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Physical Therapy Myth vs. Reality

By Kevin Dandy, PT, MPT, CMPT, CDN | November 17, 2021

  1. Patients need a doctor’s referral for physical therapy.

MYTH– Direct Access gives a PT 60 days to treat without a prescription.  At VTFC, we treat all body parts from head to toe.  We have the training to refer out to MD if a patient presents with any red flags (i.e. suspicion of cancer or fracture) or needs further work up.  If someone needs PT, the quicker we see them, the better their outcome is with less visits and a reduced financial impact to the patient.

  1. Physical Therapy is just exercises

MYTH–  At VTFC, it’s not! Manual manipulation, dry needling, modalities, aquatic treadmill – while functional exercise may be part of it, it’s lead by a licensed physical therapist in a 1:1 session. Each treatment session is dedicated to getting the patient better based on their goals and current abilities. 

  1. A tight muscle should be stretched.

 MYTH– Time and time again I see PTs outside of VTFC passively stretching a tight muscle.  This is an outdated technique that provides short-term relief at best and generally is counterproductive.  A “tight muscle” is typically a sign of a weak muscle, one that has been overused, and/or an area that the body is trying to limit motion as a protective mechanism.  The nervous system controls muscle tension and creates muscle “tightness” and can limit flexibility. The best way to improve flexibility is to strengthen with proper eccentric control through a full range.  For example using a deadlift to improve hamstring flexibility.  As with anything, treat the cause of pain, not the symptom.

  1. Pain equates to tissue damage.

MYTH/REALITY– Yes, after an acute injury pain does equate to soft tissue damage, but the body has great healing capacity and generally most injuries heal within 6-8 weeks typically. An example of this is when you roll your ankle, you injure the ligament and it hurts progressively less until it fully heals.  However, if pain lasts greater than 3 months it is considered chronic.  Current pain science explains that in absence of recurrent, or repetitive re-aggravation, the pain that you experience is likely no longer an indicator of any tissue damage, but rather a protective buffer mechanism from the nervous system.  Good PTs know that you have to educate patients on this process, help reduce fear of movement, get them to be more active, and build up strength.  The best way to get out of chronic pain is to gradually move towards the painful barrier with a tolerable progressive load over time.

  1. Patients with low back pain should avoid squatting and deadlifting.

MYTH – These are fundamental movements that are unavoidable in our daily lives! Getting in and out of a chair or off the commode = squat. Bending to pick up your keys off the floor or lifting a heavy box = deadlift. The problem lies within lack of proper preparation and incorrect biomechanics, not the movement itself. Not being prepared for the activity or doing them incorrectly is what can potentially harm the back. Doing them correctly is what provides strength, tolerance, and resilience for daily activities. 

About The Authors

Kevin Dandy, PT, MPT, CMPT, CDN

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