At Long Island Spine Rehabilitation Medicine, our experienced physiatrists observe the wonders of physical therapy daily. As our patients become increasingly pain-free, mobile, and flexible, they also become more self-confident and more happily engaged in their own lives.
We understand that most people want to avoid an operation unless it is necessary. Fortunately, physical therapy (PT) can often achieve comparable health improvement without invasive procedures, high costs, prolonged recovery, and serious risks of surgery.
How Physical Therapy Became a Recognized Form of Successful Treatment
Though some types of physical therapy have existed for centuries, Sister Elizabeth Kenny (1880-1952), a self-trained Australian bush nurse who developed an innovative approach to treating polio patients, is credited as one of the prime movers of muscle rehabilitation, a discipline that became the foundation of physical therapy.
Sister Kenny had the insight that the immobilization of polio patients prescribed at the time was counterproductive. Instead of applying braces, she began massaging, warming, and exercising paralyzed muscles with amazing results. Her intuitive, highly successful methods underlie the principles of physical therapy that now helps millions of patients recover from various diseases and injuries without surgery.
Present-day physical therapy consists of the following modalities:
Each of these components of physical therapy has an important purpose, though not all are used with every patient.
Is physical therapy really better than surgery?
There are many ways in which physical therapy, when feasible, is superior to surgery — physically, psychologically, and financially. Let’s take a look at them.
 Less Pain, More Gain
Patients suffering pain are often reluctant to engage in physical therapy, fearing that moving the affected body part may worsen their misery. Most are relieved to find that the exercises they do in physical therapy sessions will provide them with less pain and greater mobility. Even when they experience discomfort or fatigue after a professionally directed “workout,” patients find that over a short period of time they can move more with less pain.
Also, trained physical therapists will keep careful track of their patients’ pain levels. Professionals in this field know precisely when to let patients push on and when to let them rest, when to increase the number of stretches or steps they take, and when to let up. When you are receiving physical therapy, you will find that you form a bond with the therapist treating you. Your therapist will begin to know your rhythms and endurance and to work with you at the most beneficial pace for your particular constitution.
In contrast, patients who undergo surgery, even when it’s minimally invasive surgery, have to have some type of anesthesia administered, have their body entered, and have to go through some period of downtime to recover. In addition, if you have been operated on, you take on the risks of:
- Having adverse reactions to anesthesia or medication
- Bleeding excessively
- Getting a postsurgical infection
- Suffering a surgical mistake that may prolong recovery or require another operation.
 Enhanced Mobility and Range of Motion
Generally, patients beginning physical therapy have severely restricted range of motion and, depending on which muscle or joint is affected, may also have great difficulty standing and/or walking. Whether your restricted mobility results from an injury, disease progression, or recent surgery, physical therapy can be your best way to re-enter the world of normal activity. It should be noted that most patients who undergo operations for musculoskeletal problems require physical therapy as well to re-invigorate their muscles and joints and overcome stiffness.
 Successful Use of PT in Combination with Other Therapeutic Techniques
One of the wonderful things about physical therapy is that it can be effectively used in combination with other conventional or complementary treatment methods our offices provide.
Skilled physical therapists, like those at Long Island Spine Rehabilitation Medicine, know how to evaluate which treatment options are best suited to your particular needs by making certain that you have been properly diagnosed. They will then be able to determine if any of the following may be helpful in conjunction with your prescribed physical therapy sessions:
- Pulsed Electromagnetic Field (PEMF) — electric stimulation to loosen joints, reduce inflammation, and improve circulation
- Platelet Rich Plasma (PRP) therapy to accelerate healing
- Bracing, taping, or assistive devices (e.g. canes) to help you navigate with less pain
- Acupuncture to alleviate pain and reduce inflammation
- Spinal epidural injections to relieve pain and inflammation
- Ultrasound-guided Injections of corticosteroid and analgesics to reduce pain and inflammation
- Gel injections to lubricate the joint with hyaluronic acid (for the knee)
Also, in many cases, surgical procedures are combined with physical therapy. At Long Island Spine Rehabilitation Medicine, we frequently administer physical therapy both before and after an operation, at the recommendation of the surgeon, to produce optimal results.
 Improved Blood Circulation
Although there are several ways of improving your blood circulation, the best involves physical activity. Entirely natural, physical therapy, beyond exercising weak or damaged muscles and joints, improves circulation not only in the impacted area but throughout the body so your heart, blood vessels, lungs, and brain all reap the benefits. Because your blood vessels carry nutrients and oxygen to injured tissue, improved circulation also alleviates inflammation and assists in the healing process.
