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Physical Therapy: Services you can benefit from and services to avoid

Written by Diane Archer

Many of us at one time or another need physical therapy, particularly after a surgery or injury, to help us build our muscles, use our joints and move properly, while easing pain. It is often prescribed for people getting hip, knee or ACL replacements, people with arthritis or stroke. And, most insurers, including Medicare, cover some physical therapy services. To get the most of your care, make sure you are getting needed therapy; according to Choosing Wisely and Consumer Reports, certain therapies in some instances may do more harm than good:

  1. Heat and cold treatments: Ice packs and heated pads at home can provide short-term pain relief. But, beware of deep-heat machines, such as ultrasounds, for arthritis of the knee. Tailored exercise programs can be far better for you. It’s often best to move as much as possible.
  2. Strength training for older adults: It’s important to build muscle through exercise and movement or you can find yourself struggling to walk and balance as you age. Strength training should be challenging in most cases in order to build muscles, even for people who are not strong. If an exercise is easy, it is not likely working. Be sure your form is correct. If your knees or other joints are inflamed, then you should avoid challenging exercises.
  3. Treatment for blood clots: Often people are told to lie in bed if they are post-surgery and at risk for a blood clot. However, staying in bed does not help. Medicine is the chief treatment for Deep Vein Thrombosis or DVT.  You are no more likely to keep a clot from traveling into your lungs and preventing blood flow, (a pulmonary embolism) by staying in bed than by being active. And, being active is generally better for you once the anti-clotting drug takes effect. Remaining in bed can actually make a clot bigger and weaken your system.
  4. Exercises after knee replacement: Usually you will begin moving your knee within a day of surgery with help from a physical therapist, who will provide you with exercises. Moving also lowers your chances of getting a blood clot. If your doctor recommends you use a Continuous Passive Motion machine, ask questions; the evidence shows that it does not ease pain or help improve your quality of life; exercise delivers better results at lower cost. Of course, exercise is usually a key way you can improve your health, along with that of your partner.
  5. Wound care: Never use a whirlpool for wound care; there is no evidence that it works, and it can cause infections. Bacteria can spread easily to an open wound. If it does, then you are likely to get an infection, for which you will need to take antibiotics. It’s better to keep the wound clean and sterile and not expose it to bacteria that can cause an infection and possibly get into your blood stream.
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