Is Physical Therapy Overrated?

This piece in Pajamas Media addresses an important medical question, but I can’t resist dedicating the obligatory quote to the personal anecdote in the intro:

Twenty-seven years ago I found what seemed to be the only functioning storm-drain in Tanzania, in East Africa, and fell down it, severely injuring a knee in the process. The journey to the mission hospital in the back of a pick-up truck over sixty miles of rutted laterite road was one of the more agonising experiences of my life.

I had an arthroscopy when I returned home several weeks later – I could not even hobble until then – and the orthopaedic surgeon told me that unless I did physical therapy every day for a very long time it was inevitable that I should be crippled by arthritis within twenty years.

It was equally inevitable that I would not do physical therapy every day for a long time; and here I am, twenty-seven years later, without so much as a twinge from my knee. My faith in the predictive powers of orthopaedic surgeons has been somewhat dented.

35 thoughts on “Is Physical Therapy Overrated?

  1. Bill

    I’ve been working in the Physical Therapy profession for over 18 years and I have to agree with you. Physical Therapy is very over rated and mostly unnecessary. If Physical Therapist were to stick their actual scope of practice, which is in hospitals where they walk patients and see if they are able to go home without any problems, then there wouldn’t be very many Physical Therapists opportunities available. You know there’s a problem, if you have a profession that tries to step into other scopes of practice, uses them, then takes credit for it. Most physical therapists talk a lot of bad things behind everybody’s back, including most doctors too. It’s a really questionable field to be in, I’ve heard physical therapists who have been in the field for over 25 years admit, that their not even sure if what they’ve been doing has even been effective to patients or not.

    From what I have seen, “Physical Therapy” mostly in orthopedic outpatient clinics is completely useless and a waste of peoples time and money. I can say, that “Fitness Trainers” definitely have what it takes to make a difference, especially in preventive medicine.

    My observations are based on actual experience over an 18 year period within physical therapy clinics. Patients will heal from surgery and injury no matter what happens.

    1. Chip Hurst PT

      Physical therapist here–15 years. You hit it right on the head Bill.

      I was 33 when I started practicing so I didn’t drink the kool aid led by the APTA.

      We have our place–an important place. Especially in ortho hospital and initial ortho recovery. Also neuro recovery we are essential. And pediatrics we are huge. The problem is just what you said–thanks to our APTA we moved our profession to a doctorate which isn’t even legitimate. They don’t do a real thesis that they defend, don’t do orals and don’t teach lower level classes while they go to some sort of “advanced PT school.” They go to PT school just like my Bachelor’s. They take a few courses and suddenly think they are chiropractors. Recently dry needling is the rage. No matter what the scope is the PT wants inclusion.

      Simple fact is we are ancillary. And on top of that we have become a charlatan profession. We are fascinated by the new fibromyalgia and chronic pain syndromes–we create philosophies on the matter, get certed and accomplish exactly nothing. Because in all of my years I have never seen one therapist, brilliant or not, solve a chronic pain patient. Because the new chronic pain syndromes are due to obesity and poor lifestyle. Oh and the chronic neck pain patient? It’s usually stress due to again our hyper lifestyle of unhappiness in this country. Huge divorce, huge debt and overkill on the job line all while living like Modern Family. Sure we can mobilize stiff cervical segments–and the stress re stiffens them unless the person changes their lifestyle–like exercise daily. Yoga four times a week would do more for these patients than PT. And we aren’t even bright enough to see that much. This patient whose problems are a reflection of lifestyle has become the PT’s main course for financial reimbursement.

      And for the person who sprains his back? Guess what, they don’t need to rush off to PT. Time does usually take care of it. And if they are 100 pounds overweight then time won’t solve it quickly. And neither will PT.