 Improved Muscle Function
In addition to making you feel better by relieving pain and inflammation, physical therapy has the added benefit of improving muscle function. We know that regular physical activity is good for everyone, but professionally supervised physical therapy has the advantage of essentially working with a personal trainer, one who is medically trained to understand which exercise regimen is right for you and which might cause you harm. Physical therapists help improve your injured muscles and simultaneously strengthen those that may be weak.
 Strengthened Core and Improved Balance
There is much discussion lately of the “core” muscles, i.e. those in the middle of the body. Physical fitness exercises, no matter what muscle or joint they are specifically addressing, are designed to strengthen your core muscles as well since these muscles give your entire body increased stability and strength. By strengthening your core, your overall health and safety will be improved. Physical therapy that helps you to develop core muscle strength will help your balance, your ability to lift, stretch, and bend, and will keep you from becoming frail as you grow older.
Many of our patients, especially as they age, have problems with balance. Such difficulties, which may also be caused by periods of inactivity or particular injuries or illnesses, can lead to falls and further injuries. Strengthening core muscles contributes to improved balance, another issue addressed during physical therapy sessions. As a basic component of physical fitness, balance, along with endurance, strength, and flexibility, has been shown to prevent injuries not only in patients recovering from surgery or previous injury, but to reduce the risk of ligament problems in athletes.
 Independence and a Sense of Empowerment
As noted early on in this content, physical therapy has emotional, as well as physical benefits. By becoming stronger, more flexible, and better balanced, our patients naturally develop a lessened fear of falling, and therefore less timidity in terms of doing household chores, taking a hike, climbing a hill, or even dancing. Also, physical therapy offers the advantage of giving the patient a significant role in her/his treatment.
The sense of freedom provided by confidence in your own body’s strength and resilience cannot be overstated. Whether making a comeback after an injury, illness, or a period of inactivity, engaging in physical therapy, in addition to lifting many of the restrictions that have been holding you back, increases your self-esteem and sense of empowerment.
As you feel safer and more secure in your own body, you are more likely to be more capable mentally and emotionally as well. Many patients who complete a course of physical therapy are so exhilarated that they take up a new project, sport or hobby, feeling more sure of themselves and energetic than they did before.
 Social Interaction
As you may have surmised by now, social interaction, too, benefits from physical therapy. To begin with, going to a place outside your home, meeting others overcoming similar issues, and working with a trained professional who has seen your symptoms many times before — all provide reassurance that you are not alone. Furthermore, knowing that your therapist is there as a safety net helps you feel secure and able to reach beyond what you thought were your limits and reach out to others as well.
Where surgery is a lonely proposition; physical therapy is a communal activity. Several studies have shown that there is a correlation between physical therapy and improved social interaction. This is tied to feeling stronger, more able to cope, and freer to participate in a routine that others are engaged in. Patients who exercise regain a sense of well-being and personal dignity they sometimes lose during surgery and its associated (though hopefully temporary) incapacity.
The most important contribution that physical therapy makes to social interaction is that it decreases chronic pain and the hopelessness and depression that often accompany it. Let’s face it, when you’re in pain, it’s hard to smile and converse. As your pain subsides, your mood improves and you can engage more pleasantly with strangers and new friends, let alone with loved ones. The pleasure of improved relationships, in turn, becomes a motivating factor to get better so you can participate more fully in activities involving family, work colleagues, your own social network, and the community at large.
 Lower Costs
As previously mentioned, physical therapy often bookends surgical procedures. It is not uncommon for a period of physical therapy to unexpectedly make surgery unnecessary. Patients who come to our offices for weeks or months of physical therapy in preparation for an operation sometimes find that the sessions reduce their pain and stiffness to the point that they no longer feel that surgery is required.
Interestingly, some insurance companies now deny expensive diagnostic tests like MRIs until the patient attempts a course of physical therapy. These companies have found that PT may save them a great deal of money by fixing the medical issue nonsurgically. You can bet insurance companies only do this because physical therapy makes surgery unnecessary enough of the time to help their bottom line.
If you or a loved one has had surgery before, you are probably familiar with the exorbitant costs of hospitalization, doctors’ fees (specialists, surgeons, anesthesiologists), private nursing care (when needed), and in-patient rehab facilities. Even with good insurance, your deductible and copays can be very high. In addition, the time away from work may result in:
- Lost wages
- Housekeeping replacement costs
- Babysitting costs
- Pet care fees
- Payment for lawn mowing or snow removal
- Food delivery costs
You get the picture. The downtime for surgery is expensive and that’s if everything goes smoothly and there are no serious complications, such as a postsurgical infection (always a danger with hospitalization) or a surgical error that requires further surgery.
