My shoulder hurts. Where should I go?

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June 27, 2017

Stevens Point– It’s happened to all of us. We are getting into the swing of baseball season when our shoulder starts to bother us when throwing people out at first base. Or our knee begins aching during our long training runs for the upcoming cross country season. Or our back starts aching during off season squat and jump training for football or basketball.

What do we do when this happens? Inevitably, if you are anything like me, you hope it gets better in a day or two, and then jump back into our normal routine. And to our dismay, many times the ache and pain returns and we deal with it until we can’t bear it anymore. Once we finally admit we need some help, we start to think through our options and ask, “Where should I go?”

Some of us may be facing a scenario where we feel we need to be seen immediately, so we stop into urgent care or the emergency room. Others may think it would be best to set up an appointment with our primary care physician or family doctor. Likely at that point, we may receive some imaging such as x-rays, directions to take ibuprofen and ice more, and many times, a referral to physical therapy.

One option you may not have considered as your first option for care is to go see a physical therapist. In fact, it may even sound strange to think as a physical therapist as your “go-to” treatment option. But hopefully after reading this, it will help you understand how a physical therapist can help. As of January 1, 2015, all states have what is termed “direct access,” which allows physical therapists to perform some level of care without a referral from a physician. But why choose a physical therapist as the first health care provider you see for your new onset of pain? Here are a few reasons.

A physical therapist is the movement specialist. Physical therapists have vast musculoskeletal knowledge and are able to assess how individual joints move, how you walk, or how you move your arm to determine the source of your pain and how it can be alleviated. Many physical therapists have doctorate degrees specializing in movement science and rehabilitation.

Physical therapists work to identify the root causes of the issue. With expert knowledge in anatomy, physiology, and biomechanics, a physical therapist is able to find the root causes, not symptoms, of your pain and work with you to create a holistic approach to help make you independent in managing your symptoms at home for life. In fact, physical therapists trained as sport specialists are able to help athletes both rehabilitate their injury while simultaneously decreasing their re-injury risk and improving performance.

Physical therapists spend a lot of one-on-one time with patients. Most medical professionals are frustrated that they do not get enough face time with their patients. Physical therapists prioritize time with our patients (at our clinic, it is 45 minutes to 1 hour of one-on-one time) so that we can truly get to know you, your impairments, and your goals with therapy.

It can save you (and the healthcare system) a lot of money. Instead of jumping through the hoops and paying for a doctor visit where you simply get referred to physical therapy, you can begin your care immediately with a therapist. Additionally, research is finding that imaging such as an MRI is not as helpful as we thought it once was for certain conditions, and therapy is typically the first line of defense before a doctor will order an MRI or recommend surgery anyway.1,2

Physical Therapists are trained to know when to refer. Physical therapists are trained to screen for more serious conditions that may require care from an orthopedic, neurological, or other specialist. If there are any red flags or concerns that warrant further investigation by a physician, a physical therapist is trained to get you to the best option for care.

In Wisconsin, most insurance coverage allow you to begin care with physical therapy without a referral from a physician. However, there are still some insurances that require a referral that may need to be obtained before physical therapy. If you aren’t sure if yours allows direct access without a referral, you can call our insurance specialist at Point Forward Physical Therapy (I put her information at the bottom of this article). She will be able to help you navigate your way to efficient and quality care!

As a physical therapist, it is truly my goal to provide expert level care that allows you to move well and optimize your performance so that you can do all the things you love. Thankfully because of direct access and the level of education physical therapists receive, I am able to pursue that goal more easily. There are many places that you can go when your body starts to act up on you. Hopefully you now know that seeing a physical therapist may be your best first choice.

Written by: Nathan Brown PT, DPT, MS

Insurance Specialist: Jen Lepak (715-254-3978)

Nathan is a physical therapist at Point Forward Physical Therapy in Stevens Point, WI. Point Forward is an outpatient sports and orthopedic clinic that treats people and athletes with any acute musculoskeletal or chronic pain conditions as well as people with neurological conditions such as vertigo, stroke, or Parkinson’s disease.

Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., … & Wald, J. T. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology36(4), 811-816.

Nakashima, H., Yukawa, Y., Suda, K., Yamagata, M., Ueta, T., & Kato, F. (2015). Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects. Spine40(6), 392-398.

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