Is Physical Therapy Essential?

Leaning into the pain during lockdown.

I had last seen my physical therapist for back pain six weeks ago. Due to the novel coronavirus, I was worried about returning.

What is essential?

We’ve heard much about essential workers as of late. Nurses, grocery store stockers, and cashiers. All essential.

But what about physical therapy? Is it essential?

A promising appointment

A voice emanating from my phone had guided me to the office. Only my second visit there. No sense risking being late (by missing a turn).

“This is the one that’s finally going to help me with the pain. She seems to get what’s going on with me. More so than the last one.” These were the thoughts I had as I got closer.

Suite 101. I parked in the lot adjacent to the entrance.

It was a gorgeous day. I shed my jacket, tossed it on the car seat, and shut the door. I took several long strides over asphalt before doing a half-turn and hitting the key-fob.

‘Toot!’ The familiar, obedient response. I headed towards the sidewalk.

Something was different

As I walked through automatic glass doors, I was struck by a change.

A makeshift checkpoint had been set up near the entrance. A young, masked nurse sitting behind a white folding table greeted me, smiling with her eyes.

I approached the table, feeling a little out of sorts. “This wasn’t here last week,” I thought to myself. To my left stood a hand-sanitizer dispenser attached to a white, plastic free-standing post.

So, it had begun.

“Hello. Do you have an appointment?” she inquired pleasantly. She had the sparkle of youth.

“Uh, yes,” I answered, my eyes shifting from side to side as if to check my periphery for signs of danger. “I have a one o’clock with Nora,” I continued tentatively.

“Ok, perfect!” she exclaimed cheerily, after briefly scanning a printout which seemed to verify the information I provided.

“Now, I have just a couple of questions for you before you go back if that’s ok?” my newly appointed caseworker continued.

“Sure. That’s fine,” I replied, not sounding too convincing.

“Alright then,” she continued. “Have you been experiencing any fevers or cough?”

“Uh, no.”

“Alright. Very good. Have you traveled out of the state within the past fourteen days?”

“Well…yes. I visited my father last weekend. He lives in the next state over.”

“Ok,” she said. “Well, I’m going to just take your temperature real quick if that’s ok since you went out of town last weekend and all.”

“Sure, that’s fine,” I replied.

“Great!” she said as she placed the thermometer against my forehead. “You’re good to go! Take the elevator to the second floor, go left and the office will be on your right. Have a great day!”

“Ok, thanks.” I smiled meekly.

A new normal

The young woman taking my temperature had been pleasant enough. Perhaps a little too pleasant. But as I walked past her, my mind struggled. “What is this anyway? The Spanish Inquisition?” The thought was not verbalized.

Of course, I knew it was for the best. Early on, I’d seen South Korean healthcare workers on tv standing outside giving people temperature checks and nose swabs in the sanctity of their cars. “Wow!” That’s progressive!” I’d thought. “What a great idea!”

But I had also thought we’d never see that here. In America. Due to our red tape and seemingly unchanging ways and all.

Turns out I was wrong.

Turns out we could evolve here. I told myself that was a good thing.

It’s just that I was accustomed to things working a certain way. The minute change in procedure shook me.

The elevator

Reaching the elevator, I looked down at the button. A strange feeling of repulsion filled me at the prospect of pushing it. I pushed it anyway.

Just as I got on, another passenger appeared. I squelched my impulse to hit the ‘door close’ button to block said passenger, instead of inching backward to allow entry.

“Two please,” I requested of the stranger as my chest tightened. Was that claustrophobia I was feeling? Or some other ailment, perhaps?

The doors opened and I left the elevator, the other passenger having safely exited ahead of me. I quickly found the office, cringing slightly as I grasped and turned the levered handle.

Check-in

I checked in. You know the drill. Name and date of birth given, insurance card presented. I pre-payed for my visit. This would save me a stop by the window on the way out.

I analyzed every detail of the oft-followed procedures as I a squirted a gob of hand sanitizer into my palm from a strategically located bottle. I took a seat in the waiting area. Whew.

The visit

My visit ensued. It was productive. The therapist gave me two new exercises/stretches to try, and she listened closely to my complaints. It seemed like she was beginning to pinpoint some things which previous therapists had missed. I felt encouraged.

