal activities?

Expert Answers

For 20 years, physical therapist Connie Lambert has worked with individuals and families with Alzheimer's disease and dementia. As founder and CEO of Our Generations, LLC, she provides specialized dementia and behavioral management training for corporations, facilities, and groups.

As with physicians, a physical therapist in bound by the axiom, "first do no harm". It appears you were treated in a less careful manner than you deserved. I am sorry for that and suggest the following:

  1. Return to your physician for a thorough assessment of your current situation. Make certain your knee problems are accurately diagnosed and get a definitive diagnosis regarding the current condition of your shoulder.

  2. Get a referral to a different and more experienced, orthopedic physical therapist.

  3. Make certain you explain your situation and past history to your new therapist. Explain that you want to be treated by the orthopedic therapist only, not rotating therapists and NOT by a physical therapist assistant. This is a critical point. Training standards for physical therapists have been significantly upgraded over the past ten years. In many states (and soon in all states) we are required to earn doctorates or PhDs in order to practice. Your situation is complex and you have every right to be treated by a therapist not an assistant, and by the same therapist, every time.

  4. Let your body be your guide when participating in therapy. The old adage "no pain, no gain" is foolish and usually leads to injury or re-injury.

  5. The shoulder is a very finicky joint. It tends to "lock up" and lose range of motion quite easily. This is called adhesive capsulitis and can be very difficult to treat. It requires significant therapy with a skilled therapist to regain use of the shoulder.

I wish you the very best and encourage you to search until find a skilled therapist that makes you feel comfortable.

Connie Lambert, PT, CCM, PhD

Community Answers

Nancy43 answered...

Thank you Connie for your comments. I had a physical therapist for all but one session and that one was with the assistant. The therapist said she had 3 years of education for the job. Is it normal for a therapist to start you on an exercise and then leave you while they start another person? I wondered how she was able to monitor each of us well enough to make sure we were doing the exercises properly. I've got a few medical tests to do and then once I'm cleared for these issues, I will return to the orthopedic surgeon for the shoulder and knee.

Dear Nancy,

Licensed physical therapist assistants, or PTAs have a minimum of a two year degree. As for licensed physical therapists, in the mid 1980's through early 1990's educational programs were transitioned from a bachelor's degree to a master's degree. Then in the early 2000's the programs were again, and still are, being transitioned to doctorate or PhD programs. I don't know of any therapist who has had less than a four year degree. And, any therapist with a four year degree would most likely have been working for 25 years or more.

It is not uncommon for a therapist to start you on an exercise then move to another patient while you are completing the exercise, as long as they are confident you are doing it correctly. If you are not confident then ask the therapist to remain with you until you are.

The outcome of your therapy depends a great deal on the skill of the therapist and your ability to work together. Also, a PhD behind the name does not necessarily make a better therapist. Often, experience is the better predictor of skill. Find an experienced, orthopedic therapist that makes you feel comfortable.

Best wishes for success, Connie Lambert, PT, CCM, PhD

Nancy43 answered...

Thank you for all the excellent information, Connie. I will make notes and use those when I seek a new therapist.

I am glad to be of help. Best of luck with your rehabililitation, Nancy.

Connie Lambert, PT,CCM, PhD