One of the most enjoyable parts of teaching the Movement and Mobility Trainer Course for CrossFit is the one on one time I get with hundreds of CrossFit athletes. Many people come to our courses with a ton of questions and it’s always surprising to me how appreciative they are when I spend a few minutes listening to them and giving them advice. It makes me think, what the hell are most medical providers, physical therapist and chiropractors doing? My opinion is most of these providers are extremely busy with large patient caseloads in order to have a profitable business.
I understand this problem well. I have worked in clinics where I have seen 20-25 patients per day. You basically are just putting out fires all day and you don’t get the opportunity to just listen to someone. The number one, most important aspect to successfully treating someone that is injured is listening. Nine times out of ten, the patient tells us exactly what’s wrong with them and what we need to do to help them out. All we have to do is just check our over-educated egos at the door and just shut up. It’s that simple! For this reason anytime a course attendee asks me for a physical therapist recommendation in their area I base my decision off four factors and I feel you should as well.
1. Pick someone that sees no more than one person per hour.
Physical therapy is not unlike any other business. The saying “you get what you pay for” applies to physical therapy as well. Most physical therapy clinics do not publicize how many patients they see per hour. I doubt you are going to see a physical therapy clinic bragging about how they routinely treat 4 people at once.
Let me put it to you this way. Would you go to an accountant that set up meetings with 4 different clients at the same time? Hopefully you answered no to this question or pray that you never get audited. So why is it ok for people treating your most important asset, your body, with less respect that your accountant gives to your tax preparation?
I find that many of the physical therapists that treat patients in a one on one setting use a model known as fee-for-service or accept insurance on a very limited basis. The reason these physical therapists set up their practices this way is out of necessity. They refuse to sacrifice quality of care with their patients.
Let’s be honest, healthcare is one of our nations biggest problems. So far, healthcare reform has done little or nothing to change it. Many medical physicians, dentists and physical therapists have started to reject accepting insurance. The reason why is it frees them up to treat patients the way they deserve to be treated.
Medical providers with above average skills and a true passion for helping people are shifting to this model everyday. It’s good for the provider and it’s even better for the patient. It’s vital that you find someone that will treat you like they would want their own family to be treated.
If you’re doing a quick Google search in your area use key words such as fee-for-service, out-of-network and cash based physical therapy. Also, you’re physician may refer you to a physical therapist specifically. Understand that you have a choice of where you go, knowledge is power so doing your own research can go a long way.
2. Pick someone that specializes in hands on treatment.
We know that the act of physically putting your hands on someone is powerful! Think about when you go to the doctor. If they just stood their and looked at your, you wouldn't feel as comfortable as you would if they listened to you breath and your heart beat. They have to actively put their hands on your to do this and it's very reassuring.
I can tell you this much, when I use my hands for physical therapy treatment, people get better dramatically faster. If you find yourself in a physical therapy clinic where all you get is a handout and they have you doing some useless leg extensions and then put a hot pack on your knee, you’re in the wrong place! Leave immediately and don’t turn back. Places like this give physical therapy as a profession a bad reputation.
Here are some recommendations when looking at key words to find physical therapists that specialize in hands on treatment. Anyone that says they perform manual therapy is probably a good bet. Also, dry needling is a hands on treatment that works phenomenally well. Key words such as mobilizations, manipulations, soft tissue or fascia techniques are also all good to see.
3. Know what the alphabet soup means behind a name.
I’ll give you an example of what I mean. My title is this, Danny Matta DPT, OCS, CSCS. To most of you that aren’t physical therapists it just looks like a bunch of random capitalized letters. What it actually means is that I have a Doctorate of Physical Therapy, I’m an Board Certified Orthopedic Clinical Specialist and a Certified Strength and Conditioning Coach. It’s basically a bunch of letters that show I’ve passed some tough tests.
Here’s the list of credentials you should look for if you are an athlete and looking for a physical therapist.
OCS or SCS. These two are specialty board certifications through the American Physical Therapy Association and they are not easy to get. Either one of these credentials means the physical therapist has in depth knowledge of athletic injuries.
FAAOMPT, MTC, COMT. These three are manual therapy certifications that show the provider has passed testing for hands on treatment. It takes a while to get these so most providers with these credentials should be a good choice.
CSCS. This is an advanced strength and conditioning certification. This is the gold standard for someone that wants to be a high school, college or professional strength coach. If your physical therapist has this, it's a great fit for anyone playing a sport like tennis or training like CrossFit.
4. Lastly, ask your prospective physical therapist how much they can snatch.
This is an easy one and is a take on a recommendation that Kelly Starrett has on mobilitywod.com. His recommendation is to ask your prospective physical therapist what their deadlift is. I’ll take this a step further and throw in an Olympic lift.
If your prospect physical therapist doesn’t even know what lift the snatch is, you've called the wrong person. He or she is not the physical therapist for you. I'm not saying your PT needs to be able to snatch bodyweight but they should at least understand the movement and have done it before.
If you’re a CrossFit athlete, many physical therapists will tell you to stop doing CrossFit. This is like telling a runner to stop running, it’s just not going to happen. Finding a physical therapist that understands your sport is vital.
Hopefully you are healthy and you do not need to seek out a physical therapist. If you are injured I hope this blog post helps. No matter where you are in the country, you can apply these principles to picking the right PT to help you achieve your goals.
If you're in the Atlanta area and have been struggling with an injury, we can help. You don't have to live in pain. You don't have to avoid activities you enjoy. We help people just like you everyday get back to the CrossFit gym, get back to playing with their kids and stop waking up every morning with pain.Take a look at our client testimonials here.
If you're interested in learning more about how we can help you, we can set you up on a free 10 minute phone consultation with one of our Doctors of Physical Therapy.
Thanks for reading.
-Dr. Danny, PT, DPT
Dr. Danny and staff's views on performance improvement, injury prevention, and sometimes other random thoughts.