My Physical Therapy Philosophy
As a 1991 graduate in Physical Therapy, from the Medical University of South Carolina, I have found that many of my clients have no idea what a physical therapist really does. Many believe you only see a physical therapist after an injury or after suffering a stroke. I believe this to be a major misconception held by the general public as well as with many of my colleagues. Physical therapy should be much more involved in prevention rather than focusing on the problem after the insult.
I often describe myself as a “human body mechanic”. You take your car (brand new or an antique) to the auto mechanic for assessment and alignment issues. When you seek help from a physical therapist, they should look at you with a holistic approach. Not looking not at a specific body part, isolated from gross movement patterns. As the auto mechanic looks for reasons why your car is not tracking correctly, your therapist should do the same. Therapists are trained to look for faulty movement patterns. Which usually lead to compensatory patterns or movements. Put another way, a physical therapist should be able to assess how the body is “cheating” through evaluation. Then intervene to correct these faulty mechanics to improve the movement and normalize alignment. Compensation, in turn leads to further compensation and a wearing down of the musculoskeletal structures over time.
I inform my client that I can’t repair the torn ligament, the degenerative disc, or the neurological impairment. However, as a creative, knowledgeable, and experienced therapist I may be able to assist my client in the journey to regain some part of their prior level of function.
Over the years I have developed a very common sense approach to how I treat my client. I have worked in many clinical settings, in four states. At times I felt as if I were waiting tables. I grew tired of the “cook book” and “cookie cutter” approach to dealing with musculoskeletal problems. Seeing “symptoms” treated instead of spending the necessary time to investigate the cause for that symptom. Only treating “the body part” on the prescription and not taking the extra time to assess for the primary cause of the problem. Working in clinics where the client was not looked at as an individual, but rather a patient who had great insurance.
Recently I have been addressing issues directly associated with pelvic health and visceral manipulation. To my amazement, I feel like I have discovered the missing piece to so many client problems is normalizing the function and movement of the pelvic floor and internal organs.
Each client who comes to me is a puzzle. Each client has a history of how they got to this point in their lives. I listen to their subjective information and then take an objective look at the different areas, such as: muscle length, muscle strength, movement, gait, core strength and muscle recruitment. I am looking for asymmetric patterns in any of the above and how it may be affecting the existing chief complaint. And I am continually amazed and intrigued by the effect these asymmetries have on establishing compensatory movement patterns.
Needless to say, I never get bored.
-Lisa B. McIntosh, PT