There’s a good chance you’ve never thought about visiting a physical therapist unless you had to. Most people don’t have physical therapy on their list of yearly check-ups to schedule—some, myself included, have never even been to a physical therapist’s office and would have to do some digging on Zocdoc to find one. Some physical therapists, though, actually have a roster of patients who come in when they’re not injured. Instead, they treat physical therapy as a form of preventive medicine.
I recently learned this from Karen Joubert, D.P.T., a physical therapist in Beverly Hills, California, who told me that she has a lot of patients who come see her as part of their wellness regimen. “People come see us [after] surgery or sprained ankles or prehab before surgery, but the more interesting thing is that I have patients who are getting into their 30s and 40s and are realizing, ‘Wow, I want to live longer, maybe have a family. And I don’t want to have to be hunched over or have back surgery. How can I prevent that?’” Joubert says.
Joubert says that actors and models—like Jennifer Aniston and Cara Delevingne—come to her to work on their posture and overall body awareness. She also says she works with a lot of singers, helping them with diaphragmatic breathing. Non-celebs come to her for postural help too, and to learn what types of exercises they should do to keep their bodies safe during their exercise of choice.
Physical therapy is classically used to help diagnose and treat movement-related problems to improve physical function.
Physical therapists often work with people who are healing from an injury to help them restore proper movement patterns in the body and avoid future injury. They do this by teaching them how to do exercises that will strengthen important muscles, and work on improving mobility and alignment required for optimal physical function.
Everyone from an orthopedic surgeon to a cardiovascular surgeon may refer patients to a physical therapist, who will give them a full analysis and work with other health care providers to tailor exercises to their needs.
Michael H. Rieber, M.D., F.A.C.S., chief of the Joint Institute of Saint Barnabas Medical Center, tells SELF that surgery is always a last resort when it comes to injuries. “Surgery is plan Z,” he says. Unless there’s a massive tear that he knows won’t heal on its own, he often has patients try physical therapy first. Even if someone needs surgery, he often still recommends prehab—working on strength and stability work to help bolster vulnerable joints and muscles. “Doing prehab before surgery can only help you after surgery,” Rieber says.
Seeing a physical therapist when you feel perfectly fine can be beneficial for some people—especially those who hit the gym hard.
Dan Giordano, D.P.T., C.S.C.S., cofounder of Bespoke Treatments Physical Therapy in New York City and Seattle, tells SELF that he sees patients of all ages, ranging from 22-year-old college grads to 60-year-old hedge fund managers, preventively. Sometimes they come anywhere from once a week, to once a month, to every few months.
Most preventive patients are looking for ways to keep their bodies functioning properly and avoid injury. Think: someone who spends all week sitting at a desk, and then hits group fitness classes or the Crossfit box hard on the weekends. When Giordano meets with these patients, he’ll do manual work—like soft tissue massage—and then give them an exercise program so they can keep working on any alignment, mobility, or strength issues at home.
Giordano says that what starts as a preventive appointment often reveals some sort of underlying dysfunction, like a muscle imbalance, extreme tightness, or compromised range of motion. “It’s not necessarily pain, but maybe they feel off and that off feeling is something that could lead to injury. So it’s very important that it’s addressed early,” he says. He adds that often after an evaluation, a patient will have a “Well, now that you mention it” moment, where they reveal that something did feel off but they couldn’t pinpoint it.
If you’re someone who works out hard a few days a week, he says you probably have gotten used to pushing past little tweaks and pains that could become injuries. “Getting an evaluation can expose things. Something might not be a problem now but depending on how it’s presenting, we may want to start working on it before it becomes an issue.” Think of it as prehab for your HIIT workouts and bootcamp classes.
If you’re thinking of taking up a new sport or training for an endurance event, a physical therapist can help you do it safely.
Joubert encourages people to see a physical therapist before starting a new activity. “Maybe there’s an issue with your footwear we can look at,” she says. “Or if you go into yoga with a tight back and want to stretch, we’d rather you learn what’s wrong before stretching it out.” She wants to help guide people’s exercise routines so that they’re doing what’s best for their bodies. “I’d like to almost be the quarterback of someone’s fitness regimen,” Joubert says.
“I don’t know if I would promote just going [to physical therapy] for the hell of. There’s nothing wrong with it, but I don’t know if I’d promote it,” Rieber says. “But if all of a sudden you said you wanted to train for the New York City marathon, I’d say go and be evaluated, whether it’s by a rehab specialist or physical therapist or an orthopedic surgeon.”A professional can help you approach it safely.
Henry Goitz, M.D., an orthopedic surgeon at Detroit Medical Center, agrees. “If you’re running a marathon and maybe you fall off your training schedule and wind up not as strong as you should be, a physical therapist can almost become a personal trainer” and help get you back on track in a safe way, Goitz says.
Giordano says he also sees older patients who haven’t worked out in a long time and are looking for some guidance in easing back into it.
But even if you’re active, physical therapy may just not be necessary for you.
“Generally speaking, there’s not a benefit to ‘tune ups,’” Goitz says. Even for patients who have had a past injury—if it’s been treated and resolved, further physical therapy is unnecessary unless it starts acting up again. Goitz adds that “generally, you leave therapy with a home program and are expected to maintain it on your own. [You shouldn’t] really need the tune-up part.” It’s not at all going to harm you (as long as you’re seeing a qualified professional) but it’s just not necessary.
Rieber adds that if you have a regular, well-balanced fitness routine and nothing is hurting you, he doesn’t really see a reason for physical therapy. “Let’s say you’re training for a marathon and they’re going to video your running gait and help you customize your shoe wear. If they’re doing all that, great. But as a usual routine just to go? That I don’t understand.”
Physical therapy can get pricey, so it’s ultimately a personal decision about whether or not it’s worth it.
Seeing a physical therapist before training for an Ironman or joining a recreational adult soccer league is a smart idea to avoid injury and learn what your body needs (in terms of alignment and mobility and stability) during training. When it comes to just seeing a physical therapist on the regular to check in, it’s definitely not going to hurt, but it also might not be worth your money. It’s a pretty personal decision, though—if it seems beneficial to you and your health and fitness goals, then it probably is worth it.
There’s no doubt that preventive physical therapy is a luxury, and seeing a physical therapist once a week or month isn’t affordable or reasonable for many people to do.
It’s also true that getting injured isn’t cheap (or fun) so whether it’s in a physical therapist’s office or not, learning how to approach new forms of physical activity in a way that’s safe and appropriate for you is really important. And remember to always listen to your body. If something hurts, stop doing it. If you think you injured yourself, see your doctor or a physical therapist to address it before it gets worse. You only get one body, so it’s always worth giving it the TLC it deserves.