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Is that surgery necessary? Is it even effective?

Recent research is showing that surgery might not be needed as often as we think. A large review estimates that 10% to 20% of surgeries might be unnecessary and that in some specialties such as cardiology and orthopedics, that number might be higher. The reasons for so many unneeded surgeries being performed are varied, but the most common are that more conservative options aren’t tried first, or lack of knowledge by the operating physician. 

Physicians undergo long and rigorous training programs to become surgeons, but if they don’t work hard to keep learning, their knowledge often stops growing when they leave residency. Recent research is showing that certain common surgeries aren’t any better than a placebo. Two such examples are kyphoplasty – a procedure for spinal compression fractures, and partial meniscectomy – a procedure used to treat tears of the meniscus in the knee. If a surgeon hasn’t continued to learn, they won’t know that these surgeries often don’t offer any more benefit than a non-surgical treatment and will continue to perform them. 

Every surgery, even “minor” ones carry risks. These include complications from anesthesia, blood clots after surgery, delayed healing of the incision, infection, and unintended damage to nerves or other organs near the surgical site. Some of these risks cause discomfort for a period after surgery and go away, but others can result in permanent disability or even death. For some patients and conditions, surgery is a great treatment option, but with all the associated risks, when surgery can be avoided, it should be. 

For musculoskeletal problems like back and joint pain, sprains, and strains, seeing your PT before a surgeon can help keep you out of the operating room and get you back to life without surgery. Studies have shown that physical therapy is just as good if not better than surgery for a multitude of conditions and carries less risk. Some examples would include rotator cuff tears, meniscal tears, spinal stenosis, low back pain, and osteoarthritis. 

Physical therapy can’t fix every problem, and for some patients surgery is the best choice. However, research is showing that surgery isn’t a cure-all, and is sometimes just a very expensive and risky placebo. In most cases, starting with physical therapy is the right choice, and for many patients, PT is the only treatment necessary.

Data and commentary compiled from The Private Practice Section of the American Physical Therapy Association. 

What If We Told You That Not All Physical Therapy is Created Equal?

Setting: Orthopedic MD office.  You have just had an x-ray that came back clear (no breaks, hallelujah), medicine hasn’t helped the pain, and the MD enters the room:

MD:  Hi (insert your name here), everything looks clear on the x-ray and you still have pain so I think it might be time to try some therapy to see if we can get you better.

You: Ok, we can try

MD: Great.  I’m going to get you set up with the clinic across the hall.  I’ll send the referral over.  They use the same computer system and can talk to me anytime.

You: Alright.

*TIME OUT* Did you see what just happened?  I would guess most of you didn’t. What just happened is that the MD referred you to a clinic that they might have ownership,instead of suggest PT anywhere of your choosing.  Unsure how that matters?  A study1 assessed 3,771 patients with total knee replacements and the outcomes of therapy. Individuals that attended therapy at a clinic owned by physicians on average attended twice as many visits (approx. 8 more) and tended to receive less intense and specific treatment.  How does saving time and $320 sound? (based off $40/visit copay). Pretty good right?  Perhaps that referral isn’t based off care but based off self interest? I’m not saying but I’m just saying.

Bonus Riddle:  We’ve heard so many individuals voice their concern regarding visits to see their physician in which they actually see the PA. “I want to see the surgeon.” “I’m paying for the MD, not the PA.”  Common things I hear from patients in the clinic, as well as just in discussion with people.  It might be the most common thing after “is popping ok?”  So if it seems to be common thread that people want to see the MD and not the PA, why do people seem to constantly go along with therapy services in which they see commonly 5 different clinicians (PTs, PTAs, Athletic Trainers) in 6 visits?  Perhaps the thought is “that is just how it is” and the idea is that you just can’t do anything about it.

