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What If Physical Therapy was Preventative Instead of Reactive?

Without a second thought, we get our teeth cleaned 1-2 times a year. We visit our optometrist to check our vision and our primary care physician for the annual physical. While these appointments are typically a preventative “tune up”, an occasional procedure is required. Why do we make these appointments routine? To catch issues and address them before they become larger, and more severe (and expensive!) problems.


For decades, physical therapy has been seen as a reactive service. For example: Have a knee replacement, then go to physical therapy. Or you’ve been taking pain meds and neuromodulators for months, but that sciatica just won’t let up so you finally try physical therapy. Or you start to experience numbness + tingling in your hand, wait a few weeks to see your doctor who gives you an injection that helps for ~1-2 weeks, but symptoms return. So you go back to the doctor and they offer you the following options: surgery for carpal tunnel or try physical therapy. You’ve now had this annoying pain for over a month. You’re frustrated, don’t want to drop $4000 on a surgery, so you give PT a try. While physical therapy is helpful in the situations listed above, you don’t have to wait to see a physical therapist.


Physical Therapy can be helpful in avoiding the need for surgery, overuse of medications, and in reducing the amount of time it takes to recover from an injury, reduce risk of reinjury, saving money and improving quality of life. The American Physical Therapy Association has analyzed the cost savings in receiving physical therapy as a first line of treatment and found an average savings of $4,160 for acute low back pain. Savings increase to $13,981 for conservative management of knee osteoarthritis and $10,739 for tennis elbow.

I may be biased, but if PT is going to save me time and money, get me back to my daily activities without limitations, and help me avoid surgery + medications, then I want to try this conservative option FIRST, not as a last resort!


Infographic explaining large savings of money when choosing physical therapy for tennis elbow
Save $10,000 by choosing physical therapy

Additionally, physical therapy can result in further health benefits by increasing activity tolerance to reduce symptoms of chronic disease and prevent noncommunicable diseases (ie: diabetes, cardiovascular disease, rheumatoid arthritis, osteopenia/osteoporosis, hypertension, sarcopenia, depression, + more!)...Side note: check out this recent review on the benefits of physical activity on depression, anxiety, and distress. Exercise truly is medicine!


But let’s take this one step further…Imagine a world in which you had a preventative physical therapy session once or twice a year. A session where you mention to your physical therapist how your neck has been sore recently and you’re unsure as to why you’ve had an increased frequency of headaches. You’re therapist completes a quick assessment, provides education on optimizing your work desk set up, suggests a few exercises that address your symptoms and the issue subsides…without you ever having to set up an appointment with your doctor, try various medical interventions and then probably end up in PT once the issue has impacted your sleep, work and ability to play with your children.


You also mention that you’ve been having some knee pain when squatting. You’re still working out, but it’s concerning and stopping you from increasing your resistance. The therapist observes your squat form and assesses your hip/knee/ankle range of motion and strength to understand compensations your body may be using. They provide you some mobility exercises to perform prior to squatting and your knee pain resolves. You’ve now avoided injury, avoided a regression in your physical activity levels, and avoided racking up unnecessary medical bills.


Sports Rehab to improve squatting without pain
Squat assessment and technique critique

Imagine if that back ache was addressed before it turned into pain with every movement. Or that ankle you rolled a few weeks back was strengthened so your risk of reinjury decreases. What if every woman was assessed by a pelvic floor therapist after having a baby so that urinary incontinence was no longer viewed by society as a “normal” issue! These examples are truly endless.


There are a few limitations to this dream…the first being restrictions set by insurance companies. If you walk into an outpatient, insurance based physical therapy clinic and say “I would like to have a preventative assessment and treatment session today”, you’re going to have a tough time getting insurance to cover costs of that appointment and I guarantee you the therapist will try to convince you that you need 2-3 visits per week for the next 6-8 weeks. There’s minimal flexibility in a patient’s treatment due to the justification of treatment the therapist has to provide to the insurance company. Additionally, you will have a copay to cover and if you have not yet met your annual deductible, you can plan to receive a bill weeks later that may range anywhere from $1800-2500 (dependent on your insurance coverage).


This is where a cash-based physical therapy service is of benefit. Not only can a cash-based PT treat you for the full duration of injury recovery, but we are able to offer flexible, preventative care and treat multiple body regions, without the need for a prescription. You may pay a little more out-of-pocket costs upfront, but pricing is transparent. The time and overall costs will save you in the long run.


Legislation continues to change, but so far 20 states in the United States allow for direct access, meaning you do not need a prescription from a physician to receive treatment from a licensed physical therapist. Check out if your state has direct access here. For my fellow Tennesseans, I’ll save you the hassle of looking it up. Tennessee is a direct access state (wahoo!).


So I encourage you to take a proactive approach. Choose PT first for those musculoskeletal issues, and don’t wait until the issue becomes a larger problem. If you are unsure if PT is appropriate for you or are ready to take control of your issue, please reach out here and we can guide you on the next appropriate steps!


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