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Wondering what to expect from PT

MagsMMags Posts: 57
edited 06/11/2012 - 8:28 AM in Back Surgery and Neck Surgery
Hey everyone. I had a PLIF on Jan 29. I go back to my dr again on March 29 when he said he'll probably send me for PT provided everything still looks good. I know everone's experience's and dr's are different, but what should I expect from PT and are there questions I should ask at the initial visit? Thanks.


  • I was sent for a PT eval first, they spoke to me, checked my incision, I got a massage, she asked me what I have been doing, problems, etc.

    Then the actual first day of therapy we did a ton of leg stretches, hamstrings and calf, losem them up.

    I am on my 3rd week of therapy now and we are working on bending and still working on squats, leg stretches in general.
  • I would recommend that you do some research on the PT that has been recommended to you. Ask questions BEFORE your initial visit!!

    Physical therapists are not the same and you want to be sure you are going to someone with specific training and experience with spinal cases. I learned this through experience. It was not until I went to a clinic that only takes scoliosis and other back patients that I realized I had really wasted my time and money with the other two courses of therapy I had done with two other PTs.

    Do not just assume that your doctor knows the qualifications of the clinic or person he is recommending. Ask him some questions to determine if this is the case. Some really do little more than offer ultrasound, massage and exercises that anyone could find on the internet. If you can find a good one, it can make such a big difference in your recovery.
  • dilaurodilauro ConnecticutPosts: 9,856
    The Therapist
    It was mentioned by gweenie17, it is important to know the Physical Therapist and their facilities. If you have a doctor you totally trust they can be the best guide in this.
    I've been through many different Physical Therapy Rehab centers which were recommended by different doctors. The doctors would send me to a rehab center that they knew were qualified in handling the specifics in PT that the doctor is prescribing.
    Just like in any profession, there are good and there are bad. It is good to understand the center that you are going to . It is difficult however to make valid assumptions ahead of time.
    What I look for in a Therapist is someone that is an understanding person and is willing to get to know you and your problem. When I have gone to PT, I do want to make sure that I see the same therapist each time. I had a therapist that knew my body and problems almost better than I did. She would know some of my problems by just watch me walking into the center.

    The Treatments
    At your first visit to the therapy center, a therapist will do a complete evaluation of you condition, asking questions and doing clinical observations. That would include how you bend, how much you can turn, etc. They will also use some devices to measure your different range of motions.

    Your Progress
    In the first couple of sessions, you will probably not see any benefits and in fact you might get real sore. After the 4th or so session, you should then start to see benefits. Normally twice a week is what is prescribed.
    Onw thing to always keep in mind is knowing your own limitations. Most Physical Therapists are in good shape and have little physical medical problems. So at times, they might 'push' you a little too much.
    I am in all favor of passive physical therapy. That is the stretching, ice/heat treatments, ultrasound, massages, and even some very light exercises. But once those sessions
    become too much, that can cause new problems.

    Always make sure that IF you do experience problems, discuss this with your therapist and your doctor.

    Physical Therapy after surgeries or during flare ups is very valuable, but I also understand the limits to the sessions
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • You have all given me some good information to consider. Thanks. Ron, I do highly trust my dr and because he is so thorough and specific I just assumed he would send me to the center he would choose for himself. However, I will call tomorrow and find out if that is the case. How long does PT usually last for most people? 2 months maybe? Or does it just depend on how well you progress? I'm really looking forward to get started....am I going to regret that statement?!

    Ron...I enjoy all your different avatars.
  • Enjoy physical therapy, thats a new one :D

    My surgeon has his own therapy department at his officer, works out great, he keeps an eye on my progress and updates.

    It's him (spine surgeon) and a ortho surgeon. SO lots of necks, spinies and knees.

    It's also a good setup as if you have a problem the therapist can go grab a doc or PA. Yesterday I had trouble doing stretches as I sleep in a chair, and my legs have gotten very swollen, so while I did a step machine the therapist ran and got one of the PA's to come check me out.

    Not sure how yours is setup but to me its a plus plus.
  • I am on my 5th therapist in 3 years.

    I've found that different dr.'s (family practice, Physiotherapist, OS & NS) all have different opinions on who to send you to. This last time the NS just told me to find one.

    There is a LOT of difference in facilities and each place has given me different treatment. It's amazing, you would think there is a limit on what exercises a spiney can do, but no.

    In any case, the best I've found is a place that listens, has appropriate equipment (not just a tens unit, but a real e-stim machine - not just a heating pad, but the moist heat water tank thingy that keeps heat pads wet and hot) At this last place my therapist also uses Graston tools (for breaking up scar tissue) and a Laser machine to promote better healing.

    Also, appropriate exercise equipment:

    I have been told that hip abducter exercises are essential for a spiney (it's what stabilizes your gait) along with thigh, stomach and core muscle exercises.

    I have had places that had me just hold a chair back and use rubber bands - I'm sure that works ok, but I'm not that stable right now and the ability to SIT and do the exercises in a machine is a big bonus at my current place.

    Good Luck
  • One word of advise, when you make your appointment, ask for somebody who has lots of experiences with fusion patients, I thought this was very important.

    The most valuable part of PT to me was to learn to do everything I needed to do properly. The first time I saw her she asked me for a list for all activities I want to perform. During my subsequent sessions she thought me how to do everything, yes, including bending (with legs apart, knees bent and bending from the hip joint), gardening, picking up things from the floor and reaching something high. All very useful.

  • dilaurodilauro ConnecticutPosts: 9,856
    Physical Therapy.
    I can only stress how important it is to have a physical therapist that you can relate to and they to you.
    They need to understand your condition, where you were before, what happened (if there was) surgery and how you are progressing.
    A good Physical Therapist will spend the time getting to know not only your physical body and conditions, but you as an individual. I feel it is so important that once you start with a Physical Therapist you stay with that person during the time you are there. This way they can pick up on the little things, how you are walking, which way you turn you head, is a shoulder hiked or not, etc?
    In terms of the actual rehab center, that depends on how much you are going to do in PT. I am a firm believer in PT, but only to a certain point. Once they start getting into the semi-aggressive exercises on machines, etc, that is when I have always bowed out.
    With my experiences, I know when a therapist is trying to push too hard or when a particular treatment/exercise is going to do more harm than good.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Hi everyone. I want to make sure before I go back to my dr on the 30th and discuss PT that I have educated myself on the physical therapists in my area. I did call my dr to find out if he had someone in particular that he prefers and it doesn't seem that he does. So with that in mind what are some specific questions I should ask when I call around to the PT's in my area? Thanks!
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