How do you choose which physical therapist you should see? Are all types of physical therapy the same?
Physical therapists have different backgrounds, training, and specialties depending on where they went to school, what advanced courses they have taken, and their own belief systems. Physical therapists may also specialize in working with different body parts such as shoulders, ankles, or knees. Finally, there are physical therapists who work with a certain population of patients such as athletes, dancers, or those with work-related injuries.
With all the variability in therapist specialties, there is a minimum standard of care that all patients should receive. There are some types of treatments which are shown to not be scientifically beneficial to patients. The major difference between good quality care and poor quality care is the use of passive or active treatments.
Passive treatments include heat, ice, electric stimulation, and ultrasound. While these modalities can be helpful at times for some short term pain relief, they require no skilled physical hands-on techniques or any individualized, prescribed exercises. These passive treatments are better to be used as a supplement to active treatments rather than the main treatment form. According to a study by Hurley and Bearne, these passive modalities have little evidence to support them, however could be a benefit by providing a placebo or psychological, effect1.
Through scientific evidence, the most proven effective treatments physical therapists provide are active treatments. Active treatments include prescribed exercise by a physical therapist as well as manual therapy treatments such as deep tissue mobilization, joint mobilizations, stretching, and/or manipulations. Physical therapists are skilled in prescribing these treatments specifically for each patient for his or her individual needs. These active treatments are shown to get patients better faster, more efficiently, and with longer lasting effects than passive treatments. For example, in a study by Masaracchio et al, it is shown that the most effective treatment for decreasing neck pain is a combination of manual therapy paired with prescribed exercises targeted towards the neck and upper back area. This reduced short-term pain and improved overall function for the subjects in the study2.
So, if you have tried physical therapy before and did not find it helpful, think about the type of treatment you received. If you only had passive modalities such as heat, ice, ultrasound, and electrical stimulation, then you likely did not receive the full benefit from physical therapy. If you would like to see faster and better improvements in your condition, schedule an appointment at one of our Athletico clinics where our therapists are committed to staying up-to-date with the most effective treatments and all are highly skilled in prescribing both manual therapy and exercises.
Free assessments are available in-clinic and virtually through our Telehealth platform.
The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.
I like how you mentioned that active treatment is the best method for physical therapy backed by scientific evidence. My wife and I are thinking of looking for a physical therapy center because our son suffered a knee injury last month during one of his club soccer games. It seems like a good idea for us to think about hiring a reputable professional that can help us get our son back in good shape so that he can start running and playing again.
Jonathan Go, PT, DPT, OCS, GCS
It’s true! The best physical therapists will use treatments that are shown to be effective by scientific studies and active treatments including exercise has shown to be extremely helpful.
It sounds like your son would be a perfect fit for physical therapy in order to rehab from an injury, prepare him for a return to sport without problems, and prevent any future injuries!