The following is the second part of a transcript of the Dr. Jay Show from 1560 The Game in Houston, TX. Participating in the discussion are Dr. J. Michael Bennett, a Board Certified Orthopedic Surgeon and Sports Medicine Doctor with offices in Richmond and Sugar Land, TX; Danny Arnold, Director of Plex Sports Medicine and Physical Training and Therapy; and Bob Lewis of 1650 The Game. If you have an orthopedic or sports medicine issue, please call our office at 281-633-8600 to schedule an appointment. Click this link if you’d like to see the preceding section of this Dr. Jay Show discussing the importance of physical therapy.
Here’s the transcript:
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| Dr. J. Michael Bennett and Danny Arnold |
DR. BENNETT — I like to call this segment the good, the bad, and the ugly of therapy and I want you guys to know what it takes to find good therapy and know what the red flags are. So here are a couple that I think are pretty important:
Poor communication. This is a big issue, especially between the physical therapist and the physician, because this often leads to poor outcome. If that physical therapist who is treating you has no idea of what injury you had or what surgery you had and they’re just treating you with some run of the mill exercises, you could actually damage the repair that you went through. So you’re going through six weeks of formal therapy and they start you strength training too early, before the rotator cuff is healed, before there is enough scar tissue that is formed, they can actually disrupt that repair and make it a big problem for you because now you have two surgeries instead of one.
It’s really important that the therapist talk to the physician if there are any questions at all. Danny, you guys are great about that. If there’s ever an issue, we get a phone call. And I do not mind getting a phone call from my patients or my physical therapists because I’d rather you call me, afterhours or whenever, rather than disrupt my repair because I do not want to go back in there.
BOB LEWIS – Is there a difference in physical therapists, as in some for sports and some for the general population?
DR. BENNETT – There’s a number of different trainers and therapists out there. There are licensed physical therapists, athletic trainers, physical therapist assistants, chiropractors, and I think that which one is best for you depends on what you’re recovering from. I think the trainers are excellent in regards to acute injuries and high school athletes if it’s a “locker-room injury,” as I call these, like a sprain or an ankle injury. If it’s minimal or mild, like some swelling, a lot of trainers can handle this using ice, rest, wrapping and some basic strengthening exercises. But if that ankle sprain is a little more severe, then it needs to be evaluated by a physician and that physician needs to send that patient to a licensed therapist or somebody that they trust. And I say a licensed therapist, but there are actually also some really good chiropractors out there as well, but you’ve got to make sure your physician is comfortable with that person and really go by their recommendation.
DANNY ARNOLD – When it comes down to those things, the type of therapy and who you use, not to undermine the chiropractor or therapist or trainer but it’s not rocket science. The stuff is a little bit more basic than people make it out to be. Obviously those professionals are going to tell you otherwise, but if you go to the basics – like he just talked about, the importance of communication – you’re just doing some basic movements at first. So if you have a doctor and therapist communicating about that patient, now you don’t have only one expert, you have two experts – including one who possibly did the surgery – working on this patient. That plays a huge role.
The other thing is that you need a motivating person, someone who is going to motivate you to come to therapy because not many people are going to look at therapy as a positive thing. And the doctors love that because at the end of the day they might perform a great surgery, but they want this person to heal. And if they’re not showing up for the therapy or the rehab, it’s not going to happen. And one other thing is to have someone who has dealt with your injuries. So often we think that therapy is all the same. It’s like with Dr. Bennett. We can send our pro players over there because he has worked with the Tampa Bay Buccaneers, he’s done a fellowship, he has the confidence to handle the injuries that take place on the football field or the basketball court, where there’s some other doctors that we may refer to but we don’t refer the sports injuries because they don’t have the expertise.
It’s the same thing with the therapist. You don’t want to send someone who has a sports injury to a facility where 80 percent of it is Medicare because in Medicare environments their job is to get them to be able to walk again and just have a normal, functioning day. The athlete needs to be aggressive and understand that they’re going to take blows to their knees or their shoulders or whatever. So it’s not only the communication, not only the attitude/motivation, but also the experience that they have. And don’t buy into the big façade of the buildings and things like that. We would have no problem at all about someone who is referred to us running us through an interview process asking about what level of care we offer and what our expertise is and how we would work a particular situation. If a therapist is offended by that, they’re probably not qualified to do it.
LEWIS – I think what I’m hearing is that rehab also encompasses injury prevention to keep it from being re-injured again.
BENNETT – Exactly. We’re going to talk about that here in a little bit in regards to sports specific training and sports performance. But going back to what Danny was saying, it’s really important that you feel comfortable with your therapist. Another red flag that we have out there is that we encourage questions; I want patients to ask me all their questions. Because if you leave my office and you still have a question and you feel uncomfortable, then I didn’t do my job. I want you to ask me, and you can call me at anytime if you have questions after hours.
It’s a problem if the therapists don’t have an answer for you or take insult to the fact that you’re being inquisitive. It’s okay for them to say that they need to look into that or that they need to talk to your doctor, but if they start taking offense to this, then there’s a reason behind it. Either they’re trying to cover something up or they just don’t know what they’re doing. So that’s a big red flag.
And another thing that Danny brought up is that you really need to be excited and motivated to do your therapy and go to your therapy facility. You don’t want to go to a facility where they’re going to stick you in a corner, have you do about 30 reps and then come by and check on you about 30 minutes later and say, “hey, your session’s up. You did your 30 reps. That’s about 50 bucks for your session. See you later.” And there’s a lot out there that do that and it drives me nuts. And a lot of people will go to a physical therapy facility because it’s convenient, because it’s near where they live – and there are a lot of good ones out there but some really bad ones, too – and they’ll come back after they’ve spent all that time, all that effort, and it will be like their knee motion is still 90 degrees, and you want your knee motion to be about 135 degrees. So they’ll come back and they’re all upset and then I get upset because it’s not good enough. You sometimes have to make that sacrifice to drive to a reputable place. Ask your physician what they recommend because there are the good, the bad and the ugly out there.
If you have questions about the information discussed here, please call our office at 281-633-8600. We have two offices serving patients in the metro Houston area — one in Houston, TX, and the other in Sugar Land, TX.
