What should you expect at your first Physical Therapy visit?

A lot of people are nervous when they arrive at their first physical therapy session. You might have heard rumors about PT being "Pain and Torture" and have a false sense of what to expect. Here are some tips to make your first PT session go smoothly.

1.  Your first visit is the initial evaluation.  The therapist will talk to you about your symptoms, when they began, and how you are feeling now.  If you have had surgery, they will ask about your recovery so far.  At this visit, the therapist spends time getting to know you and your personal goals for recovery.  Take the time to talk about what you are feeling and what you would like to get back to doing. 

2.  Dress comfortably.  Wear clothes you can move around in without restriction.  If you are coming for knee pain, they will need to see your knee. Pants will be fine as long as you can pull them up and expose the knee.  For your shoulder, a short sleeve or sleeveless shirt should be fine.   If you are coming for your back or neck, loose and comfortable clothes might be fine or you might be asked to change into a gown.

3.  Remember, you are in control.  The therapist’s job is to evaluate your symptoms, develop a plan of care, and use the appropriate treatment techniques.  Treatment techniques can include manual therapy (using their hands to mobilize and stretch) and exercise therapy.  It is important to remember that you are in control.  Be sure to communicate what you are feeling and let your therapist know if an exercise is causing you pain.

Physical therapy is a collaborative effort between the therapist and the patient.  You will work together to set reasonable and personal goals so that you can get back to life with as little “Pain and Torture” as possible.

Cynthia York King, DPT

Physical Therapist

OrthoVirginia/West End Orthopaedic Clinic

Good Posture

Having good posture is one of those things that many people know they should focus on but few people do.  Simply put, posture is the way you hold your body in an upright position while you are sitting, standing, laying down, etc.  Having good posture is important even when you are perfectly healthy, but in patients that have pain from sitting or standing for too long, posture has an even greater impact.  Staying in a poor position stresses your muscles and can irritate muscles that are already tight or weak.

Consider your posture when you are sitting, particularly if you are at a desk or driving for much of the day.  Many people tend to slouch the longer they are sitting, which straightens the normal curves in the neck and back.  Sit with the shoulders straight and the head over your body.  You may need a roll at the curve of your back for proper back support and to avoid slouching.  Your knees should be bent, and your arms can rest comfortably on your desk or armrests at about a 90 degree angle.  Sit so that your feet can rest on the floor (or a stool if your chair is too tall for you).  When driving, you want to adjust the seat position in the car so that you are not leaning or reaching to use the wheel or pedals, but the knees can still bend comfortably.

Standing with upright posture can also require retraining your old habits.  If standing up straight is challenging for you, try standing with your back against a wall or a door, and try to let the back of your head, shoulders, and butt touch the wall.  If you need to stand for a long period of time, shifting your weight from one side to the other can help you tolerate standing with less discomfort.  Other suggestions to keep in mind include: not locking the knees when you stand, keeping the feet slightly apart, and keeping the chin tucked a little to keep the head level and avoid the head being too far forward on your body.

While most people will not be consciously aware of their posture while they are asleep, having good posture while lying down can make sleep more comfortable.  Use pillows or rolled up towels to position the body in as neutral a position as possible.  Support your neck and make sure your pillow is under your head and not your shoulders.  If lying on your side, folding a flat pillow between your knees or rolling a towel under your waist may allow the back and legs to remain in good alignment while you sleep.  Use a firm mattress for appropriate support, although the level of firmness that works best for you can change depending upon a person’s preference.

Even if your posture is perfect, you will need to change positions every so often.  The human body was not designed to sit or stand all day, but to keep moving.

“Posture for a Healthy Back.” http://my.clevelandclinic.org/healthy_living/back_health/hic_posture_for_a_healthy_back.aspx

 “Guidelines to Improve Posture.”   http://www.spine-health.com/wellness/ergonomics/guidelines-improve-posture

Alicia Dettmer, DPT