Improving ability and reaching milestones

Physical therapy is the evaluation and treatment of various impairments and functional limitations like pain, decreased range of motion, decreased strength, poor balance, and decreased functional mobility.

Pediatric PT is the evaluation and treatment of patients who are less than 18 years old. It is different, as it is provided in a one-on-one situation where play is a main component of the sessions. Pediatric PT is often more habilitative, meaning it is used to help children master skills that they have never had before. Compare that to rehabilitation, which helps people to remaster a skill that they have already acquired in the past.

Physical therapists use exercises to help patient achieve functional skills. An example is a baby that is not yet able to crawl. A PT will use a combination of strengthening and mobility work to help the baby achieve the skill.

Physical therapy can help with strength and overall mobility independence for patients.

Physical therapy works more with gross motor skill development, while occupational therapy works with the sensory system and fine motor skills. PTs and OTs often work together to co-manage patients who have needs in multiple areas. A co-treat is a session in which an OT and a PT can see the patient at the same time, each tapping into the other clinician for assistance to facilitate a well-rounded session for the patient.

Pain, decreased strength, decreased balance, and delayed motor skill development.

Back pain, hip pain, decreased balance, shoulder pain, sport injuries, along with spina bifida, cerebral palsy, Down syndrome, infant prematurity, toe walking, torticollis, and poor movement patterns.

A typical PT session is a one-on-one experience with the PT and the patient. It can be anywhere from 45 to 60 minutes, often depending on the stamina and motivation of the child. Play and games are a main component of each session to gain rapport and allow the child to have fun. It is typical for a session to include blowing bubbles, coloring, or putting together a puzzle.

There are many treatments that can be provided by a PT. Some, to name a few, are stretching and range-of-motion work, either through exercise or through manual work by the therapist; strengthening with or without weights; balance training with mirrors for visual feedback; and coordination skills like jumping. Often PTs will use exercise balls to help with core strength and overall stability. Some physical therapists are trained in Kinesio® taping, which is used to help facilitate positions and movement patterns with application of tape in certain ways.

Physical therapists require a bachelor’s degree as well as a Doctor of Physical Therapy (DPT) degree from a graduate school with an accredited PT program.

Many therapists have certifications that allow them to perform certain interventions. These include but are not limited to Kinesio® taping, neurodevelopmental technique, and manual therapy.

Each session lasts anywhere from 45 to 60 minutes, depending on the goal that day and the stamina of the patient.

Some patients will only need six total sessions, while others may need physical therapy for many years. Each situation is different.

Progress is measured by using goals. Goals are looked at each session and can be either not met, emerging, or met. In pediatrics, there are outcome measures that can be used to compare the skills of a child to same-aged peers to see if the patient is performing skills of a typically developing child. There are various tests that can be used depending on the age of the patient and/or the concerns.

In Illinois there is something called direct access, in which you can see a PT for five visits without an order from the doctor. However, if you are using your insurance, the carrier may require that you have a doctor’s order for reimbursement purposes from the start. Trestle always recommends clear communication and encourages you to get an order from your doctor prior to treatment.

A referral may be needed if you have certain insurance plans that require it. Your insurance company can verify this for you.

Physical therapy is an excellent choice because it is a non-invasive treatment option that is proven to be effective for many different patient groups.

Choosing private practice is often a better financial option for patients. Billing and cost can be more at a hospital facility. Private clinics are able to create a culture of treatment that can be more creative and more autonomous.

Physical therapy does require that you move your body. Sometimes, if those movements are new, there can be some soreness one to two days after treatment. If something that the therapist is having you do or doing to you is painful, you have every right to speak up. When
that happens, the activity is either stopped or decreased in complexity. It is important to
remember that you have the right to advocate for yourself. A main purpose of PT is to alleviate pain, not to cause more.

At Trestle, we do not believe physical therapy should hurt. If you ever feel pain during your protocol, stop and let us know so that we can address it. There is a difference between pain and muscle soreness. Often people are unfamiliar with muscle activation and can describe it as pain. If something hurts, that is the body’s way of trying to protect itself, and it should be reported to your PT.

There are many ways that physical therapists can help with pain. Manual work like soft tissue mobilization, joint mobilizations/manipulations, muscle activation, gentle stretching, and exercise are all ways we can decrease pain.

Yes, that can often be the case.

It will help you! Patients who complete plans of care and do exercises that are recommended at home will make progress toward their goals.

We can provide a therapeutic diagnosis. An example would be a child who walks on their toes. The therapeutic diagnosis would be “abnormality of gait.” A physical therapist is not allowed to diagnose a patient with conditions like autism or cerebral palsy.

It can take longer if the patient is not following the recommendations that are put in place by the PT. Sometimes patients try to speed up the process by doing too many activities, and that can create injuries or other problems and increase their therapy time. On the other hand, if a patient cannot or does not perform the recommendations, that can also create more time in therapy. It’s a fine balance, which is why we encourage patients to follow the recommendations as given. As you’re building strength, it will help motor skills. However, there can also be relapses. Every patient moves at their own pace. No need to get discouraged as long as progress is moving forward.

It is up to the clinician, but a typical plan for a pediatric patient is once per week. If a patient is post-surgical, it can be two to three times per week.

Each insurance plan is different in terms of the coverage for physical therapy, but it is covered in most cases. Some insurance plans require a referral from a primary care doctor, and some do not. Some plans have limitations on the number of visits allowed per year. All these things should be checked with your insurance carrier ahead of treatment.

Clothes that are not restricting are best for physical therapy. A perfect outfit is a tee-shirt and comfortable shorts or pants and grippy socks.