Virtual Physical Therapy Isn't for Everyone, Especially If You Have Extreme Pain
As cyclists, aches and pains that come with training are par for the course, so calling up a physical therapist to schedule routine, in-person treatment can become standard for some. But thanks to the coronavirus outbreak, that might look a little different now.
Turns out, the same video calls we use to connect with friends and family can also be used with your physical therapist. Virtual physical therapy appointments can serve to help assess your non-emergency injuries if your PT office is closed or you’re not comfortable going to an in-person appointment. And, depending on your injury, your doctor can guide you to work toward recovery from the comfort of your own home.
So, we tapped Jess Mena D.P.T., C.S.C.S., Kate VanDamme, P.T., D.P.T., NYU Langone Sports Performance Center Team, and Brooke Conway Kleven, D.P.T., Ph.D.(c) in epidemiology and biostatistics at UNLV School of Public Health to help you assess what type of therapy is right for you at this time.
Be sure to check local health guidelines and the CDC for up-to-date information on the Coronavirus pandemic before making any decisions.
How Is the Injury Affecting You?
One effect the pandemic has on cycling is race cancelations, but new injuries can happen when you’re maintaining your base. Or injuries you were working on healing through rehabilitation that may have been put on hold temporarily due to COVID-19 might be flaring up. Neither should be ignored, says Mena.
As a rule of thumb, the more severe and more constant the symptom, the sooner you should contact your primary care physician. And if you suspect a serious injury, with severe and constant symptoms or the inability to bear weight on the area, you should consider going to either the emergency room or an urgent care, says VanDamme.
“The question for patients or athletes seeking PT should ask themselves, ‘Is this pain affecting my training performance?’ Mena says. “If the answer is ‘yes,’ then seeking rehab services may be imperative in order to continue training without making injury matters worse.”
Decide What Your Specific Needs Are
Conway likens this to a flow-chart game—there’s not a straight answer, and it’ll differ for everyone. The first few questions to ask yourself would be “What are my specific needs?” and “How much is this problem affecting my quality of life?”
From there, consider if you can correct the problem with education and a home treatment plan, says Conway Kleven. “If yes, you can start with virtual therapy, but if the answer is ‘no,’ maybe set up a time to see your doctor and then re-evaluate.”
No matter what, you shouldn’t neglect your health. “I think, unfortunately, when people are in a high-fear, high-stress situation, they forget about the reality that protecting the immune system and keeping it strong decreases risk of illness,” Conway Kleven says.
Can Telehealth Work for You?
If you’re able to bear weight, the pain is not extreme, and there is not a malformation of bone as a result of the injury, it is okay to seek a virtual consult first, VanDamme says.
Even via telehealth, your physical therapist or doctor can get a thorough enough assessment via a movement screening. A virtual assessment still allows the clinicians to point out obvious muscle power or coordination imbalances, movement impairments, and or stiffness, adds Mena.
Treatment can also largely be completed via telehealth. “You’d think the physical part of physical therapy would make it difficult for treatment to occur virtually, but we are good at thinking outside the box and show our clients how to stretch, strengthen, retrain their muscles properly all virtually,” says VanDamme.
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Things like strengthening, stretching, and retraining muscles, in addition to RICE (rest, ice, compression, and elevation) can all be performed from the comfort of your home, VanDamme explains.
Still, there are some drawbacks. With virtual rehab visits, there will be no manual therapy; instead the responsibility falls heavily on the athlete to really invest time to work on mobility via stretching, foam rolling, and soft tissue release, Mena says.
If that’s not right for you, or you have a more serious injury, an in-person visit will be the right option.
When Is In-Person Physical Therapy the Right Option?
In some instances, hands-on treatment is necessary, like if you have joints that need assistance gaining their full range of motion beyond stretching them, your therapist may need to see you in person so they can perform skilled touch to help you obtain adequate motion, explains VanDamme.
Additionally, if your symptoms are not present during virtual evaluation measures and you can only elicit your symptoms through exercise, then observing you in-person would be useful to determine what is contributing to the symptoms during your workouts. A virtual visit may work you have a treadmill at home, otherwise an in-person visit may be necessary.
Know What Your Clinic Is Doing
Every clinic is going to have a pandemic preparedness plan, explains Conway Kleven. It will be dependent on the clinic’s structure and take into consideration patient needs. So, before you make an appointment, call up your clinic and ask what they’re doing and how they’ve prepared. You’ll want to make sure they’re enforcing protocols like temperature checks for both doctors and patients, requiring health screenings, masks, and hand washing, and have physical distancing protocols in place.
Ask whether they’re holding appointments in private rooms—a lower risk—or in an open gym setting with other physical therapists and clients. But, any time you are face-to-face with others, it puts you at risk of infection, Mena says.
And don’t feel obligated to make an appointment if you aren’t comfortable.
Think About Your Own Risk
Different people have different risk concerns. “I’d never advise my grandpa to go in an open gym space, but if that same grandpa was going in and seeing his PT doctor alone in a treatment room, that would be a lower level of risk,” says Conway Kleven.
If your facility is offering private rooms or maintaining distances in a big room, your level of comfort in that risk depends on your situation. For high-risk individuals, private rooms where both patients and doctors are taking proper precautions, such as temperature checks, mask wearing, and hand washing, would be safer. For low-risk individuals, a large room or gym setup where a clinic is practicing distancing, mask wearing, and sanitization would likely be safe if in-person therapy is necessary, says Conway Kleven.
Additionally, you’ll want to know the rate of community spread in your area before making these decisions. “Be your own advocate,” Conway Kleven says.
Bottom line: Know yourself and your own body. Keep in mind, if you neglect other aspects of your health, you’re putting yourself at higher risk of getting sick, says Conway Kleven. Be sure to sleep, recover, get outside and exercise moderately, drink water, and fuel properly.
“Preventative care, especially right now, is the best treatment we have,” Conway says.
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