3 Reasons Your Physical Therapy Isn’t Working
and what to do about it.
You've been in physical therapy for months. You saw some progress at first, then hit a wall. Maybe you slowly stopped seeing results over time.
That persistent shoulder pain is flaring up with a vengeance, and nothing seems to be working. Your physical therapist just keeps piling on exercises that take more hours out of your day, and you still don’t know why you’re even doing them.
20% of physical therapy patients drop out within three visits and 70% never finish their treatment plan. It’s a frustrating cycle that the vast majority of my Craniosacral Therapy (CST) clients experience. When they decide to explore CST or other forms of bodywork, it’s usually because they've tried everything else and are feeling hopeless about their pain. They’ve been let down by providers who spend more than five minutes with them, then send them out the door with a cookie-cutter treatment plan.
It’s not that physical therapy never works. There are a lot of PTs out there doing fantastic work. So before you start throwing rocks, I want to clarify that there is nuance. In every modality, there are practitioners who are highly effective and some who are less so. But if you’re one of the many people stuck in an impossible loop of pain and even the best physical therapist in town isn’t helping, these might be some of the reasons:
Exercises treat symptoms, not the system.
Like most Western medicine, physical therapy generally treats symptoms- not the root cause of an issue. If you go to a PT because you have knee pain, they may have you do a bunch of knee extensions or simply tell you not to squat below 90 degrees(some of the least helpful advice in the history of biomechanics.) But none of that is going to help if you have a bunion that’s mucking up your gait.
The problem isn’t always where the pain is.
While targeting a specific muscle or group can be helpful, it’s important to look at the context of how it operates with the rest of the body. It’s only one piece of a much, much larger puzzle.
3. You’re Restricted by Insurance.
Unless you have a unicorn for an insurance broker, most plans only cover a limited number of physical therapy visits over a period of time- but that is not how healing works. It is not finite, it is not linear, and there is no “done” button. Healing can take time, frequency, and consistency. Sadly, our medical system is not designed to support individual needs.
Insurance restricts not only how much care you can get, but also who you can see. If I had a dime for every time I heard a friend or client say “I loved my PT but they’re no longer in network and now I have to see someone else who isn’t as good,” I’d be chilling on the coast of Ireland with glass of 20-year-old whiskey while I write this.
Having almost no control over which practitioners you see means that many people end up going to providers who aren’t actually helping just because insurance will pay for it. This is not the fault of the practitioner or the patient, but IS a reflection of what a huge clusterf!@#k our medical system is.
What is the solution? Hell if I know, but it’s a bigger problem than one blog post can possibly solve.
3. You’re not Getting Enough 1:1 Guidance
When a craniosacral therapy or personal training client brings me their physical therapy exercises, they often lament that they don’t know what these exercises are doing for them.
If you don't know why you're doing something, chances are you won't be very motivated to do it. Again, this isn't necessarily the fault of the PT. There simply isn’t enough time spent helping patients understand the tools that support long-term healing.”Fast food” PT sessions are usually either dictated by insurance or by corporate clinics who aim to get as many patients crammed into a day as humanly possible.
If you're struggling to maintain results from physical therapy, I encourage you to have compassion for yourself. Your body isn't broken. There is nothing wrong with you. This is the way our medical system is designed and it doesn't set anyone up for success.
How to Find a Physical Therapist that Works for You:
Finding a good physical therapist can feel like searching for a needle in a haystack. Going through insurance is limiting and laundry lists of certifications, degrees, or education doesn’t tell you anything about what they can do for you.
Here are some ways you can find a PT who suits your needs:
Ask for referrals
If you have practitioner in another modality, ask them if they know a good PT. Craniosacral therapists, reiki healers, acupuncturists, massage therapists, and chiropractors all have referral lists on hand and can point you in the right direction. If you like and trust someone, chances are they will know other people who are doing good work.
Asking friends, colleagues, or Facebook groups is also a great way to find someone. A while back, my aerial teacher mentioned that she loves her PT who specializes in dance-related injuries. So, when a dancer friend of mine injured her hip, I told her this PT came highly recommended and knows how dancers use their bodies. My friend went to her and came back raving about how great she is.
Read reviews
Reviews on Google or Yelp can give you some insight on whether a PT is going to be a good fit for you. Of course, reviews aren’t perfect examples because not everyone writes them. But, you may find that others’ experiences, good or bad, will give you more information.
Ask the provider
If in doubt, give your prospective PT a call and ask what a session looks like. They won’t be able to give you advice over the phone, but they can tell you generally what to expect. If they balk at you for asking, take note. If they listen with compassion and answer with patience, that’s a green flag.
The downside is that if you are going to see the provider you want, you might not be able to use your insurance. Before you totally write them off, ask about cash pricing. Some providers have a discounted rate if you pay out-of-pocket, likely saving you money in the long run. Keep in mind, this depends on your insurance plan, your financial situation, and whether you have a chronic, ongoing issue that requires long-term maintenance.
If you’re still struggling with your physical therapy, it can be helpful to find a coach who focuses on rehabilitative movement (like me!) Getting some 1:1 guidance can boost your motivation, break down exercises, and help you get the most out of your program.
To set up a session, grab your spot on my schedule here.