      Last year I quit a fellowship due to this nonsensical attitude. This “profession” has become utterly and completely ridiculous. First of all, most OP PTs are treating two patients at a time which is a waste of time. Do that and there will be no skill level 10 years later. And that IS how most OP clinics operate. I don’t and I’m usually the only one in the room who doesn’t. I also discharge the 100 pound overweight patient who won’t change his lifestyle. Now there are many many patients who have pain developed where ever in the 6 month to year zone that I can help–usually if they are active as a person. Mobilizations and soft tissue and a few key reprogramming exercises will do it. Usually in 6 visits max. But most PTs just bring them in and watch them do exercises with someone else in the room. Second, we keep taking the same patients back over and over as if what we do THIS time will somehow result in something new from the same thing we did LAST time. All while we shove research out screaming “evidence based, evidence based,” as these idiots shove multiple patients through the assembly line all day. While at the same time claiming they are “doctors” too.

      PT is the most pretentious profession I have ever encountered in the medical field which is ironic as they have the least amount of actual substance in their long term outcomes due to our sedentary lifestyle and obesity which has become epidemic. PT is also a profession largely made of do goodies who are myopic for what the rest of us call reality. The insurance companies should crush us and force us to go back to what we were primarily created for—neuro and ortho recovery in the short to mid term. And peds. Because the simple fact is that most of what we do now is a waste of time and resources.

      1. Bill

        Hi Chip! I just read your post and re-read my old post. I left a lot out of my original post, but you basically said exactly what I was referring too. Physical Therapy has it’s place in healthcare IF, future PT’s remain within our scope of practice. As for now, I see way too many new DPT’s coming out of school thinking they’re better than actual Physicians and there will be a day, when our profession gets put in it’s place by the gate keepers/Physicians. I feel we have more strength as a profession if we stay within our scope of practice.

        1. chip hurst

          Unfortunately, Bill, our opinion is in the minority. You should see the hate mail replies I get when I post the above on the forums. “You should get out, you’re five steps behind the modern PT, why are you bashing us, bitter much?, I would be terrified to let my patients near you?”

          I think a lot of it is a chronic anger when they realized they just got a huge debt that they are never going to pay off.
          I warned of this twelve years ago. If you type “Chip Hurst, Are you a Healer or a Sellout” you will find a now archived letter to the editor of Advanced PT. Way back in 2004 when I had less than 4 years in the field. Stating much of what I stated above. And now it is here. Old PTs are very vocal about the “new patient population”—-which is largely one of Generation X and Y irresponsibility and apathy. I’ve got less than five years left in the field and I’m done as the problem used to be the system—now it is the system and the patients themselves.

          Good luck out there in continuing on, Bill in whatever you do in PT land. ,

          1. Clinton Post author

            As Texans say, I have no dog in this fight, but I found this thread interesting and entertaining. Also, impressive that you all are reflective enough to accept the limitations of your profession. My own profession often pretends to be more effective and helpful than it is as well. Best wishes.

      2. Jillian

        Thank you for this. You made a lady smile, today. I’m not doing something wrong. It’s just not working. Thank you.

    2. Steve

      I am not in the medical field, but I have extensive education and work experience in the sciences. So, generally, I can smell BS a mile away and determine competence.

      When in a physical therapist office, I can smell BS.

      Doctors send nearly everyone to PT first to satisfy insurance before doing what they should do to being with which is: send the patient to a specialist MD and get proper testing done (including the coveted MRI) in order to determine what the actual problem is.

      Instead, they send you off to a mid-20s PT that pulls on your arm and makes you do some tests, but doesn’t actually know for sure what the problem is. They then make you do stretches and exercises that for all they know might be making matters worse. Then, they make you keep coming back to the office to do these simple exercises so that they can extract money from you. They add in a novel exercise here or there to make it seem like there is a progression and so it is vital to keep coming back while your bank account is drained.

      Then they recommend quackery like dry needling, which is not science-based medicine but PTs like because it makes them money and makes them feel like an importance surgeon.

  2. drew

    A few years ago I experienced considerable pain in my left hip. After visiting the Doctor I was sent for an xray . The xray technician would not reveal any information until I badgered her mildly,pointing out that she was probably more experienced in interpreting the results than many young physicians.She told me there was nothing organically wrong with me……so I was sent to PT.