I’m here with great news! The grass is greener on the other side. While many clinics may have this scenario, there is something better.  At Greensboro Physical Therapy,we strive to bring you in with the same Doctor of Physical Therapy and keep you with them during your entire treatment.  We want to be your DPT for life!  We pride ourselves in getting to know you, your goals, your worries and more.  This you-centered focus allows us to get you where you need to be (apparently faster and better per research).

So if you’ve had that conveyor belt, bouncing around experience before and want something more, Greensboro Physical Therapy waits for you.   You have a choice, we hope you choose us.

1 Use of Physical Therapy Following Total Knee Replacement Surgery: Implications of Orthopedic Surgeons’ Ownership of Physical Therapy Services Jean M. Mitchell Ph.D. James D. Reschovsky Ph.D. Elizabeth Anne Reicherter P.T., D.P.T., Ph.D.

Want to Start a New Activity? Have Movement Goals? Here’s How Greensboro Physical Therapy Can Help.

When companies that operate in big industries like financial services and pharmaceuticals want to update their business models, streamline their market approach or launch a new commercial product, they often turn to the expertise of consultants. These experts have vast knowledge to help companies solve problems and achieve their goals. Did you know there’s such an expert that can help you manage pain, reach your fitness goals and prepare to try a new activity safely?

Meet us, the Doctors of Physical Therapy, the DPTs (sounds like a new Marvel Netflix series of heroes).  Think of your DPT as a movement consultant, trained to help you build the strength, endurance and flexibility needed to attain your goals. A common misconception is that DPTs are only trained to help clients improve their performance in the sports and leisure activities that they already participate in. But wait, there’s more: DPTs can educate clients who are interested in pursuing activities that they’ve never tried before, too. Let’s say you’ve always been a casual bike rider but want to train to run a 5K road race, where do you start?

At Greensboro Physical Therapy, our DPTs have the right training  and background to help you reach new goals.  Here are three ways to maximize your rehab sessions:

1. Know what you’re aiming for. Having a clear idea of your goal or goals—before going to that first PT appointment—will ensure that you can communicate exactly what you’re looking to achieve. Take the time to jot down some ideas for the future as well as goals you’ve attained in the past so you can jump start the conversation with your DPT.

2. Listen to your limitations—and your DPT. Of equal importance to communicating your wants and needs is taking the time to listen closely to what we might say.  We work hard and trained specifically to assess your body’s signals and then use that information to identify injuries in the making and uncover weaknesses and limitations that could prevent you from reaching your goals.

3. Be prepared to take it one step at a time. Our DPTs will work with you to establish an appropriate timeline to achieving your goals. For example, it’s unlikely that you’ll be ready to keep up with your best friend and avid runner at the town 5K the following weekend. However, your DPT can help modify your approach so you can still participate, even if you aren’t ready to run the entire distance.

These three steps will help your DPT design a customized exercise program that suits all of your needs and gets you to the finish line quickly—and safely.

RunTheBoro 2019 PSA

So spring is here, as well as everything that comes with it – warmer temps, rain, pollen, rain, short sleeves, rain, pollen…  While we can do with a little less of some along the way, it usually means more activity, getting outdoors and having some fun!  Know something else that comes with spring?  Runnerdude’s RunTheBoro

What is This RunTheBoro Thing?  Good question, thanks for asking.  RunTheBoro, now in its 4th year (the brainchild of Thad McLaurin, aka RunnerDude), is a series of FREE group runs every Saturday in May and June, starting this year on May 4th (and May the Fourth be with you).  Each Saturday at 7 am, a group of your closest friends and soon to be running buddies take off in groups, or gaggles, of runners with Pace Leaders from 8 mins/mile to walking.  There are two routes, the feature 8-10 mile route, a shorter 4-5 mile route.  The Pace Leaders take you on the route through various historically significant and often new to you neighborhoods throughout Greens”boro”.  Directions are provided for the runs, as well as water at halfway and finish.  Want to have more fun? Remember it’s not a race.  Sign up and read the weekly newsletter to learn about the path of history you will complete that coming Saturday.  Last year’s final run had over 330 people!  In addition, some cool SWAG can be earned for repeated attendance, as well as shirt/magnets and more available for purchase to commemorate your experience.  Donations are also accepted for the Greenway Water Fund.  If you’ve ever seen those coolers on the A&Y Greenway, that’s because of RunnerDude and the Greenway Fund!