But also, I was relieved when the visit was over. I felt strangely uncomfortable during this socially up-close-and-personal therapy experience. No one was wearing masks yet. It hadn’t yet been recommended.

Locking down was ramping up

This appointment was at the start of things. At the onset of twilight-zone days and weeks to come. As lockdown orders ramped up, I wondered, should I keep future appointments?

Safety first

I thought of all the people my therapist must come into contact with each day. In-person physical therapy is not a socially distant activity. Hands-on is the name of the game.

I may have had discomfort in my back, I mused, but at least my lungs seemed to be working fine. I didn’t want to do anything that might cause that second fact to change.

Cutting back

After weighing the potential benefits of seeing my physical therapist against the dangers, I told myself, at that time, that the pain wasn’t quite bad enough to justify in-person therapy. I could manage without it for a while. Do my part to stop the spread.

I called and canceled six weeks’ worth of appointments, keeping three visits on the schedule for later on — in hopes of things relaxing.

I hoped my tense back muscles would relax as well.

Just as people had cut back on their consumption of certain items during world wars, I was cutting back on my reliance on physical therapy. At home, I performed a few exercises I already knew.

Ranking the pain

As six weeks of sheltering in place came and went, the first appointment I had remaining on my therapist’s schedule was beginning to loom closer.

My son’s girlfriend had just gotten her wisdom teeth out. She had gone home to have the procedure done right before she was to begin working at a new summer job, having already rescheduled once due to the pandemic. A procedure such as that was necessary, I knew. I did not judge her decision at all. The wisdom teeth needed to come out, for sure.

But, wasn’t physical therapy different? More optional, perhaps? Couldn’t my needs, my progress be put on hold indefinitely?

The pain takes a turn

Suddenly, the pain was no longer the low-grade ache that had been taunting me. This pain — it put me flat on my back. I was barely able to stand. Rising after sitting was excruciating.

But I couldn’t be too distraught. At least I wasn’t facing COVID-19.

A new perspective

Given this ramping up of pain, and despite the dangers, I regrouped and decided to resume my physical therapy regimen. After a quick call, I was able to get in the next day.

A remedy for the pain

So far there is no panacea for the new coronavirus. Perhaps the road to curing my back pain won’t be a simple one either. But, if I can share one thing from my experience it is this — physical therapy helps!

I went to my appointment and boy, was it a relief! Although I still have a way to go, I am optimistic that I’m on the right path to get some real help.

Appointment protocol

At my appointments, some patients have had masks on while others have not. I have chosen to wear a mask.

My physical therapist has also worn a mask for all appointments and informed me that stringent cleaning procedures were followed between patients. This is comforting to know.

Progress during a pandemic

Considering so many activities have slowed down during these uncertain times, can we expect progress on any level? At a time when progress and life, in general, seem to have come to a screeching halt?

Maybe not. But, then again, this might just be a great time to slow down and take care of our bodies and our health. Goodness knows we have the time.

On second thought, progress during a pandemic might just be possible after all.

What is essential is a judgment call

There’s no cut and dry answer as to whether or not one should attend physical therapy sessions right now. People must weigh the risks and potential benefits themselves.

For me, right now, I have decided that physical therapy is an essential activity. For you, the answer may be different.

Some takeaways

Here are a few questions to consider when deciding on whether to start or continue a physical therapy regimen during a time of pandemic:

• What safety measures and/or increased cleaning practices have been put in place?
• Can you be assured your physical therapist will wear a mask during all appointments?
• Are patients screened with questions about symptoms and recent travel? Are temperature checks incorporated?
• Is telehealth an available or appropriate option for you?
• Could symptoms be managed at home with stretches and exercises you already have, until you feel safe resuming in-person appointments?
• Could worry about whether or not to attend therapy lead to an actual increase in symptoms? (This may have been the case for me).

In conclusion

Take care of yourself! Moderate physical activity and stretching are good ways to cope right now. People are in pain. And some of our personal and national pain requires attention sooner rather than later.

And just remember, as a farmer might say, whenever the season isn’t right for planting or harvesting, the least you can do is work on repairing your equipment!