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Better Outcomes Ahead with PT Changes

Better Outcomes Ahead with PT Changes

Updated June 9, 2021 Originally published January 10, 2018
Danny Sanchez, PT, CEAS

Changes are afoot in the physical therapy profession and that’s good news for injured workers. The cookie cutter-approach is being replaced with more evidence based techniques. What’s more, we see a distinct trend toward more hands-on, less modality-based PT.

What it means for injured workers is that the therapy is tailored not only to their specific bodies and ailments, but to what they do and how they move — in their jobs as well as in their personal lives. Working one-on-one with injured workers gives us the opportunity to focus exclusively on their needs and help them regain function, get back to work, and avoid repeat injuries — typically in less time and with fewer treatments.

Functional Therapy

Our training as physical therapists is very hands-on. We learn how to manipulate the muscles and tendons to reduce pain and help the body heal. It’s rewarding when we can see an injured person progressing and recovering.

To be a physical therapist today also requires us to have advanced, post-graduate degrees. We undertake extensive scientific research into our craft, which gives us valuable insights into anatomy and how to heal it.

For too many years, though, many of us have not been able to fully utilize our training to help patients. The approach to PT has been more of a one-size-fits-all. In many PT clinics, there are so many people from different scenarios; people recovering from surgeries, elderly patients trying to regain balance or movement, and, of course, injured workers.

Putting these different types of patients together can sometimes result in a static approach to PT. At a typical clinic, there are a handful of therapists in a room filled with patients. A patient is typically put on a machine, such as a stationary bike for a certain period of time, then he’s moved to another machine. He may be shown some exercises and asked to do them on his own.

There are a couple of problems with this model.

  • Often there is no continuous oversight, so patients may be doing the exercises improperly or may be left on a machine for too long.
  • The machines and exercises are geared toward helping the average person move better but are not tailored to a specific individual’s body and movement needs.
  • There are typically multiple therapists working on each person, so no therapist is focused solely on one patient at a time.

To be truly effective and efficient, PT needs to be functional; it needs to be hands-on and based on real-world movements that people do day in and day out. This is how we can help address the individual needs of each patient.

PT and the Real World

PT must be relevant to a person’s life in order to be effective. Take a truck driver with low back pain, for example. Putting him on a stationary bike for 15 minutes three times a week may help marginally, but it won’t give him much relief and, more importantly, it won’t prevent the pain from returning as soon as he is back on his job.

Chances are this worker has been doing things the same way for years – getting into and out of his truck, sitting in the same position, taking (or not taking) breaks at certain times, and, probably, not doing stretches that can help him avoid additional pain.

Sending him to a clinic where he has machines and exercises won’t adequately address his problems. He needs consult and advice from a trained physical therapist focused on his needs.

In addition to helping the worker recover, the therapist can educate him on injury prevention. The therapist can show the worker better ways to enter and exit his truck that won’t stress his lower back; he can go over ways to sit that will reduce his pain and show him certain stretches to do before and/or after driving to help increase the flexibility in the muscles surrounding his back; and he can explain the benefits of taking breaks at certain intervals and what to do during them.

This is only possible when a therapist works one-on-one with the injured worker and has deep insight into his work tasks. Where possible, we provide PT at the injured worker’s work site. This allows the therapist to truly understand the tasks the worker must do each day. It also helps form the basis for the treatment.


As physical therapists, we are able to help injured workers reduce pain and improve or restore their mobility, typically without expensive surgeries or long term use of dangerous medications. The shift taking place within the profession, to a more hands-on, evidence based practice is welcome news — for us and the injured workers we treat.


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