Myths and Misconceptions about physical therapy, from a physical therapist

Going to physical therapy, whether you were referred by your doctor or chose to self-refer, is becoming more and more common. The awareness that physical therapy can help a wide range of orthopedic and neurological conditions is increasing among physicians and the general public. Which is great! However, everyone seems to have different perceptions and expectations for going to physical therapy (PT). PT can help with many different conditions. But after spending seven years in the field, I have a few takeaways about the myths of going to physical therapy.

1. Physical therapy -> pain

You can be referred to PT for many different reasons, but a physical therapist’s goal is never to cause pain. Sure, pain and discomfort are common because even stretching without injury can be considered painful and uncomfortable. The only time a PT is looking to cause pain should be during the initial evaluation, when it is often necessary to re-create pain to determine the cause. A good physical therapist will monitor your pain during treatment, with the end goal of reducing your pain. Always be communicating with your PT about what you are feeling. 

2. “No pain, no gain”

I heard this ALL THE TIME, especially when I worked in outpatient orthopedics. And I was never the one to say it. This came from patients. The “no pain, no gain” concept is very situational. If you are recovering from a surgery, like a total knee replacement, then there is some truth to this because a physical therapist has to push and pull on that knee to ensure that you regain mobility and can walk normally. But if you are recovering from some other type of injury, like an ankle sprain or shoulder impingement, pushing through pain is not the goal. 

3. A physical therapist will keep me from doing my favorite activities

NO! A physical therapist’s goal is to get you back to doing your favorite activities. A good PT will incorporate your hobbies and favorite activities into your treatment plan, providing education on form and incorporating strengthening/stretching that directly relates to your goals. And if your physical therapist didn't ask what you want to get back to doing, TELL THEM!

4. Physical therapy is for people in pain

While pain is one of the most common reasons people get referred to PT, it's not the only reason. I have been sent patients for just generalized strengthening or balance who have no pain. And one condition many people don't know that PTs can treat: vertigo! No pain there (unless you count the potential nausea that can come with the dizziness)

5. You need a doctor to refer you to PT

Not anymore! Check with your insurance, but self-referral is becoming more common. Certain insurance, like medicare, require an physician referral but many other insurance plans offer self-referral to PT but will only authorize a certain number of visits. Insurance may require you to see a physician if you want more visits beyond what they initially approve (they make the assumption that PT may not be helping you so they want you to see a physician to get checked out before they decide to just keep paying for more PT).

6. Physical therapists just give massages

This one hurts. If PT were just about giving a massage, then there would be no PT profession, and we’d all be massage therapists. While some soft tissue mobilization (aka massage) may be incorporated into some treatment plans, it is entirely dependent on the condition. Have trigger points all over your back? Yes, I’m going to rub and dig on those and then guide you through stretches and strengthening for the area. Have a painful shoulder from repetitive lifting? I’m going to focus more on mobility, strengthening and stabilization. 

7. Physical therapy is for athletes/post-surgery

PT is for ANYTHING! I’ve treated people for vertigo, weakness, balance, pain, post-op, and the list goes on. I’ve also treated people from ages 8 years old to 100. PT is for anyone.