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Do The Work: Why Physical Therapy Is Important

By Mary Wolf Detwiler | Courtesy Photo

Each year, millions of people utilize physical therapy services. So we sat down with Chad Garvey, clinic director for KORT Louisville Downtown, to ask him why it’s so important.

Extol Magazine: How long have you been studying physical therapy?

Chad Garvey: I’ve been a formal, licensed physical therapist for 17 years, but studying technically close to 20.

Extol: In your estimation, what are the top reasons patients end up in physical therapy?

Garvey: The biggest reason … is due to pain. That pain can come from a variety of reasons or a variety of circumstances, some of which being post-operative, some being sports injuries or some being pain that’s just developed over time for no reason whatsoever. That’s one of the reasons why we have to spend as much time evaluating and educating and training the patient as we do.

Extol: What is the average length of treatment for a sports-related strain or injury?

Garvey: There are a lot of variants in there. Typically, most sessions of treatment of physical therapy will last anywhere from five to 10 sessions.

Extol: What is the No. 1 mistake patients make when it comes to physical therapy?

Garvey: I would say not enough follow up. Our job is to try to make the patient as independent as possible (and) as self-reliant as possible. When you’re dealing with an injury or when you’re sick – sick from an injury or sick from a flu – it’s really difficult to completely recover with one visit or two visits. I would say that’s true even with your doctor in some respects. Doing some sort of follow-up with a physical therapist is where the mistakes are made. Some people will go to their physical therapist two to three times a week, but some people don’t need that. They may only need once every other week. It still goes back to having a follow-up (plan) to ensure the understanding of treatment and the condition, how to progress their condition and build a treatment plan. As we all do, we run into hiccups and roadblocks. Having someone to come back to help clear that situation up is really where the value comes in, having the physical therapist as a consult for you physically.

Extol: Why do you believe physical therapy is a misunderstood but necessary treatment?

Garvey: A good physical therapist provides hands-on treatment. It does so many things to the system to help the brain and the body relearn how better move and how to safely move. A lot of reasons people come in for therapy is because of pain, and one of the things hands-on treatment does is that it helps mitigate pain and provide safety to the patient who is typically in pain to move, and how much to move. When I say ‘hands-on treatment’ (that includes) dry needling, massage or joint mobilization. That all provides safety to the brain and body and allows for a much easier
and/or smooth transition into a
physical activity program, which
is typically what the goal is. It’s to get people more physically active using their own brains (and) their own central nervous systems to see that activity as being safe. Our part is to help create the program that is not only safe for the brain but also safe for the body, not too much too fast.

Extol: A great part of your treatment plan revolves around pain education and learning from where pain originates. How has that education and understanding increased in the last five years?

Garvey: I think it’s changed in that we’re going through a revolution right now in the understanding of how the brain works from a global medicine prospective – not just physical therapy, but in other branches of medicine. We can look at it. We can study it. We’ve had theories for a long time that the brain really dictates how much pain a person is in, and how much pain a person experiences. Only recently have we been able to document that on things like functional MRI. What that does is put the onus more on the therapist and really any medical provider who does this to make sure that the messages that we send physically through physical activity match what the patient perceives and understands what the brain is experiencing, too. When you exercise, you’re also educating your brain on safety and filling it with good endorphins. It ensures that the messages match. That what we say matches what we do. Before, we’d just tell patients to work through the pain. But we know that’s not the case even in very high-level athletes and people who compete at the very highest level. It’s not necessarily their (physical) condition or the status of their tissues. It also has to do with them outside of training –how much sleep their getting, how much stress they’re under, what their social circumstances are like. All those conditions are profoundly impactful and only recently have we made a concerted effort to address those formally in the treatment session.

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