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  • Nicki Ferramosca

Physical Therapy Should Be Functional



“Physical Therapy isn’t hot packs and ultrasound.”


Have you been to physical therapy in the past? Did it leave you less than fulfilled and not feeling that much better? We hate to hear those stories but the truth is, not all physical therapy is created equal.


I was recently reminded of this when treating a new patient who was here visiting. I knew I would only get to see them for one visit but upon hearing their story, I knew I could help.


Here’s why!

This particular patient was suffering from an arthritic flare up of her knee. Her physical therapist in her home town spent a lot of time using heat and ice, and gentle exercises most of which were performed on the treatment table. My questions included things like, “How are you feeling about going up and down stairs?” “Do you do any stair training?” “Any exercises while standing?” “How is your balance?”


Physical therapy is not just about getting a person pain-free, it’s also about getting each person back to their functional and recreational activities in a safe manner. The problem with this patient's physical therapy is that it focused too much on making her feel better in the short-term and not preparing her for functional activities of her daily life. Physical therapy should focus on that functional training.


How do we do that?

First it takes a lot of questions about the patient’s goals. “What do you want to do in the future?” “What were you able to do before this recent injury/surgery/setback?” We start there so we can come up with a plan on how to get you moving correctly to achieve these goals.


Getting the patient up and moving for those specific activities is where those patients can really thrive! Feeling better in the short-term is part of it, but certainly not all of it. For this particular patient, having her perform some of these functional (i.e.standing) exercises made her also feel more confident that she could return to them at home. She was never going to get stronger doing straight leg raises on the table forever. Add resistance, work on balance, break down a movement into components. That's the way to true success in physical therapy. That’s what physical therapy should be all about!





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