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Conceptions and misconceptions about physical therapy


A physical ache, pain or injury can send you to the doctor, who may suggest surgery or pain medication. But there may be another option. A method in which people are often able to increase their strength and mobility, regain health, and avoid harsh treatments that may cause long-term side effects.

This week on “Take Care,” Dr. Erson Religioso speaks with us on what physical therapy is and how it may sometimes be the healthier treatment option to choose for injuries. Religioso has a doctorate degree in physical therapy, is an expert in manual therapy, and is an adjunct faculty member at SUNY Buffalo.

Physical therapy can help prevent spending time and money on surgeries in areas, such as the neck, back, shoulder, and knee, according to Religioso.

“I used to just tell patients if it hurts when you move have a P.T look at it first, because if we tell you, you need surgery, you may really need surgery,” Religioso said.

Although it may be assumed a doctor referral is needed to see a physical therapist, Religioso says it is not and walk-in visits are welcomed and often still covered by a person’s insurance.

“Before I became a cash-based P.T, 75 percent of our patients at the practice I worked at were self-referred,” Religioso said. “I think that’s one of the biggest misconceptions: that you need to see a doctor to see a physical therapist first.”

Religioso says that receiving prior diagnosis to physical therapy can even hinder your ability to heal in some cases, because you expect your body to behave a certain way in reaction to the injury. This is referred to as the “nocebo effect.”

“You go in expecting the worst, [but] when you don’t have all these misconceptions about what physical therapy is or what your condition could entail, I think those patients end up doing better,” Religioso said.

Although many people may see physical therapy as a way to work out injuries through exercise, Religioso says there’s more to it than just that. Along with corrective exercises, strength training, and hands-on techniques, physical therapy is also a valuable education process. One of the first lessons: don’t fear pain when treating an injury.

Religioso says much of the pain patients may experience can be alleviated simply through education.

“I tell them that it’s okay to move, that pain is based on perceived threat and it’s not often related to what’s seen in an X-ray or a CAT scan,” Religioso said.

Once people learn that pain during physical therapy is a natural response, and is not a necessarily a signal to stop the movement, patients start to have a more successful recovery, Religioso says.

After teaching patients to not fear pain, exercises can be learned that patients can do at home without the help of a physical therapist coaching them through it.

“The goal is to be able to treat yourself,” Religioso said. “Very few conditions need maintenance care week after week after week.”