Transcription:
The Benefits of Physical Therapy

Caitlin Whyte: You're listening to Children's Health Checkup. I'm your host, Caitlin Whyte. And today we're talking about physical therapy, how it benefits athletes and what to expect. Joining us is our expert, Stephan LaPlante. He is a team lead Physical Therapist at the Children's Health Andrews Institute for Orthopedics and Sports Medicine. So let's start with some basics. What is physical therapy?

Stephan LaPlante: Physical therapy is medical care that's directed at improving someone's pain movement and ability to perform daily tasks, as well as recreational activities with less complications, restrictions, or movement impairments.

Host: And why is this type of care so important?

Stephan LaPlante: Yeah, so physical therapy really is an essential element of healthcare, has a tremendous impact on improving the quality of life, especially after someone's been injured, maybe in a motor vehicle accident or just got injured playing sports and they're trying to get back. There are a lot of things that happen after someone's injured that physical therapists do a great job in correcting to make sure that that patient maximizes their potential to go back to the way they were before they got hurt.

Host: And how specifically does physical therapy help athletes? What are the top benefits for them?

Stephan LaPlante: What happens after injury is it's kind of a cascade of events. So the athlete gets injured, they have pain, they lose something called motor control. So their ability to move properly changes. And so therapists come in and our job is to basically take some of those compensatory strategies and fix them to the way it used to be. So the best analogy that I can kind of give you, and the fancy term for this that we use is called regaining neuromuscular control. And I got to think about the body, kind of like a computer, right? So the body is the hardware and then the brain is kind of a software. And so when we get hurt, the software can kind of get altered or modified to kind of fit in that current status of where they're at. And then we as therapists have to kind of come back in and reset that software. So really, you know, we have the word physical in our name, but like a lot of what we do is actually directed directly at the brain and how to kind of reorganize those strategies so that the athlete can move more efficiently and that they can go back to their sport with a decreased risk of injury.

Host: So when it comes down to it, who needs physical therapy and then when should they go?

Stephan LaPlante: Anyone who's been injured or having any difficulty just performing their daily activities or having trouble with any kind of recreational activities such as baseball or football or just running in general, should definitely be seen by a physical therapist. So we know that a lot of injuries do kind of get better on their own, but I would recommend that if anyone's just continuing to deal with some issues or they just feel like they're not getting better, they should see a sports therapist. And I can think of a countless number of cases where I just said, man, I wish this kid would have come and seen me two or three weeks earlier and I could have really changed because we tend to develop a lot of really bad habits when we're in a painful state. So we move differently than we do when we're not in pain. And if we can address those issues earlier, it's a lot easier to correct those inefficiencies.

Host: So if I'm someone who has never done physical therapy, I mean, what can an athlete expect going into this experience?

Stephan LaPlante: So the first visit they come see us, they're going to have a very thorough evaluation that can take anywhere from 30 to 60 minutes. After that point in time, we develop a plan of care with that patient based on their goals and try to get them some exercises to get started. And then at each of their next visits, they're going to come in, we do a reassessment to see if what we've done in previous treatments is actually helping. And then we make some changes to their plan based on how they respond. I like to tell all my patients it's very common that yes you can expect some soreness initially after some of those first visits cause you're using things that maybe you haven't used in awhile but you know that's a normal process and it's nothing to be concerned with. I tell them too though, if you're having a lot of bad pain with these exercises, we need to kind of regress and change our strategy up a little bit as well.

Host: This is probably the million dollar question, but how long does it take for physical therapy to work?

Stephan LaPlante: Yeah, that is the million dollar question and honestly the best answer I can give you is that each case is different. Right? So you know, depending on how acute it is, how chronic it is, it's gone on for a long time. Your therapy is going to take a little bit longer sometimes to correct, the severity injury makes a big difference. So like minor strains and sprains, family take four to six weeks for full return to sport. Things like an ACL tear or shoulder labrum repair, like surgical cases may take more like four to six and even as long as like nine to 12 months just depending on what they are. But what's unique about what we have here at children's is that we do rehab it and we also have something called bridge. So we'll actually put the athlete into more of a performance based system, you know, maybe around four or five months after like a major surgery just to get them more sports oriented. And I think that's something that's very unique about what we do at our facility.

Host: Now how often should an athlete do physical therapy and are there things they could do at home even between physical visits?

Stephan LaPlante: Yeah, so our typical frequency is about two to three times per week. And we strongly encourage all of our athletes to do their HPT at home on a daily basis. And that's really because, you know, I talked earlier about resetting that software or like if we've had a lot of really bad inputs coming in, we need a lot of really good ones to kind of fix that software so that the hardware can work and it just takes a lot of repetition. And so if you think about therapy of only coming to see me two to three hours total a week, how much better it would be if that kid could get an extra hour in every day of the week really to restore that normal pattern. It's really, really important that they do their stuff at home that we give them.

Host: Are there any misunderstandings or myths you want to clear up about physical therapy?

Stephan LaPlante: Oh yeah, there's a lot. I think the biggest one is that physical therapy is going to be painful. And one of the biggest things, especially postoperative, the kids come in and these are adults, kids. It doesn't matter who they are. Anyone who's had surgery. I think that first session they're very fearful about having pain. Our goal as the therapist is not to create pain during the treatment session. It's actually counterproductive what we're trying to do. So we had mentioned earlier that pain is not really good for movement, right? We move a little differently when we have pain. Our number one goal is actually reduce pain so that we can move better. Now that's not to say that therapists do, occasionally have to push the patient into a painful place just to kind of push them through and get them on track. But we do that so rarely that I always tell patients don't be concerned with that. That's kind of one of those options that we would do later on.

Another one that I hear a lot is like the only option that I've been given is I need to have surgery and then I always have to ask like, did you do any conservative therapy? Did you try four to six weeks of therapy? Because I've seen a number of cases where, you know, they were convinced this person had to have surgery and then six weeks they're walking out of the clinic without any pain and they're totally functional and so that happens all the time. And then I think the other big myth is I don't think a lot of people think they can do their own PT, that they can do their own treatment at home. There's so much on the internet, right? Like I can go to Instagram and I can go to YouTube and I can find all these strategies to fix myself, but therapy is so much more than that. We have a lot of like manual techniques and a lot of things like dry needling that we're certified in and certain things that you really can't do to yourself at home. Physical therapists are very well trained, not only in school but beyond school to do things that people just can't mimic at home.

Host: And Stephan, is there any other advice for athletes you have needing or currently in physical therapy?

Stephan LaPlante: The biggest piece of advice is like if you're going into physical therapy, like go in with an open mind to go in with a positive attitude and don't be afraid of pain. We're really trained to really alleviate pain more than increased pain. The other thing that therapists do is that we kind of have this cool role of like playing the, the psychological factors that really come after an injury, right? So a kid gets hurt and they question if they're ever going to go back to play. Well we can kind of put them in a scenario where they're in the clinic with other kids going through that same issue and they can kind of have that like common bond and they can talk. It's also, we know we have a lot of cool strategies that we can do. It's kind of reverse that like depression a lot of kids get just by getting them moving again just by teaching them that they can actually still be an athlete even though they are in an injured state. And that's where I think a lot of physical therapy is really probably bigger than even the physical portion is really that psychological portion.

Host: Thank you so much for your time and for your expertise Stephan. That was Stephan LaPlante. He is a team lead physical therapist at the Children's Health Andrews Institute for Orthopedics and Sports Medicine. Find more information on orthopedics and sports medicine online at childrens.com/Andrews. This has been Children's Health Checkup. I'm Caitlin Whyte. Thank you for listening.