these are the questions you need to be asking in pt

Asking better questions is the only way to get better answers.

This could not be more true than in the realm of physical therapy and rehab. We all want to end up with the right answers: the solution for whatever pain we’re in, the reason the pain began, etc.

But if you’re not starting with the right QUESTIONS, then your chances of actually getting where you want to be are much slimmer.

As a physical therapist, a big part of what I do is answering questions. Questions from my clients, from my family, from my friends, from random people on social media. And what I’ve found is that, in the course of answering these queries, I often end up reframing or rewording the question itself.

Let me expand on that by giving you some of the most common questions I receive (questions that you yourself have probably had at one point or another), and how I might make them better to focus on the right things, and get to a better answer.

• I saw this one video on Instagram for knee pain—should I do it to fix my pain?

• I’ve heard cold plunging, ultrasound and redlight therapy are good for what I’m experiencing. What do you think?

• I started having pain in X place. Does that mean I need to stretch more?

Now, let me show you how I’d make these questions better, so that they’re actually getting to the heart of the issue, the ANSWER that the person in front of me probably needs to hear.

Should I do this one exercise to fix my pain?

This one is so so common, and that’s unsurprising because of the way that many social media posts portray the relationship between exercise and pain. Yes, it’s possible that the exercise in question could be a positive addition to your rehab, but the question is missing the forest for the trees. One exercise alone is not going to single-handedly “cure” your pain in 99.9% of instances, and to view pain as something that can be fixed by a single exercise is reductionist. There are lots of factors that influence pain, including sleep, nutrition, stress, mobility, capacity, etc. Exercise is just one part of that, and a random exercise, in isolation without context, probably isn’t going to do a whole lot. You need to have an intent for the exercise, and it needs to be part of a bigger program that is focused on building the QUALITIES (mobility, strength, endurance, power, etc.) you need to bridge the gap from where you’re at to the things you want to get back to doing.

A BETTER question might be (provided that your PT has a knowledge of your history and has done an exam):

• What would a program that addresses my pain look like?

• OR what qualities do I need to get out of pain, and could this exercise be helpful?

I’ve heard cold plunging, ultrasound and redlight therapy are good for what I’m experiencing. What do you think?

These things could be helpful in conjunction with a bigger program, but they’re ultimately the 0.1% against the 99.9% of things like stress management, a solid training program, good recovery, etc. They shouldn’t be relied upon in isolation to produce significant results when it comes to pain, especially if you’re not doing the other big things that will move the needle much more significantly.

A BETTER question might be:

• What are the things that are going to move the needle the MOST when it comes to my getting out of pain / getting back to X activity?

I started having pain in X joint/area. Does that mean I need to stretch more?

“Stretching” has long been synonymized with what PT is. “Go to PT, do some stretches for 6 weeks, get out of pain.” Blech. It’s a narrative that needs to be rewritten 50 years ago. Sure, stretching can be beneficial. But it’s far from the end-all-be-all (sensing a trend with these questions and answers yet?). If mobility is something that your PT identifies as a relevant missing piece in your exam, then stretches may very well be a part of your program to work on that! But that’s just the start. As mobility improves, CAPACITY (qualities like endurance, strength, power, etc.) need to be layered on top of it to bridge the gap from pain to function. If you pulled a hamstring running, or hurt your back while squatting, I can guarantee that your “not stretching” was not the root cause of your injury. Mobility may have played a role, but there are so many OTHER factors at play that need to be considered and addressed in the rehab process.

A BETTER question might be:

• What seems like a root cause of my pain? Is mobility something that needs to be addressed for me to get back to X?

You get the gist. I’d say 90%+ of the questions I receive revolve around some sort of majoring in the minors. And that’s not the fault of anyone who’s asking me a question! It’s the narrative and relatively unimportant factors that have been normalized/portrayed as important by social media, below-average PT clinics, and other healthcare professionals over the past few decades.

But that’s why I’m here, trying to rewrite the narrative and redefine what PT is. Because it IS more than these things—more than stretches, therabands, ultrasound, reductionist underloaded exercises, and ice packs + e-stim for 15 minutes. People deserve more and they deserve better.

They deserve better answers.

And it starts with better questions.