What to Expect From Your PT Evaluation

Why PT?

If you’re reading this article, chances are either you or a friend has come across some sort of physical symptoms. When those symptoms are related to gaming and esports, they most likely involve pain, pins and needles, or numbness in either the hand, wrist, forearm, shoulder, neck or back.

If you do have gaming-related pain or symptoms, it’s important for you to:

  1. Know what it is
  2. Know how severe it is
  3. Know what to do to (self-) manage it and prevent future problems

Physical Therapists or Physiotherapists, as the health professional title suggests, are experts in physical health and performance. They know how muscles and joints move, and all the nerves that control them and sense pain. Their job is to not only assess and diagnose your problem, but to provide ways that they and (mostly) YOU can solve it.

But what about other health professionals? Aren’t chiropractors, osteopaths, and massage therapists the same? 

Techniques to move stiff joints and massage tight muscles can be helpful in managing pain in the short term, but without targeting the underlying cause, the pain will eventually come back. The last thing anyone would want is to be reliant on any practitioner to perform a particular type of therapy on you for weeks on end. And yes, that includes physical therapists as well – there are some not-so-great ones out there. The good practitioners from every profession (they do exist!) will provide you with homework-like exercises, changes to your ergonomics or loading schedule, and other healthy lifestyle modifications so you can create long-term positive changes without needing to remain a patient forever.

What if I don’t have any pain or symptoms? Do I still need PT?

Prevention is better than cure, and there is a difference between being healthy and performing optimally well. More of that in a future article!

So How Does PT Work?

Let’s start at the beginning of an assessment and work our way through.

History

The first and most important part of a physical therapy evaluation is thorough history taking. Many conditions have certain patterns of pain and symptoms, and the best management plan takes into account what YOU do as an individual.

Your physical therapist will ask you about lots of things. They’ll include questions like what makes your pain worse or better, when you first noticed your symptoms, and what kinds of things you’ve tried so far. As they start to get a better idea of what your symptoms are likely to be coming from, the questions will get more specific.

In the context of gaming, this often includes:

  • What game you play, and what role (e.g. DPS, support etc).
  • How do you play (e.g. controller, grip style etc)
  • How often do you play (hobby, scrims, tournament schedule)

Physical Assessment

By the end of the history-taking, a physical therapist should have a good idea of what your injury is and will proceed to a physical assessment to confirm the diagnosis and rule out others. This assessment will likely include seeing joint range of motion, joint mobility, muscle strength, and muscle endurance. Some tests will be specific to a particular structure of the body, while some tests aim to see if it reproduces your symptoms.

As you can imagine, the accuracy of the physical assessment is dependent on the ability of the therapist to see the areas of concern, so please dress appropriately to reveal these areas.

Treatment/Management

After the history and physical assessment, your physical therapist should have two things for you:

  1. A diagnosis, including the source and cause of your pain and any contributing factors
  2. A plan for recovery that gives you both short- and long-term guidance

The diagnosis should be presented in a way that makes sense to you, and you should ask as many questions as you need to to understand. Usually this diagnosis involves helping you understand exactly what is causing the pain (nerve, muscle, tendon, etc.) and the factors that led to this tissue becoming irritated (posture, ergonomics, endurance, mobility, etc.). If these are not clear to you by the end of the first visit, then you ABSOLUTELY NEED TO ASK.

The plan should address your specific goals, lay out steps, and provide a timeline for getting you there. It is very likely to include pacing how much you play to allow the body to recover and specific exercises to target the problematic body structures. Joint mobilisations/manipulations, and massage might also be used to help facilitate improvement, but generally it is strengthening, stretching, and lifestyle changes that will make the most improvement over time. Posture and ergonomics also play a role, but not as much as most people think. Nevertheless, physical therapists can assess your whole set-up and provide recommendations in the context of your symptoms.

How Often Do I Need PT?

It depends!

It depends on the severity of the condition, and how much guidance you need as you improve over time. While a physical therapist should follow-up and reassess you at least once, these follow-up consults should become less frequent over time. This is because as they review your progress and update your plan, you should be transitioning well into self-management. 

One of the most important things you can do during your recovery period with physical therapy is to consistently perform your home exercise program. The individual exercises–their volume, intensity, resistance, and type–are prescribed to address the source of your specific condition. Physical therapy is not about your therapist “fixing” you. It should be about helping you fix yourself AND avoiding future need for fixing.

By the time you finish physical therapy, you should feel comfortable that you understood what you did and why. After you finish working with your physical therapist, you should also feel confident that you’re capable of managing and preventing these symptoms from coming back. 

So How Do I Get to PT?

Depending on where you’re located, going to a physical therapist might require a referral from your primary care physician or a general practitioner. 

In the US, some states allow you to see a physical therapist without a doctor’s referral. You can look up your state’s laws for more information. Take a look at the quick reference below to get an idea if that’s an option for you.

In Australia, you don’t need a referral to see a physiotherapist and currently any patient can see a physiotherapist from any state. Dr Kevin Ho is our resident Australian Physiotherapist, and he’s a great resource for Aussie-based questions!

What if you want a health practitioner who has more experience with gamers in particular? Someone who speaks the same language and understands you?

Not to sing our own praises too much but 1HP does offer Injury Management and Performance Optimization services virtually. Check them out here if you are interested:

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