17 Feb How to Choose a Great Physical Therapist

When choosing a physical therapist, there are many factors to consider. From the amount of time spent with your physical therapist to whether the exercises prescribed were practiced within the session, the following briefly summarizes what to look for.

Time spent with your physical therapist

Typically, the quality of a meal is proportional to the time being spent to prepare it. For example, the taste of a hamburger prepared from frozen patties from a fast food restaurant chain will be significantly different from that of an establishment that takes the time to prepare each hamburger from select cuts of meat and freshly baked buns. Similarly, the quality of physical therapy varies in the same manner. If a therapist seems rushed to work with you because they have to work with multiple other patients in the same room, chances are they won’t have the adequate time to thoroughly assess, comprehend and treat your condition. As a general rule of thumb, a great physical therapist spends a minimum of 30 minutes for your initial evaluation and at least 20 minutes of personal one on one time for every follow up visit. Also, you should feel there was enough time at each visit for them to answer any questions or concerns you have.

Systematic analysis of your condition

There are a multitude of reasons as to why injuries occur. For example, if you’re coming to physical therapy because of pain in your lower back, your physical therapist should be able to analyze the multitude of factors that may be related to your condition. Is the pain coming from the back itself or does the hip have a role? What about your pelvis, knees or feet? If it’s coming from your pelvis, hips, knees or feet, which side is it coming from? Or is it from both sides? Once the side is determined, which specific joint, muscle and/or nerve is it? There are numerous joints, muscles and nerves that can be at play. For instance, the knee joint itself has 3 specific joints (tibiofemoral, patellofemoral and tibiofibular), while the foot can be categorized into at least 8. Or is your back pain coming from something more nefarious (e.g. cancer, kidney disease, diabetes, etc.).? Your physical therapist, should be able to systematically analyze all of these factors and customize your treatment plan based on your unique presentation.

Assessment of baselines/concordant signs at every visit

There is an infinite amount of treatment possibilities your physical therapist can prescribe. A great physical therapist, will be able to decipher which ones are going to have a high probability of working for you. For example, if you’re coming to physical therapy because of pain in your neck and looking to the left is extremely difficult, a great physical therapist will assess and use “looking to the left” as a baseline prior to performing any intervention and continue to use that marker throughout the session to see if what they’re doing is working for you. If the right treatment is prescribed, you will typically see some sort of improvement by the end of the visit, whether it’s an increase in range of motion (i.e. your ability to turn your head to the left), increase in strength and/or decrease in pain levels. In addition, because you are constantly sitting and moving thousands of times between the time you leave your visit and the time you return, it’s extremely important that your therapist re-assess you at the beginning of each appointment. A great physical therapist will never jump into any sort of treatment, whether it be hands on work or prescribing an exercise without having re-assessed you first.

Home Exercises were assessed and practised during the session

As mentioned before, because you are constantly changing your body positions throughout the day, it’s likely that your baselines will change as well. A great physical therapist will re-assess you at the beginning of each visit and will have evaluated each exercise before prescribing it to you. You should’ve practised each prescribed exercise multiple times before leaving each visit. Home exercises should never be handed or given to you without having been assessed under the watchful eye of your therapist, making sure everything from your form, position, resistance and repetitions were correct before leaving.

Advanced Specializations and Certifications

The American Board of Physical Therapy Specialities (ABPTS) defines Board Certified Clinical Specialists as a prestigious group of physical therapists that demonstrate competency in a specialized area of physical therapy and advanced clinical proficiency. Their greater depth of knowledge and skills exceeds that of entry level physical therapists. In addition, the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) defines a Fellow as a Board Certified Therapist with substantial clinical experience within a particular specialty area of clinical practice, education or research. Statistically, ten percent of physical therapists will achieve Board Certification, with the majority being a Board Certified Specialist in Orthopaedic Physical Therapy (5% nationwide), while approximately one percent will achieve Fellow Status. Looking for a Board Certified Specialist or a Fellow, would ensure that you would be getting a highly credentialed physical therapists.

Personable, Ethical and Attentive

A great physical therapist is personable and should make you feel that they genuinely care for you. They’ll take the necessary time to listen to all your concerns and will never make you feel rushed or dismiss any questions you have. No question or concern is absurd. Also, they will take the necessary time to thoroughly explain your condition and treatment plan. Lastly, a great physical therapist will realize their limitations and will know when to refer out to another healthcare professional if your treatment is not going accordingly.

In conclusion, a great physical therapist is a caring, humble and attentive person. They will spend the necessary time to understand you and your reasons for coming to physical therapy. They will systematically analyze your condition and individualize your plan of care. Most importantly, they are ethical and empathetic people and you should feel their caring nature right from the beginning.

This article is written by Dr. Ritchie Kim, PT, DPT, OCS, FAAOMPT. Ritchie is a Doctor of Physical Therapy, Board-Certified Specialist in Orthopaedic Physical Therapy and Fellow of the American Academy of Orthopaedic Manual Physical Therapy.