The history of physical therapy in the United States traces back to the early 20th century, evolving through various stages influenced by wars, polio epidemics, and advancements in medical technology and knowledge.
Early Beginnings: 1914-1920s
Physical therapy's roots in the United States are often linked to the outbreak of World War I. During this time, there was a significant need to treat and rehabilitate soldiers who were injured in the war. The term "Reconstruction Aide" was used for individuals who were trained in physical rehabilitation techniques. These aides primarily consisted of women who were trained in physical education and other related fields.
The American Women's Physical Therapeutic Association, formed in 1921, was one of the first professional groups for physical therapists. This organization later became the American Physiotherapy Association and, ultimately, the American Physical Therapy Association (APTA) in 1947, which remains the primary professional organization for physical therapists in the U.S. today.
The Polio Epidemic: 1930s-1950s
The polio epidemics of the 1930s and 1940s significantly impacted the field of physical therapy. With thousands of children and adults affected by polio, which often led to paralysis and muscle weakness, there was a heightened need for physical therapy services. This period saw a surge in the development of new techniques and approaches to rehabilitative care, with a focus on improving mobility and muscle function.
During this time, physical therapy began to emerge as a distinct healthcare profession, with increased emphasis on professional education and training. The first physical therapy research was published in the Physical Therapy Review in the late 1920s and early 1930s, and by the 1940s, the first physical therapy bachelor's degree program was established.
Post-World War II Expansion: 1950s-1970s
The post-World War II era marked a period of significant expansion and development for the physical therapy profession. With advancements in medical technology and a growing recognition of the importance of rehabilitation services, physical therapists began to work in a wider range of settings, including hospitals, private clinics, and public schools.
In the 1950s and 1960s, there was an increased focus on specialized training and education. Physical therapy programs began transitioning from bachelor's degree programs to master's and doctoral level programs. This period also saw the growth of subspecialties within physical therapy, including pediatrics, sports medicine, and orthopedics.
Modern Developments: 1980s-Present
From the 1980s to the present, physical therapy has continued to evolve and adapt to the changing landscape of healthcare. The profession has embraced evidence-based practice, emphasizing the use of research and data to inform treatment approaches. Technological advancements, such as telehealth and computerized rehabilitation tools, have also begun to shape the way physical therapists deliver care.
In recent years, there has been a growing emphasis on preventive care and wellness, expanding the role of physical therapists beyond traditional rehabilitation. Physical therapists now play a key role in helping individuals maintain mobility and quality of life, addressing issues such as ergonomics, fitness, and injury prevention.
What is the pelvic floor?
The pelvic floor is a dome-shaped muscular sheet that separates the pelvic cavity above from the perineal region below. This sheet is part of our deep core and is composed of fascia, connective tissue, and three layers of muscles. The pelvic floor helps control continence (both urinary and fecal), contributes to stability in our hips and pelvis, and aids in sexual arousal.
Why would you seek out pelvic floor physical therapy?
My doctor told me to do kegels.
Your doctor may be right or your doctor may be wrong.
A lot of people have heard of kegels but are not totally sure what they are and most women seem to think just doing kegels will solve all their pelvic floor problems. Pelvic floor PT is not just about kegels. In some cases, yes, strengthening the pelvic floor will help reduce symptoms, but that is definitely not always the case.
A kegel is a contraction of all three layers of the pelvic floor muscles, accompanied by a closing and lifting sensation in the pelvic floor. Sometimes it feels like your sit bones are being pulled together. The sensation of a close and lift needs to be followed by a relaxation/ dropping back down sensation. We also don’t want to be clenching our butts or thighs while we do the contraction.
When are kegels not appropriate? They are usually not appropriate for someone who is experiencing pain in the pelvic floor or any symptoms of pelvic floor tightness. These symptoms might include the inability to initiate urine flow or might include chronic constipation. Sometimes people actually leak urine when their muscles are tight, not weak. A good example of this is to make a tight fist and then try to squeeze your fist tighter. Not much will happen in that scenario, but if you relax your hand then try and make a tight fist you can squeeze a lot harder. This is what happens with a tight pelvic floor. It's already tight so it cannot contract to help control bladder incontinence.
Pelvic floor health physical therapists help people who have problems with sexual intercourse, urination, fertility, pregnancy preparedness, pelvic and/or tailbone pain, postpartum recovery, erectile dysfunction, and other conditions.
Depending on exam findings, treatment includes manual techniques, specific exercise prescription (a Kegel is not simply a Kegel!), and the use of electrical stimulation and/or biofeedback/stretching tools.
More confused than ever? Schedule a consult.
We often cannot avoid sitting for longer periods of time, and more often than not we wind up in a forward flexed posture that is very hard on our necks, backs, and shoulders. A couple of small adjustments can make sitting a little easier on our bodies. First thing, take a movement break as often as you can--at least every 30-45 minutes. Our brains tend to take a mental vacation from what we are working on around that time anyway so just add a 30 second standing or movement break to help change the forces on your body. Additionally, small modifications to your work set-up can go a long way. Make sure that your screen is at eye level, your keyboard/mouse are at elbow level. Keep your back and hips scooted back to utilize the backrest and add a small lumbar support (like a small pillow or rolled towel) if there isn’t already one in your chair. Keep your feet flat on the ground, and sit in a chair where the hip height is slightly above the knee height. Practice keeping your ears in line with the base of your neck to prevent your head from migrating forward. Most importantly, remember that the best posture is the next posture and keep moving. AND, if you are still having neck/back or shoulder pain while working that doesn’t get better with some small changes, visit us at Life in Balance PT and we can help make an individualized treatment plan for you.
