The words "physical therapy" might prompt memories of the time your tore your ACL or needed help recovering from surgery. But with an ever-increasing number of subspecialties, today’s PTs can help you with way more than sports injuries and post-surgery rehab. We caught up with experts to find out what they can do.
RETRAIN YOUR BRAIN
Strokes and traumatic brain injuries, like concussions, can make it hard to walk, exercise, and do things that were easy before. “If there’s damage in one part of the brain, it can really affect the way that it communicates with the muscles in your body,” says Randy Karim, DPT, NCS, CBIS, a rehab specialist at the Cleveland Clinic. Physical therapy can retrain your brain and teach damaged motor pathways how to function. By forcing your body to go through the motions you want to relearn – walking, for example, or playing baseball—you rebuild connections between your brain and muscles.
For example, “if someone wants to get back into golf, we will take them through the exercises of balance, and make sure they have the flexibility to do that,” says Karim. Doctors and scientists are still researching neuroplasticity – the brain’s ability to adapt after injury – but “one thing we do know,” says Karim, “is that the therapy we do actually helps to strengthen the pathways, remold the brain even.” For this therapy, you’ll need a physical therapist with a specialty certification in neurology.
TURN YOUR WORLD RIGHTSIDE UP
If Hitchcock’s Detective John “Scottie” Ferguson had visited a physical therapist, he might have been cured of his vertigo a little sooner. Or…maybe not. Regardless of your interpretation of the movie, the fact is that physical therapists have been treating and in some cases permanently curing vertigo for years. With benign proximal positional vertigo (BPPV), for example, the most common cause of vertigo, just one or two sessions with a physical therapist can sometimes do the trick.
The prevailing theory is that by going through a series of head, neck and body movements with a patient, known as the Canalith Repositioning Procedure, or Epley maneuver, a PT can clear the inner ear system of a calcium carbonate crystal that interferes with normal function. For this treatment, see a PT who subspecializes in treating vestibular disorders.
RECOVER FROM A HEART ATTACK
If you’re lucky enough to survive a heart attack, you’ll need to strengthen muscles weakened by coronary artery disease. PTs can help you strengthen your heart with basic gym equipment – treadmills, rowing machines, ellipticals. But this isn’t just a normal day at the gym. The exercise regimens are prescribed carefully so patients don't push their bodies too far.
This not only reduces risk factors for future heart disease but also improves how their heart heals. “[Exercise] helps limit what we call remodeling,” says Jonathan Whiteson, M.D., director of cardiac rehabilitation at NYU’s Langone Medical Center. An abnormal change in the heart’s size or shape, “exercise actually helps to improve that modeling where the muscle fibers heal in a more organized manner, and helps to preserve and improve heart function.”
Chronic lung diseases like emphysema can make breathing difficult, which leads to other problems, like muscle loss. Physical therapy can help you build muscle, improve breathing, and clear your lungs.
Pulmonary patients often do aerobic training similar to what heart patients do. Then, they add additional strengthening and breathing exercises to optimize breathing patterns and oxygen intake. “Another big part is the hands-on care from the chest physical therapist, where they will actually give little taps and percussions and vibrations to the chest wall to help clear the mucus out of a particular segment of lung,” says Dr. Whiteson. For this, a PT who has trained in chest physical therapy is the way to go.
REDUCE JAW, HEAD, AND NECK PAIN
Bad posture and excessive stress can contribute to temporomandibular joint dysfunction, or TMD, one of the main causes of jaw pain. Bad posture can alter your bite or force your muscles to work harder, and stress can lead to nighttime teeth grinding. “Most of the males I’ve seen are college students,” says Anthony DiFilippo, PT, DPT, OCS, CSCS, president of the Ohio Physical Therapy Association. “And I’ve seen quite a few pilots. So both sitting quite a bit, high stress.”
Bad posture can also contribute to neck pain andtension headaches. For these problems, DiFilippo typically starts with manual therapy to loosen up muscles and tissue. Then he moves to postural exercises that can treat and prevent the problem.
EASE YOUR BACK ACHES
Low back pain is by far the most common problem DiFilippo treats. Postural exercises can help, but active therapy is the way to go, he says. Depending on the cause of your pain, a PT can lead you through exercises where you bend forwards or backwards to counterbalance your typical postures. “A person who is younger and is sitting quite a lot, we try to get them to avoid postures that mimic sitting because they’re doing that all day anyway,” DiFilippo says. “We put them on the exact opposite.”
A core stability program comes next to help you engage supporting core muscles more fully. After that, it’s up to you to continue doing the exercises your PT recommends on your own.
HOLD YOUR PEE BETTER
Urine problems are never fun to talk about, but a PT is a good person to confide in. Stephanie Lowery, PT, DPT, and Dip MDT at Active Care PT Inc., helps people with stress incontinence. Caused by a weakness in pelvic floor muscles, “if [the patient] sneezes or opens a heavy door, urine leaks out because the muscles are weak,” says Lowery. With pelvic floor exercises, patients strengthen their muscles and gain bladder control. Unexpectedly, a lot of Lowery’s patients come to her because of back pain. She always asks them about pain or dysfunction in other areas, and sometimes she’s found that after treating a patient’s lumbar spine, his groin pain, rectal pressure, or urine flow may also be affected. “Oftentimes a male patient doesn’t associate back pain and changes in urine flow,” says Lowery. “They’ve just never associated that before.” For this problem, find a PT specializing in pelvic therapy.