So Why Should You Participate? We could run through the health specifics regarding walking/running and improved cardiovascular function, etc etc etc, but most of us know that exercise is usually a good thing for health.  How about the why RunTheBoro vs. a walk down your street, as told in quotable quotes? 

“Variety is the spice of life” – some guy in some poem in the 1700s.  I like to think he was talking to us that run/walk day after day the same route in our neighborhood.  RunTheBoro is a great opportunity to get out and see areas of our city that we might have never been.  Maybe we drove through it once but we were in a car and late for work and didn’t even see that cool house where an episode of Hoarders was filmed.

“The greatness of a community is most accurately measured by the compassionate actions of its members.” – Coretta Scott King.  With 200-300 plus members hanging out together, you are bound to find a new friend or old friend in the pod of 15-30 that you run/walk with that day.  Personally, I have found a great running coach/friend and some really good friends along the way.  The compassion of those in the running community is stellar – come out and you’ll see. 

“Why the heck not?” -quote it!

So in summary – variety, community, why the heck not?  If you like to walk/run, are free on a Saturday (or all Saturdays) in May and June, come on out.  Check the RunTheBoro website for start locations, sign up for the newsletter and come out and experience greatness with the rest of us.  You never know who you’ll see/meet. 

Greensboro Physical Therapy is proud to be a small part of helping make this shindig happen.

The No. 1 Thing You Can Do to Improve Your Physical Therapy Experience

Dealing with the pain and limited mobility associated with an injury or illness can be stressful for so many reasons. You might have questions like, “How long will I be sidelined?” and “What do I need to do to get better?” Or maybe you’re worried about how you’ll pick your children up from school, walk to the train for your commute or prepare meals for your family.

These are all perfectly normal concerns. Luckily, there are some ways that you can gain control over the situation and ensure that you return to the activities you care most about—especially if physical therapy is part of your plan.

What can you do before your very first appointment—and during physical therapy—to take control of that injury-related stress? First and foremost, it’s important to come prepared for physical therapy. And no, I’m not talking about dressing appropriately and arriving on time (or even better, 15 minutes ahead of your scheduled appointment). That stuff is important, of course, but there’s one thing you can do in the days leading up to your appointment that will set you up for success.

Any guesses? I’m talking about starting a list. What kind of list? Well, every time that you feel pain in the affected area or notice an activity that is harder than it was pre-injury, add it to the list! And the more specific you are, the better. Here’s an example to help drive this point home: Let’s say that you’re recovering from a moderate meniscus tear and you have an appointment with your physical therapist in three days. Take notes on how your knee feels first thing in the morning after you’ve been off your feet. How does your knee react when you stand up from a chair—does it feel unstable? Or do you find that you need to clutch the back of the couch on your way to the bathroom? Sharing each of these details helps your physical therapist understand your limitations beyond the injury printed on your intake form.

Now let’s take that list a step farther and add some details about the activities that you typically participate in on a regular basis. Let’s say that you normally play a weekly round of golf, spend your mornings weeding your garden or meet up with friends for a four-mile walk two evenings a week. These activities have become an important part of your life so let’s make sure that they’refactored into your list, perhaps in the “what you hope to get out of physical therapy” category. Painting a clear picture of how active you are—and what types of activities and sports you participate in—can help your physical therapist design an individualized treatment plan and to better help you on your road to recovery.

So we know what the #1 thing you can do to improve your PT experience, but you have to call to schedule to start your PT experience.  Remember, no referral needed (unless directed by your insurance policy).