What Comes After Physical Therapy

Have you ever completed Physical Therapy without being entirely sure what comes next? Have you seemingly recovered from an injury but then ended up in pain and back at the doctor or in PT months later? If so, you’re definitely not alone. While Physical Therapy is essential and great for treating such a wide array of orthopedic conditions and injuries, too often patients aren’t sure what comes after they either graduate from or have had enough of their PT.

There are many reasons for this. In some circumstances, patients leave PT without a clear post-PT plan or leave PT prematurely. This may happen because:

• Symptoms have reduced.

• Dissatisfaction with their progress.

• Save time or money.

As with other types of therapy it is always best to plan an end date. As that date approaches you can communicate with your therapist as to how to make a safe and smooth transition into regular fitness activities. This concept is analogous in many ways to other non-orthopedic illnesses such as GI disease, mental illness or heart surgery. In all of these cases, just because the bulk of the treatment is finished and symptoms are under control or behind you doesn’t mean you’re out of the woods and are good to go 100%. 

The other reason why patients often struggle after Physical Therapy is what I will focus on here. This is the lack of a post-Physical Therapy Fitness Program that helps patients transition from Physical Therapy to optimal fitness.

In the vast majority of clinical cases, there should be a transition phase in between Physical Therapy and a return to advanced and/or previously normal fitness activities. This post-injury / post-rehab transition phase can be the difference between leaving an injury completely behind you or regressing and even finding yourself back where you started.

Post-Injury Rehabilitation sessions. Click here!

The greatest risk factor for injury is previous injury. This means that if you’ve had a knee injury, ankle sprain or suffered from low back pain in the past, you are at high risk for experiencing those injuries again. To reduce those chances, it is helpful to make smart decisions upon completing PT

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For example, say you’ve experienced a running injury such as a chronic hamstring strain, shin splints or Plantar Fascitis. You’ve gone through PT and feel really good. Perhaps you’ve begun light to moderate jogging for short durations on alternate days while doing light strength training and mobility exercises. You don’t have symptoms or they have decreased by 90% but you haven’t started to push it hard yet. Then, you finish PT and you’re suddenly on your own with limited guidance and maybe a false sense of total recovery. Your Physical Therapist may not have given you a ramp up running plan or a complementary strength training and mobility program to ensure your old patterns don’t return. As a result, you may be at risk for reinjury if you ramp up too quickly and aggressively.

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This happens. To avoid it, make sure you communicate with your PT clearly throughout the treatment journey and come up with an exercise regimen together that gets you safely to the next level of health and performance in the weeks and months following PT.

Because you can’t expect this from all Physical Therapists these days, you need to BE YOUR OWN ADVOCATE.

There are personal trainers out there with advanced training in corrective exercise, functional training and post-injury rehab. They can help get you through that transition phase without a relapse (I am one of them but there are many). Whereas physical therapists are primarily experts in the injury rehabilitation process, many personal trainers are more geared towards fitness and strength.

One strategy is to have your PT and the next coach or trainer you work with communicate as to the best strategy. Your PT knows as much about your injury and recovery than anyone. So it’s great to resource them as you move onto going it alone or working with the next wave of fitness professionals.

The bottom line is that the biggest risk for getting injured is previous injury. Following through on your rehab process from start to finish is vital and that process does not end when you leave the Physical Therapy office for the last time.

Mark Greenfield is a Licensed Massage Therapist, Certified Personal Trainer and Active Release Techniques provider in New York City. He has over 16 years of experience helping clients reduce pain and prevent and recover from many types of orthopedic and sports injuries. His practice is centrally located in the heart of Midtown Manhattan just steps from Grand Central Station.