    I went once to PT. When the cost was relayed to me I knew that I simply could not afford it.However I do have a physical therapist of my own; a fifteen pound schnauzer that demands to be walked extensively every day…….my pain went away.

    1. Chip Hurst

      Gee, activity and natural time healing solves acute pain. Like it has for thousands of years. Go figure. And wow–didn’t even need the help of a PT.

      My point about what our profession is getting reimbursed for on a global scale.

  3. Tim

    Every time I have been to Physio its a not so intelligent person with silly half baked exercises that I could do at any gym for 1/10th the price.

    Just went after Spinal fusion and after a few visits its the typical Physio nonsense. No one on one individual teaching me how to move properly. Just silly exercises I knew already.

    Seriously .. I feel like phony my insurance and telling them to take Physio coverage away. In my opinion thats all the industry does is milk insurance/benefit companies.

  4. Mr Brian

    I been to PT more than anyone you know. I had and still have plantar fasciitis, had and still have shin splints, 4 knee meniscus surgeries and rotator cuff surgery. It cost the insurance company in the $30k-$40k range! In my opinion, not yours, it was a huge waste of time and money. The first time I feel it was useful to show you how to do all the exercises, but no need to come back for the next 11 times to just do the same simple exercises I can do at home for free! Typical session, I walk in and they ask you how you are feeling and write something down on a clipboard. Then, put a heating pad on me for 10 minutes and I ride a stationary bike for 10 minutes. Then, they tell me, “Just do the exercises I showed you yesterday.” Afterwards, they put an ice pack on me for 10 minutes and I leave! I have gone to 4 different PT places in different cities in the last 15 years and that’s the norm. On the last session, they always say the same thing, “Call your doctor and see if you can add some more PT because I feel you could benefit from more sessions.” Apparently, I’m too stupid to do simple exercises at home and need supervision. Let me also tell you, in most of the places, they booked 2-5 patients in the time slot and the PT is running around! One place, I did one exercise, then waited 5-10 minute for the PT to come back because she had 4 other new patients she was instructed. Those 1 hour sessions turned in 2 hour session because of all the wait time. One time, I left 30 minutes early because she never came back and when I returned two days later, she asked me why I left 5 minutes early?

    1. chip

      First off your physical therapists were charlatans. I would have had you one on one. You would have been given a few key self mobilizations that would correspond directly to the MANUAL therapy I was doing. This will shock you but once you demonstrate whatever I tell you to do at home I never look at that again–because I’m working with my hands. I would have looked at foot mobilizations for the plantar problems then would have looked at the pelvis where I bet one side is higher than the other. Then would have looked at not only shoulder restrictions in the capsules as well as the thoracic and cervical ribs which can be huge contributors. And we would have worked on those for 45 minutes straight one on one. And maybe I couldn’t 100% resolve you—and if not I’d have let you go no hard feelings.

      What you got were charlatans who think they are doctors for going to PT school after a degree which was unrelated and don’t have the brains to realize they are being nothing more than glorified athletic trainers

  5. Debbie Kerchenski

    This is all very interesting and in agreement with what I have been feeling. I hurt my arm and shoulder and went for an x-ray with an orthopedic doctor. He is unable to tell me exactly what is wrong because without an MRI there is no telling for sure if I have a tear somewhere or it is another type of problem. But, unless I go to physical therapy, the insurance company will not pay for an MRI. So I am bound to go to physical therapy where they will probably make the matter worse because how can you treat something that you don’t even know what you are treating? I don’t want them to make a rotator cuff tear worse or if it is another tear in the arm somewhere. I have been to physical therapy after a car accident and it helped none whatsoever. Rest, cold packs, heat and massage worked better. Granted, it was only a soft tissue injury but in any event the physical therapy did not help at all. My neighbor was sent to physical therapy after she fell, and again, without an MRI, they had no idea what they were treating. She was in excruciating pain and had cortisone shots and the whole nine yards. In the end, she demanded an MRI and came to find out she had a severe herniated disc that was not going to get better at all with any amount of physical therapy or cortisone shots unless she had surgery. After the surgery, which was done by a fantastic doctor, she is able to move freely. I too believe that a lot of people are milking the system. I will go to physical therapy as directed only for the amount necessary to get an MRI.

