Can My Chiropractor Perform Physical Therapy?
posted: Apr 17, 2018.
We often get asked by new patient's or prospective new patients if we do Physical Therapy?
My answer is "yes, we do Physiotherapy, Exercise Therapy, or Physical Rehabilitation." Is there a difference you might ask?
Well it's just a matter of semantics. While both a Chiropractic Physician and Physical Therapist in the State of Idaho (and many other states) can perform legally and bill insurance for active and passive physical therapy procedures due to a separation of professions there has been set in place distinct laws governing how one must talk about "what they do" or "who they are" professionally.
I always say that any good Chiropractor if not doing "Physiotherapy" will refer out for "Physical Therapy" to provide "complete" rehabilitative care to their patient's. Likewise any good Physical Therapist if not doing "Manual Therapy" or as most Chiropractors would say "Chiropractic Manipulation" are referring out to a Chiropractor to provide the same "complete" care to their patients.
The reality is that Physical Therapy and Chiropractic Medicine have many areas that cross over. The biggest difference is more in how they manage patients. In general most Chiropractor's tend to favor more manual therapy and/or Chiropractic manipulation early on then incorporating exercise therapy, physiotherapy or physical rehab (your choice :) ) at a later point in patient care.
Physical Therapists generally tend to start into exercise therapy / physical therapy / physiotherapy as a first line of treatment reserving manual therapy for "difficult" cases.
Having worked with over 25 physical therapists and seeing common patients over the years I have heard two common complaints:
1. "My physical therapist just kept telling me to do the exercises, but it hurt so bad to do them I discontinued therapy." "I just wasn't helping, in fact it felt like it was making my pain worse."
2. "My Chiropractor just kept adjusting me and doing the same thing everytime I went in. It's like he didn't even hear me saying that it wasn't improving." "I got tired of just going back time and time again with out a change in my pain." "I finally just quit going."
It does not take a rocket scientist here to see the common thread.....poor communication and PROFESSIONAL TUNNEL VISION. If all you have is a hammer, all you can see is a nail!?!?
It is these two complaints that have always influenced the way I practice. I always tell patients, "If you're not comfortable, I'm not comfortable." Communication is key in providing good care!
Lastly my experience and in my opinion, common sense tells me that in treating a patient if I want not only quicker, but longer lasting results I have to address 3 issues.
1. Joint Range of Motion
2. Muscle/Soft tissue Flexibility
3. Muscle/Soft tissue Strength
Generally in that order. These three factors create "FUNCTION" When our function is high, generally our pain is low.
As mentioned previously, while this may seem like common sense over 90% of the patients I see week in and week out that have seen both physical therapists and chiropractors have NOT had this approach. I find this very perplexing as it really does just seem like common sense.
So as a treating clinician that specializes in muscle and joint pain my goal is always to restore ROM and reduce pain FIRST, then and ONLY then incorporate active exercise therapy / physiotherapy / physical rehab to strengthen and stabilize the patient within the new pain free range of motion we have just created.
Physical Therapy / Physiotherapy / Physical Rehab / Exercise Therapy
The difference?......I think you get the point :)
Always look for open minded clinicians that provide "COMPLETE" rehab services for you specific injury. And please don't get lost in the rhetoric. That's all for now!
Dr Burtenshaw is a Board Certified Chiropractic Physician - Sports Injury & Rehabilitation Specialist - Board Certified in Physiotherapy - Manipulation Under Anesthesia Certified