Physical Therapy - How to Choose

[Jenny]

Looking ahead, I’m going to need PT for my ankle. It seems that there’s a PT practice on every street corner around here now.


Do we have any therapists here who could give some pointers on how to pick a good practice/therapist? Any certifications to specifically look for? Things to look out for?


Any info would be appreciated.

 

[Brian Finch]

First, what is involved with your ankle and what type of therapy are you looking for? Second, it’s increasingly common for individuals to go and interview a potential therapist. I would suggest you narrow your search down and go talk to one or two of them in person-you will know who you want to work with!!!

 

[Jenny]

From the operative notes, procedures performed:

Right low lying muscle belly and peroneus brevis excision (2-3 cm full thickness tear of peroneus brevis)
Right peroneus brevis tendon transfer to peroneus longus tendon, proximal stump
Right peroneus longus to brevis tendon transfer, distal stump
Right fibula avulsion fragment excision
Right superior peroneal retinaculum repair

So, I’m looking for whatever PT will make my ankle work again.

I'm a complete novice at this, basically. The last surgery I had before this was getting my tonsils out when I was 9. I just want to make sure I make an informed choice, and don’t end up at some place that exists only to bill insurance companies. I've started internet research, but don't know what to look for, really. There seem to be so many different letters after the names!

 

[Brian Finch]

In your case look for someone who has experience with tendon transfers & complex LE surgeries.

Ask how much 1:1 time they spend, will you work with the PT or assistants/aides.

 

[François Pugh]

I recommend you get a sports specialist, and ask lots of folk for recommendations. I lucked out and was recommended a good PT by a co-worker. The recommendation included NHL players who had benefited from the PTs work. It made sense to me if someone who had access to many PTs chose that particular one, she must be good. She was good; with her help I restored a great range of motion in my shoulder from after a 3rd degree shoulder separation - range that had been lost 15 years prior after a motorcycle crash.

 

[Jenny]

OK, complex surgery, 1:1 time.

Sports specialist.

I’m going to have my husband check with his hockey teammates and see if they have any recommendations. At least one of them works in the medical field and another has some connection with the hockey team in town. Maybe I can get some leads that way. Gotta find a contact for the baseball team, too . . .

Have also gotten the name of one place from a former physical therapist, too, although she goes to a location in another town, so probably wouldn’t be able to get the same person.

I still have 23 non-weight-bearing-in-the-cast days to go before I move on to the next phase of this journey, so there’s some time.

 

[pchewn]

Wouldn't your surgeon refer you to a PT with specific instructions on his recommended treatment?

 

[Jenny]

Wouldn't your surgeon refer you to a PT with specific instructions on his recommended treatment?

I’m not 100% sure. When I went to the first doctor, right after it happened, he didn't recommend a certain PT, even though they had one right at the same office. So I’m not sure if that was just him, or if there's something that says they can't specifically recommend or what. I won't see the doctor who actually did the surgery for 23 more days, and I have lots of sitting around time in between now and then, so I picked this as something to research and obsess about for now. Keeps my mind off all of the activity in the cast, sort of.

Maybe I’ll start by sending a patient portal message and see what they say.

 

[Brian Finch]

I’d call & see what surgeon is thinking now, nothing worse than finding perfect PT & learning they are booked for a month.

Some letters to ponder

OCS Orthopaedic Clinical Specalist
SCS Sports Clinical Specalist
CSCS Certified Strength & Conditioning Specialist
FRCms Functional Range Conditioning Mobility Specialist
COMT Cert Ortho Manual Therapist

 

[Ron]

@Jenny please listen to @Brian Finch !!!!

And, most surgeons will not recommend a PT...

 

[Jenny]

I’d call & see what surgeon is thinking now, nothing worse than finding perfect PT & learning they are booked for a month.

Some letters to ponder

OCS Orthopaedic Clinical Specalist
SCS Sports Clinical Specalist
CSCS Certified Strength & Conditioning Specialist
FRCms Functional Range Conditioning Mobility Specialist
COMT Cert Ortho Manual Therapist

Thank you for the info - I really appreciate it. Are there certain things that it’s ok to have an assistant and others that I would specifically want the fully certified person?

One of the practices with a bunch of locations has their staff and certifications on their website. So I can find:

This person (not very conveniently located, but doable) -
DPT – Doctor of Physical Therapy
COMT – Certified Orthopedic Manipulative Therapist
FAAOMPT – Fellow of American Academy of Orthopedic Manual Physical Therapists
DScPT – Doctor of Science in Physical Therapy

Or this one -
OCS – Orthopedic Clinical Specialist
CSCS – Certified Strength and Conditioning Coach
Cert MDT – Certified McKenzie Method

Or this one (conveniently located) -
MSPT – Masters in Physical Therapy
ATC – Certified Athletic Trainer
SCS – Sports Certified Specialist

The practice that does the hockey team and has a sports clinic doesn't have nearly as nice a website for looking up their staff. Gotta do more digging on their people, because they also have a location minutes from my house. Luckily, though, two days a week we drive 40 miles to work, so I go past a lot of possible locations! Not the first person on the list above, though. She's 30 minutes in a direction I never go, but will if that’s what I need to do.