  6. Reginald Cociffi-Pointdujour, PT

    Well, surprisingly enough, this threat didn’t hurt my feelings. I’ve been practicing for 12 years and have found that some people get better, some don’t. Some of the things I used to do a long time ago and swear by, I don’t do anymore. We’re moving into a space of evidence-informed practice and really the drivers of that practice are the therapists who were frustrated about all the nonsense their counterparts were doing and about all that wasn’t working. The new grads, whom you think are too arrogant, are all over the idea that they need to do better to help people more. They will be the clinicians who reform the view of who physical therapists are and what they do. I love PT. I’ve helped a lot of people, even if it was just to convince them that they need to develop a better lifestyle, including eating better, sleeping more, taking regular walks. And that definitely falls within my scope of practice. And I track validated outcome measures for all of my patients so that I know what’s helping, what’s not helping, and where I’m weak and where I’m strong. I’m not bitter at all. If I feel I’m not helping, I’ll change or stop. Definitely not bitter about the profession. I’m more excited than I’ve ever been.

    1. chip

      Are you excited about the profession where 80% of the clinics see 16-20 patients a day running them through assembly line exercises?

      Or is it the new chronic pain patient that gets seen over and over who is 100 pounds overweight that PT nor anyone else can fix that you are jazzed about.

      Maybe you’re in the 20% of people in this profession who is operating ethically. But this profession as a whole is made largely of charlatans now. And by the way–clinical results trump evidence based research that the new grads keep mouthing off about in-between falsely declaring they are specialty doctors which they aren’t as they see two patients at a time.

      1. Raven

        You seem angry and maybe have been burned in the past. Even if it is a few in outpatient, is the profession worth it to give back their lives and have them live painfree with manual interventions, home modifications, exercise and movement fine tuning and professional educational sessions? Or do you throw it all away and tell those that benefit, it didn’t work for me immediately so you don’t get a chance?

  7. Disgusted with One Trick Pony Orthos and their staffs

    I have only found PT useful post op when I had a minor meniscus issue fixed several years ago . Worked great.

    Pulls, etc….
    Forget it. Woke up totally healed from a rotator cuff strain after 6 months of PT in the interim when my insurance was being evaluated a couple of weeks after I stopped the therapy and I was going 3 times a week with little tangible improvement during the therapy for all that time. Never was bothered again with the stiffness and it was over 15 years ago.

    They are also useless for hamstring strains, I recommend rolf massage type therapy for that. One session brought me out of a 3 year bout off and off and useless expensive PT. I walked down the stairs with EASE after ONE rolf treatment. Their stretch therapy, totally wrong and not geared toward tight fascia like rolf is.

    Orthopedics are bone/joint people. Their lack of knowledge on muscle/tendon issues is abhorrent to put it mildly. I don’t think I ever heard the term IT band either in an orthopedic doctors office.

    With those experiences, I can only conclude if they don’t have to cut you, they just aren’t interested in really helping at all and their PT is really a waste of time and money for anything but surgery rehab.
    And yes it is also abhorrent at $250 a session to not have hands on treatment the entire time and have them run several patients at a time. Someone is cleaning up with this rip-off set up.

  8. Lori Langeland

    Physical therapy for most aches and pains is a waste. Been there done that. You walk into a state of the art gym. Most of the more sophisticated machines are not used. Most of the concentration is placed on “elastic bands” – so the therapist can do as little as absolutely necessary. Furthermore the “band” route is something a dr’s nurse could explain how to do during an office visit office. The band exercises are simple. No need for a therapist. Something you can do in the privacy of your home.