 Customized Treatment
Although physical therapy is in widespread use, one of its greatest advantages is that it can be tailored to fit each individual’s specific needs. A talented physical therapist will be able to treat the condition that ails you without hurting other parts of your body in the process, especially important if you have another congenital or chronic condition or unusual sensitivity of some kind.
The physical therapists at Long Island Spine Rehabilitation Medicine can, in many cases, circumvent the need for surgery by working with you to promote natural healing. They are well-trained to customize treatment for nearly all musculoskeletal disorders or injuries, especially those affecting shoulders, knees, and backs. These include:
Rotator cuff tears are the most common shoulder injuries. They typically occur as a result of straining the joint by repeated overhead motions. Small to moderately sized rotator cuff tears usually respond well to physical therapy, though variables such as age, pre-existing medical conditions, and the severity and location of the injury feature in the decision of whether an operation is required.
Our offices regularly confer with orthopedic surgeons to discuss the best treatment options. One major advantage of physical therapy over surgical repair for rotator cuff tears is that the former strengthens the impacted shoulder to protect it from recurrent injury.
In many cases, we will agree that it is certainly worth trying a course of physical therapy before deciding that surgical intervention is necessary. A government study of treatments for rotator cuff injuries agrees with our findings that physical therapy may provide outcomes superior to surgery, particularly in elderly patients. In fact, PT may be an effective treatment for between 73 and 80 percent of patients with rotator cuff tears.
Physical therapy can also yield good results for the multiple kinds of muscle and bone damage that happens to knees, such as:
- Small fractures
The goal of physical therapy when administered to patients with knee injuries is, as with other musculoskeletal problems, to diminish pain and increase strength and range of motion. Knee problems are extremely common, especially as we age. Studies show that almost everyone over the age of 50 has some degenerative arthritis in most joints. Even when there is no serious injury or disorder, PT helps lessen knee pain and restore knee strength and function.
In our culture, in which obesity is so prevalent, stiff, achy knees are becoming nearly universal since excess weight puts more pressure on the arthritic joint, making it deteriorate more quickly. This is why physical therapy is an important revitalizing force. Putting the knee through its paces slows the deterioration of arthritis, increases blood circulation to the damaged site, and makes the muscles surrounding the knee stronger and more supportive.
Reporting on a study comparing arthroscopic surgery to PT for knee injuries, a 2017 British medical journal recommended against arthroscopic surgery. It found that physical therapy provided more lasting pain relief and improved function more than the surgical procedure.
A great many of the patients who come to Long Island Spine Rehabilitation Medicine for physical therapy are suffering from chronic back pain. Because their pain is often severe and extremely debilitating, they often come to us as a last resort, feeling sure that they will eventually need surgery.
Nonetheless, the results of ongoing physical therapy can be remarkable, both in terms of relieving pain and in terms of preventing its recurrence. One of the benefits of physical therapy is learning how to strengthen your core muscles so they can be used to prevent straining your back and causing further injury.
These days, physical therapy, rather than surgery, is usually recommended as the first choice for patients facing chronic back pain. It is less invasive, less risky and a better means of promoting and restoring normal function.
Whatever the underlying cause of your back pain, physical therapy is likely to be helpful. Our physical therapists may be able to make a major difference in your life by assisting you in relieving the pain of:
- Cervical and lumbar radiculopathy
- Herniated discs
- Spinal stenosis
Participating in a program of PT will help in pain management and rehabilitation, the specialties our doctors, all physiatrists, have studied in-depth.
How Long Island Spine Rehabilitation Medicine Can Help
As you can see, physical therapy is, in many ways, better than surgery. It has the advantages of offering the benefits of decreased pain, increased mobility, strength, and flexibility, lower cost, more camaraderie, and a greater sense of self-reliance. While there are certainly times when surgery is unavoidable due to the traumatic nature or severity of an injury, you should always discuss options with your doctor.
At Long Island Spine Rehabilitation Medicine, we are well-known for our excellent diagnostic skills. If you come to us in pain, we will do any necessary diagnostic testing. While we offer topflight physical therapy which may be all that’s needed in your case, we will never hesitate to refer you to our surgical colleagues if we believe that’s the right course of action.
By the same token, if you have been advised to consult with a surgeon, don’t ever be reluctant to ask that surgeon whether it would be wise to try a course of physical therapy before making arrangements to have surgery. Remember, any surgeon who is trustworthy, as well as skilled, will be honest about whether physical therapy may be all you need to feel better and move more easily.
Contact Our Acclaimed Long Island Spine Rehabilitation Specialists Today
Our practice is based on a holistic approach to healing. Whether you are experiencing the pain of a new injury or a chronic condition, don’t suffer in silence. Make an appointment to visit one of our conveniently located offices and let us help you regain your health and your equilibrium through physical therapy.