"Sitting is the new smoking" is a catchy and somewhat alarming comparison that highlights the potential health risks associated with prolonged sedentary behavior. This phrase is often used to emphasize the dangers of a sedentary lifestyle, which can include long periods of sitting, whether it's at work, during commuting, or in leisure time. The comparison to smoking is made to underline the seriousness of these risks, even though sitting and smoking are different in many ways. Here’s why sitting is considered so detrimental:
Increased Risk of Chronic Diseases: Prolonged sitting has been linked to an increased risk of various chronic diseases, including heart disease, diabetes, and certain types of cancer. This is similar to smoking, which also significantly increases the risk of these conditions.
Obesity and Metabolic Syndrome: Sitting for long periods can contribute to obesity and metabolic syndrome, a cluster of conditions that includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. These are risk factors for heart disease, stroke, and diabetes.
Impact on Physical Health: Extended sitting can lead to muscle degeneration, particularly in the lower body, as well as poor circulation and even blood clots (deep vein thrombosis). It can also contribute to osteoporosis due to insufficient weight-bearing activity.
Mental Health Issues: A sedentary lifestyle can also impact mental health. There is evidence to suggest that it can be associated with an increased risk of depression and anxiety, similar to the detrimental effects of smoking on mental health.
Decreased Longevity: Just like smoking, a sedentary lifestyle can decrease overall life expectancy. Studies have shown that prolonged sitting is associated with an increased risk of mortality, independent of physical activity levels.
Impact on Posture and Musculoskeletal Disorders: Sitting, especially with poor posture, can lead to back and neck pain, repetitive strain injuries, and other musculoskeletal disorders.
While sitting can be harmful, especially in excess, it is not as directly damaging as smoking. To mitigate the harm, we, of course, recommend regular physical activity, taking frequent breaks from sitting, practicing good posture, and incorporating standing or walking into daily routines.
If you're asking the question, the answer's probably yes. But let's get specific.
Are you having difficulty doing your daily chores or work tasks due to pain, loss of range of motion (just can't reach that high shelf), or weakness? Then, yes.
Are you looking to minimize the risk of injury? Then, yes.
Are you having a musculoskeletal issue (muscle, ligament, nerve, tendon, bone) that's not resolving with time and your own efforts (ice, heat, over-the-counter drugs, trying the thing your neighbor did)? Then, yes.
How about a list?
Top Ten Reasons To Seek Physical Therapy:
1. You're in pain.
2. You're injured.
3. You want to avoid surgery.
4. You've recently had surgery.
5. You're about to have surgery.
6. You're not moving as easily as you used to.
7. You've fallen for no good reason.
8. You've fallen more than once in the last six months.
9. You hate asking for help when you're perfectly capable of doing it yourself, but for some reason you aren't capable right now.
10. You gardened fiercely over the weekend and now your—back, shoulder, neck, hip—is a wreck.
Injury occurs when load exceeds capacity. You've pushed too hard or worked too long and your body responds with aching, burning, stabbing, and/or throbbing sensations. Or your body responds with tenderness or abnormal tension. If you've really done yourself in, your body responds with an all-out inflammatory avalanche of swelling, heat, sensitivity, pain, and reduced motion. These are all signals that load is exceeding (or has exceeded) capacity, and you need to back off and better prepare yourself for the task no matter what it is.
Back to the questions.
Is there a physical reason you've stopped doing something you love to do?
Is there a physical reason making it difficult to do something you love to do?
Then yes, you need physical therapy.
Let's first start by defining what physical therapists (PT) are and do.
Physical therapists are experts in human movement, and help injured or ill people improve or maintain mobility and manage pain. Physical therapists evaluate, diagnose, and treat individuals across the lifespan. They are an important part of preventive care, rehabilitation, and treatment for patients with injuries and chronic conditions or illnesses. PTs evaluate each person and then develop a treatment plan with goals of improving movement, reducing and/or managing pain, restoring function, and delaying or preventing disability. PTs also help folks who simply want to become healthier--move better--and prevent future problems.
The work of physical therapists varies by type of patient, and thus you'll find PTs in
hospitals, nursing homes, workplaces, outpatient clinics, people’s homes, schools, and sports and fitness facilities. You've found this blog, which is affiliated with an orthopedic outpatient physical therapy clinic.
A DOCTOR OF PHYSICAL THERAPY (DPT) earns a doctoral degree, which includes training in all areas of human anatomy and physiology and musculoskeletal evaluation, diagnosis, and treatment, as well as doctoral-level research. A doctoral degree is a clinical degree focused on treating people. It differs from a PhD, where the focus is on research and generating original scholarly work. The DPT program is typically three years, following a bachelor's degree. All PTs must be licensed in the state in which they practice.
DPTs weren't always Doctors, but, because they are now a “doctoring” profession, DPTs have the ability to evaluate and treat patients via direct access, meaning without a physician referral.