  9. Lori Langeland

    GPS prescribing Physical Therapy 4 every ache and pain is like sending some1 to a Chiropractor who also practices voodoo. Physical therapy these days seems to be the magic cure-all from everything from the common cold to farting. It’s over rated, In most cases there is no improvement. Also, most of the exercises are done with bands, simple enough to follow where a Dr, could print off a copy of the exorcism involved have his nurse give u a rubber band and send u on your merry way. Also, GPS will generally write a prescription for a certain amount of sessions, Once visiting the place the Physical Therapy’s business office 1st contacts your insurance company to find out how much of this voodoo they will actually pay 4 & then take advantage of the situation. With the money wasted on physical therapy and the bozos working there that same money would be better spent on joining a neighborhood “Y” and working out a couple of times a week.

  10. Sacguy

    I agree. After fracturing my right distal fibular near my ankle, the podiatrist only took xrays and refused to take MRI and tells me 6 weeks later the fracture is almost healed and sends me off to local PT who is a total clown. So now I have to go complain to my new primary care doctor about poor Sutter healthcare sham system and demand a second opinion and MRIs to find what the reason why my ankle is not getting any better and I still have excruciating pain almost 8 weeks later!

  11. Almost burned out

    This is so true! What a relief! I just had a big realization today with the current practice of PT that it is getting worse with insurance and clients. As a PT for 10 years, companies jut want us to please patients and just do whatever customer wants. It is no longer an evidenced based practice but a patient knowledge based practice. Maybe that is why they called it patient centered duh. If they want 30 min of massage that’s what they get even of its useless or placebo but if they say it works in their head then it works adding a beautiful lip service will make it seem like a grand experience. If the patient become even a slightest sore from the minimal exercises prescribed lol the bands that you can do at home. We are barraged with complaints of incompetence from patient and company. Only a few patients can be pushed to achieve goals of range of motion, strenght, posture, ergonomics and etc… It is draining and exhausting if you really want to help clients. Companies prefer that we provide minimal treatment for patient satisfaction and see more patient reaulting to decline and quality of care. You cannot move an immovable objects and only lead a thirsty horse to the water.

  12. Ev

    I found this site because I have been going to PT over the last year, and I have become completely skeptical that it is a legitimate therapy for any of the issues I suffer. so I went online to see if others had the same experience or perception. As a few others have mentioned here, all PTs do is a brief little massage session and then have some assistant run you through basic exercises that I’m quite sure are not really doing very much. if I was trying to become more mobile after something like surgery, I could totally understand it. But they have done absolutely nothing to help my hamstring problem, my glute problem, my shoulder problems, and my forearm problem (which I’m pretty sure has been torn for 3 years now). I have even had to tell them that I just can’t do most of their exercises because it’s simply hurts too much. I swear, they are doing more harm than good, and it is a complete money-making racket.

    Combine all of this with the fact that scientists can hardly put out reproducible results at a rate much greater than chance (see Crisis in Peer Review), this kind of degradation in “medicine” makes sense, sadly. The amount of garbage coming from our scientific and medical institutions these days is an abomination!

    1. chip hurst

      Question since I’m burning up this thread. I’m the one above attacking my own profession. Hamstring injury–did anyone look at the hip ball and socket alignment, did anyone see if your pelvis was off, for shoulder and forearm–did anyone extensively look at the neck and spinal segments *the forearm could be related). Did anyone compare upper trap to overactive levator scapula?

      If they just gave you core exercises then that is the problem and the typical “PT” nowadays as they see 20 patients a day. I will bet they didn’t actually look at any of the above. 10% of my treatment time out of a 45-60 minute session one on one is actually exercises to reinforce what I do with my hands. Do you see what I’m saying?

