Too Far Gone for Physical Therapy

By: Steve Ibach

I am treating a client who came to the spa with severe and debilitating pain in the left gluteal area. She was in constant pain and could not perform many regular everyday activities. Upon assessing her muscle condition I could immediately tell there was an extreme imbalance between various muscles that act on the hip area. Some muscles were severely hypertonic (overly tight) and others were hypotonic (less tone than normal). This imbalance was causing postural abnormalities including elevation and anterior rotation of the hip among other areas.

After a few minutes of working on the client and discussing her condition and background a little more, I suggested she speak with her doctor about seeing a physical therapist. Although I was certain that massage therapy techniques would be a great help to her, and perhaps alleviate her pain completely in the near term, the client also needed strengthening of the hypotonic muscles to help correct some of her symptoms. Although I have no problem recommending general exercise to clients, physical therapists are the appropriate health care professionals to work with when seeking specific rehabilitation exercises.

So that brings me to the whole point of this post. According to my client, her medical doctor told her she “was too far gone for physical therapy”. This is not a joke? In my opinion my 75 year old mother who had heart valve replacement surgery is not too far gone from physical therapy. What does that even mean? Is the doctor saying death is imminent? My client is in her 30’s – 40’s. Instead her doctor thought it was better to give her cortisone shots! Cortisone shots, while they are useful under some circumstance, are much more invasive then physical or massage therapy. They have many possible side effects.

Why would a doctor recommend such a course of action? Certainly he will make more money from the insurance company giving her cortisone shots compared to giving her a referral. Did he really believe that was the best course for my client, before even at least trying physical therapy?

This is an example of a failure of our medical system. Family practice Medical Doctors, whom I greatly respect as a group, are not the foremost experts in the musculoskeletal system. This client should have been referred to a massage therapist, physical therapists, or another medical doctor who specializes in this type of condition.

My client has seen me for a few weeks in a row and is now greatly improved. The debilitating pain is gone and she is beginning to do normal activities again. Despite the fact that she was “too far gone for physical therapy” she has started an exercise program of her own to strengthen her muscles.

Regardless of how we improve the medical system, there will always be some doctors, physical therapists, nurses, massage therapists, etc. who give bad advice. My recommendation is to not accept everything your healthcare provider says as absolute fact. Educate yourself on your condition, speak with a variety of people, get second opinions, etc. Your healthcare is your responsibility and you cannot depend on your doctor to always be right. There are varying opinions among the most qualified physicians and specialists so always evaluate all your options – especially if an invasive treatment such as surgery, shots, or medication is recommended over physical therapy, massage therapy, etc.

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