 

[Guy in Shorts]

Found my PT here on Pugski. I picked the one with the cast on his arm.

 

[Jenny]

Found my PT here on Pugski. I picked the one with the cast on his arm.

LOL, long way from Michigan, though!

 

[Brian Finch]

Thank you for the info - I really appreciate it. Are there certain things that it’s ok to have an assistant and others that I would specifically want the fully certified person?

One of the practices with a bunch of locations has their staff and certifications on their website. So I can find:

This person (not very conveniently located, but doable) -
DPT – Doctor of Physical Therapy
COMT – Certified Orthopedic Manipulative Therapist
FAAOMPT – Fellow of American Academy of Orthopedic Manual Physical Therapists
DScPT – Doctor of Science in Physical Therapy

Or this one -
OCS – Orthopedic Clinical Specialist
CSCS – Certified Strength and Conditioning Coach
Cert MDT – Certified McKenzie Method

Or this one (conveniently located) -
MSPT – Masters in Physical Therapy
ATC – Certified Athletic Trainer
SCS – Sports Certified Specialist

The practice that does the hockey team and has a sports clinic doesn't have nearly as nice a website for looking up their staff. Gotta do more digging on their people, because they also have a location minutes from my house. Luckily, though, two days a week we drive 40 miles to work, so I go past a lot of possible locations! Not the first person on the list above, though. She's 30 minutes in a direction I never go, but will if that’s what I need to do.

If you are down to 3, I’d call each & ask for 5 minutes of their time.

 

[Brian Finch]

@Jenny - I also have a friend who owns a practice in Portland Michigan. I think very highly of him & would be happy to connect you two if that location works.

 

[Jenny]

@Jenny - I also have a friend who owns a practice in Portland Michigan. I think very highly of him & would be happy to connect you two if that location works.

Dang, that’s still an hour away but I do appreciate the thought.

 

[Jerez]

my husbands surgeons (back, neck, shoulder and hand) All recommended the PT they wanted him to use. And yes, it helped expedite the appointment.

 

[karlo]

1:1 time they spend, will you work with the PT or assistants/aides.

1:1 time is really important. I was going to a PT practice where, after some attention by the PT, my exercises were overseen by an assistant, one that was overseeing three others. Now, I go to a PT that devotes the entire session with me. How I do my exercise is monitored closely, and corrected as needed. Big difference.

 

[Monique]

I saw a PT and then a trainer associated with the surgeon's practice. It facilitated communication. The trainer in the PT office was also covered under insurance (somehow - not sure if that was fudged).

HOWEVER I do have a caveat. Not sure how broadly it applies. After my true PT was finished, I wish I'd spent the money on seeing my long time personal trainer rather than continuing with the PT office trainer. "My" trainer thinks outside the box. After many PT and supposedly specialized training sessions at the PT office without making progress, I finally broke down and spent the money on my trainer. He immediately identified stretches and exercises that helped me with skiing and in general - and he's still doing so. I wasn't able to do squats without pain until he had me do a particular form of one-legged squat - instead of TRX assists or using a box to sit on, he had me put (say) the left leg on top of an exercise ball, with a pole loosely held for balance. Squat, press against the ball, stand up, rinse, repeat. It allows the body to move more naturally than the box, and allows for partial-weight squats. After a few weeks of that, I was able to do deadlifts without knee pain (and without a heel lift), and just yesterday, I did front squats with weight - and no pain in my knee, during or after. During ski season, he also figured out a great stretch for my hip flexor. I don't think my PTs or trainers ever figured out that my issue was there. He also helped me with better ways to foam roll and use a lacrosse ball.

So I guess what I'm saying is, a great PT is great, but sometimes, answers can come from other places, too.

 

[Jenny]

So far, it seems that the surgeon is part of a medical group that includes physical therapy clinics. Luckily, I hope, that includes one with a specific sports medicine focus. I will be touring their main location Thursday, but they also have a satellite location 5 minutes from my house - less time if I don't have to wait for the stoplight. And one of the therapists from the main location also works out of the satellite one.

The therapists are actually employees of an extremely well-regarded rehab hospital in town.

I spoke with the PT Coordinator today. She confirmed that they work 1:1, and she said they are all PTs, not assistants.

So I think I just need to get a look at the place, and see what I can find out about certifications.

Pretty sure the clinic also takes care of the minor league hockey team. I don't think they do the baseball players, though. I think the rehab hospital takes care of them.

This feels like progress.

@Brian Finch - If your Portland friend has any intel on anyone in GR I certainly wouldn't mind hearing about it . . .