  13. Jenn

    About 3 or 4 years ago I acquired what the ortho called a shoulder impingement. (not really sure how it happened-maybe work) He sent me to PT and it went great. I think I went a total of 6 times (whatever the insurance said). I DID do my homework – all the stretches and exercises the guy told me to do at home. Pain was completely gone and I moved on with my life. All was fine until April/May of 2020 when I went a little to aggressive on the erg and all of a sudden had incredible pain in the same shoulder. (I had completely forgotten about the first time 3 years ago.) Ortho says same thing – shoulder impingement, I can prescribe PT or you can do them at home (this was the beginning of the pandemic). I figure I can handle this and start looking up exercises – the familiarity of the exercises is what reminds me ‘hey, I’ve had this before-3 years ago’. I continue the at home thing but it’s really not getting that much better so I decide to push for an MRI and find out I have a frayed supraspinatus. Mind you, the ortho just says ‘frayed rotator cuff’. I am completely pissed that the Dr. didn’t look at my chart and say “Hey you had this 3 years ago!” but moving on…….. I continue the home PT and it is NOT getting better. 7 MONTHS LATER I decide maybe I need PT after all and guess what – it is working! He is the one who asked me to get the actual paperwork that says which specific muscle is frayed (this is how I know it is the supraspinatus). I go to the same guy each time, he gives me HW and I do it. He asks me specific questions about things like sleeping, blow drying my hair, work related movements, etc. Its been about 2 months – twice a week usually but some missed appointments due to the pandemic and shutdowns and this morning was the first time since it happened that I woke up without stiffness, aching or pain. No one will ever be able to tell me that PT didn’t help me. My husband thinks its all nonsense – he has had 2 hip replacements and didn’t finish PT either time and barely did his HW. He limps around and blames it all on his hip replacements. Physical therapists aren’t magical. Its a team effort and you have to hold up your end or its not going to work for you. Obviously not everyone has the same injuries or surgeries and some may never heal to where they were before their injury or surgery depending on many factors. A complete tear is different than frayed, some people aren’t as healthy to begin with, maybe they are overweight, etc. But to throw the whole profession under the bus seems, quite frankly, a little ridiculous.

  14. chip hurst PT

    I didn’t throw all of the PT profession under the bus. I threw about 80% of it under the bus and that is completely legitimate.

  15. Anna

    I found this thread after googling “is physiotherapy useless”. I came to believe it was after one appointment with a PT (for shoulder/wrist pain on one side). I was given some grandma exercises to do at home and told to come back the following week.

    Instead, I went back to googling and found bob and brad videos. They were helpful but I still thought I could do better. I then found a book on hanging to help shoulder pain and that was the panacea I needed. Not grandma exercises with 5lb weights but serious strengthening through calisthenics. I bought a pair of gymnastics rings and a pull-up bar and 2 years later every creak and click has gone away. The tightness in my shoulders is gone.

    I found a program online that is based on foundational moves in gymnastics and I think it could benefit anyone. Jump, squat, push, pull, flexion, extension – all basic body moves that we do as children that we don’t do as much, or at all, as adults.

    I could have gone to physio for a decade and not come half as far as I have with calisthenics workouts. They can be as basic or as advanced as you like so anyone at any age can benefit.

  16. Billy Rankin

    The only thing physiotherapy has ever achieved for me is draining my bank account.

    Might as well have a shaman casting bones or burning entrails.

  17. Tina

    Like everything, no 2 are alike even if they are manufactured. Dr.’s, people, PT’s. 3/4ths of them are taught to make money not help people. The others help people no matter what someone wants them to do. Those are the ones you want, those are the ones you want to teach others going into the field. Fight for what you know is right. For the few that you can truly help and have helped. Fight with the bad doctors and make them see you, not just their 40th patient of the day. Find the good ones and support them. Know the person that is ultimately responsible for your well being is your self. Sometimes it is as bad as you think but you can still enjoy the ride.🤠

  18. Aksun

    Just went for 2nd round of PT, just doing it for the MRI and shot. So ridiculous. The orthopedic doctor sent over my records I’m sure with my specific diagnosis but the PT spent the first hour trying to figure out what body part is hurting? Well did you take the time to look at the referral? From the DOCTOR?

  19. BikerGirl

    Just came upon this forum after Googling PT. About a year ago, I was diagnosed with moderate hip osteoarthritis, which totally shocked me because, although age 59, I have been active all of my life and am not overweight. (I am 5’5.5′ and weigh 118 pounds.) I suspect all of my bicycle racing, rollerblading, rock climbing and waterskiing in earlier years are catching up with me.

