What to say to your physical therapist

A good physical therapist can tell a lot about your family, your job, and your health—without you ever saying a word.

What do physical therapists do?

At a basic level, physical therapists help people heal. That usually involves learning about the health, symptoms, and goals of their patients followed by a plan for managing and relieving symptoms. But before they even lay eyes on your medical chart, physical therapists can tell so much about your wellbeing by looking at you. Here are the secrets they know.

You sit too much at work

“People are less active today due to technology and better mass transportation. Sedentary jobs have increased 83 percent since 1950 and physically active jobs now make up less than 20 percent of our workforce. Plus our average workweek is longer—about 47 hours working each week—and all this sitting takes a toll. When I see the trifecta of back pain, neck pain, and repetitive strain injuries, I know you are sitting too long at work and not taking breaks.” —Joe Tatta, physical therapist and author of Heal Your Pain Now. (If you do have a desk job this is the essential stretch you need.)

You have a drinking problem

“Typically a patient’s posture and soft tissue or muscle restrictions can reveal stress or fatigue, like from a hangover. Additionally, because I see them so frequently, I can notice any other signs of disturbance in their daily function. I never judge though and try to build a level of trust with my patients that not only allows me to use my hands to treat them, but makes them feel comfortable enough to open up to me about whatever may be impacting their physical health.” —Matt Rector, physical therapist at H&D Physical Therapy in Manhattan

You hate vegetables

“Just by looking at [someone’s] somatotype (body shape) and phenotypical traits I can tell which health problems they are likely to be at risk of or already suffering from. For example, striations in their fingernails and cracked skin indicate they are deficient in essential minerals, vitamins, and other nutrients.” —Matt Reimann, MS, CEO of ph360 

You’re a runner who doesn’t stretch

“If you are a competitive or recreational runner but do not stretch or strengthen you can be predisposing yourself to injury. Many people complain of chronic hamstring strains or struggle with knee pain from tight IT bands. I can tell just by looking at the way you walk or the muscle imbalances you have that you’ve been running too much and need to balance out your program.” —Joe Tatta

When you’re lying

“People assume pain is a simple response to a stimulus and that a straightforward exercise or modality will fix them. However, it often is much more complex, and we have to tease various things out of a patient to better understand their pain. It is my job to find out the stressful things about a patient’s life, their work, their family, their marriage, and others. Sometimes they tell me things they have never told anybody. We also find out things that are encouraging to them, and sometimes they find positives they had not realized before. To help someone truly understand and deal with the pain we need to help them find a balance between these things. It is only then that our various treatments will achieve their best chance of success.” —Andrew Walker, physical therapist, owner of PhysioWorks, Sports, and Wellness, in Huntsville, Alabama

Your romantic life is suffering

“That sore back isn’t just one of the most common reasons for skipping work. It can also affect your happiness in the bedroom. Certain positions may increase lower back or pelvic pain, especially for women, leading them to avoid intimacy. It doesn’t have to be this way though; a physical therapist can help you and your partner get back to normal.” —Joe Tatta

Your baby won’t stop crying

“Sometimes I can just tell by looking at a mom that her child isn’t sleeping or seems to be crying all of the time when she puts him or her on the floor. When I put my hands on my patients, I can feel their frustration and listen to their problems. Often the child lacks mobility so they become frustrated so they act out with behaviors, cry, and are restless which takes a physical and mental toll on both of them.” —Katie Henry, physical therapist and health coach

You’re depressed

“My patients’ bodies give me clues to their emotional state. I’ve become fairly accurate in knowing when I’m working with a patient with anxiety or depression. There are two clues. The first is whether a patient is able to relax enough to allow me to easily move their limbs passively. If they can’t this tells me there is excessive tension in their system. Second are trigger points, tender little knots within the muscles. Often pressing on a trigger point will cause a referral pain elsewhere. So when someone has many trigger points in some key areas, in addition to not allowing smooth passive movement of a limb, I begin to suspect an underlying emotional stressor creating excessive tension in their system.” —Rick Olderman, sports and orthopedic physical therapist and author of the Fixing You series

You pee a little every time you laugh

“Pelvic floor disorders, especially urinary incontinence, affect up to one-quarter of American women. Many people don’t realize that this is something a doctor of physical therapy can help. Learning exercises to strengthen and retrain the pelvic floor muscles can reverse or prevent urinary incontinence in both men and women. Weak pelvic floor muscles can manifest as pain and weakness not just in the pelvic area but also in the legs and hips. Don’t be embarrassed to bring it up with us, chances are we already know.” —Joe Tatta

You reserve a table for one

“There are many patients who are withdrawn and lonely, and it is evident during treatment. They will ‘overreact’ or have negativity surrounding their level of pain (for instance saying their pain level is 10 out of 10 for even the slightest movement), and think of things as glass half empty versus half full. They also tend to have a withdrawn posture.” —Lawrence Kim, a board-certified orthopedic physical therapist at Edge Physical Therapy and Sports Medicine

You have abuse in your past

“People with a history of physical or emotional trauma are more likely to struggle with chronic pain syndromes. We doctors of physical therapy are good at recognizing the link between trauma and its effect on the body and helping to treat it.” —Joe Tatta

What you do for a living

“Patients will come into treatment with a style and plan based on their job. Lawyers need to understand the full relevance of the treatment and its concrete evidence of how it’s supposed to work, engineers want to know the mechanics behind each exercise, and mechanics will often think of their bodies as a combination of auto parts put together and so forth. I can figure out pretty quickly what you do just based on how you react to your treatment, even if you don’t tell me straight out.” —Lawrence Kim

You’re constipated

“Digestive issues and discomfort are very common and I can feel areas of tension. If their tummy is tight or painful, or if it hurts to stretch out, it often has to do with stool or gas.” —Katie Henry

Sources

• Joe Tatta, DPT, CCN, author of Heal Your Pain Now
• Matt Rector, PT, DPT, physical therapist at H&D Physical Therapy in Manhattan
• Matt Reimann, MS, CEO of ph360
• Andrew Walker, PT, owner of PhysioWorks, Sports, and Wellness, in Huntsville, Alabama
• Katie Henry, physical therapist and health coach
• Rick Olderman, MSPT, a sports and orthopedic physical therapist and author of the Fixing You series
• Lawrence Kim, PT, DPT, OCS, a board-certified orthopedic physical therapist at Edge Physical Therapy and Sports Medicine
• Tim Cummings, physical therapist at Elite Physical Therapy and Integrative Health in Missouri

Originally Published: March 16, 2018