    Anyway…the doc said I “may or may not” need surgery, but they wanted to send me to PT (this was before he got the results of the MRI, which, yes, did confirm his diagnosis.) I asked him point blank if hip osteoarthitis was reversible, as I wanted to keep a very active lifestyle, and he said it is not, and that the cartiledge could continue to wear away. Crap.

    So, because Covid rates were high in my area, I didn’t want to be in a room with everyone huffing and puffing. When I went to the first PT appointment, I explained to the PT that I would like to know which exercises to do, and I would do them at home because of the pandemic. He gave me an annoyed look (he was a “doctor” of PT), and gave me three exercises. Seriously?! THREE?!

    I went home, logged into my electronic med records account, found the notes from my doc for the PT. He had listed about eight exercises, plus “cupping” over the course of a 12 week treatment period.

    Yeah. Like I have the time (not to mention money) to go three times per week for 12 weeks.

    So, I looked up some videos online on how to do the exercises and started doing all of them myself. After about three weeks, the pain started to subside, but then I hit a plateau. So, I went back online, searched for more exercises, and found several that my doc did not recomment for the PT. I stated doing those exercises ON TOP of the original in his notes and, lo and behold, I REALLY started to feel better–for almost eight months. Honestly, some days I had ZERO pain!!

    Sadly, now the pain is again starting to slowly edge up. I think it is because I have been sitting more at my desk for work lately. So, once again, I added more exercises. But this time, the added exercises are exacerbating the pain. Still, I’m going to keep doing them for at least a month to see if things change.

    My point in all of this is: Most of this you can do at home. The only time I can see a PT being necessary is: (a) If the patient is lazy and won’t do the exercises without supervision; (b) If special equipment is needed to perform some exercise (like an elliptical or bike, etc.) or (c) To ensure that the exercises are being done properly.

  20. Matt

    Former PTA with ten years of experience. Most of PT is nonsense and the profession should be slashed by 90% or more. I don’t understand why it even exists in its current form. PT should be utilized for patients who require true physical rehabilitation. Patients who have experienced catastrophic physical injury or disability in the appropriate setting. Not private, for profit clinics or Nursing Homes. Those places are going through the motions to be reimbursed by Medicare and Insurance Companies. At its best it’s mostly snake oil bologna, at it’s worst it borders on elder abuse and harassment of the elderly and particularly those with dementia as they don’t have the cognitive capability to decline these unnecessary services which often further their confusion all for the purpose of enriching the business’s that perpetuate massive and constant fraud. We get it to it to help others but I often knew I was doing no such thing. In fact, I was participating in a scheme whose purpose was designed ONLY to make money. It’s often a despicable enterprise.

  21. Claire

    This is something I’m super curious about myself. I have officially decided for myself that chiro is essentially snake oil but haven’t cemented my ideas on physio. I have a genetic connective tissue disorder called EDS and have been experiencing more and more pain and dislocations because of it. I’m hoping to learn more on how I can move my body and strengthen my muscles to prevent more dislocations and I’m hoping a physio will help. I’ve only been once thus far to a physio who specializes in hsd and eds and will try to remember to update with my thoughts. I am hopeful but definitely cautious.

  22. Teresa

    Late to the party as they say.

    I appreciate manual physical therapists and I have had a good PT that is half manual and half exercises. The best thing you get from PT sessions is accountability, someone who will notice if you’re not exercising and making progress. They’re pretty much a personal trainer funded by insurance.

    My latest PT experience was the classic type, where they slow walk you through a set of exercises you can look up in a book and then dump you the minute they have to go to the work of seeking more pre-authorizations. The amount of PT they believe you “need” is directly proportional to how many sessions your insurance will allow before pre-auth is again required. It’s a mill, it’s a scam, it shouldn’t even be covered by insurance, except with elaborate justification.

    I will never do this to myself again. Going forward, I think massage might be worthwhile sometimes for tight muscles, heat, stretching. But PT mills are a joke.


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