Rehabilitation and Revision - Physical Therapy during the COVID-19 Pandemic
By Karlo Arciaga
As a physical therapist, myself and the rest of my colleagues had to revise the way we approach our care. How are we supposed to provide physical intervention while maintaining social distancing? The past year has hosted many challenges for myself and the rest of physical therapists across the nation.
As a physical therapist (PT), we strive to improve an individual’s function by facilitating natural body healing. Nothing that we do is invasive in nature. The majority of the interventions that we provide are offered in the instruction and administration of therapeutic exercises in conjunction with manual techniques (soft tissue mobilization, joint/spinal mobilization). As an orthopedic specialist, I primarily consult individuals who may deal with various musculoskeletal conditions (tendinitis, arthritis), injuries (ligament sprain, muscle strain), and surgeries.
While I may be asking my patients to participate in various exercises and move in novel ways, much of the patient experience is also facilitated by an appropriate rehabilitation environment. We understand that the rehabilitation process for many will often take weeks, and for some, even months, before the body is fully capable of returning to a level of function that an individual was at prior to their injury and surgery. Amidst the stress being created by this pandemic, how do we optimize outcomes of these individuals? How do I ensure that a patient/client stays motivated when they understand that a long journey is ahead of them?
The evolving challenges that we as healthcare practitioners face cause us to constantly have to alter our practices. I considered the dawn of this pandemic a much different challenge. How do we foster and maintain therapeutic alliances and relationships while keeping the overall stress related to the pandemic low? We strive to maintain optimism within my workplace several ways. Our main strategy to was implement thorough changes to ensure the safety of our patients: temperature checks at the front desk, daily temperature logs of employees, re-positioning of treatment tables six feet apart, and mandatory mask use of all patients and therapists. It was elected by our clinic directors to operate strictly on an in-person basis. We value manual therapy strongly as an adjunct to your treatment. No implementation of virtual consults were conducted.
I am blessed to work at a facility with wide open space—this enables patients to maintain their distance while working throughout their exercises. Music is comfortably sounding throughout the clinic floor, allowing patients to maintain an upbeat energy. Staff also maintain a smile on their faces and continuously communicate with each other to ensure patients are being monitored properly. It is important that our patients are in an appropriate “head space” throughout this entire process. We understand that physical rehabilitation is not easy, and at times, therapeutic outcomes (reduction in pain levels, improvements in range of motion, gains in muscular strength) may not be readily observed between individual treatment sessions.
The onset of the pandemic has created a shift in the demographic of the patients whom we see. Typically we consult many individuals who sustain an orthopedic-related injury due to their assigned occupation or participation in sport. Due to the cessation of such activities, it became worrisome that the amount of patients presenting to our facility would reduce. To our surprise, many individuals choose to proceed with elective surgeries. Such surgeries were conducted in hopes of improving quality of life for these individuals. Fortunately, the granted time off enabled such individuals to properly undergo surgical management while also allotting sufficient time to conduct their post-operative outpatient rehabilitation at our clinic.
Patients are surrounded by many others who are also dealing with their own experience of pain. The majority of our clients present to us with a chief complaint of pain. For those who have dealt with long lasting symptoms, their experiences begin to permeate into other aspects of their life. Pain no longer limits their ability to move, but it begins to invade their capacity to take care of themselves, or take care of others. We want to ensure that an individual's visit with a physical therapist is a change to heal—an opportunity to explore movement and to better understand the multi-faceted nature of the pain they are dealing with.
I aim to serve the community as an allied health professional by educating individuals on how to help themselves heal by use of movement. When individuals are nervous due to fear of reproducing pain with motion, I instruct them on how to gradually re-expose them back to “normal” movement. This steady, consistent approach will enable the body to heal while protecting injured tissues. The interventions I provide combined with an uplifting rehabilitation atmosphere will ensure utmost success as long as a patient maintains participation with our plan of care.
If any individual wanted to seek out further insight regarding their ailments, I would strongly encourage consulting your healthcare professional.
Photo/Tim Soder Physical Therapy. https://soderpt.com/
Karlo Arciaga PT, DPT is a Doctor of Physical Therapy serving the valley at Tim Soder Physical Therapy at its Green Valley location in Henderson since 2017. Karlo provides patient care to all patients, managing symptoms due to various musculoskeletal disorders, injuries, and orthopedic surgeries. He is also a certified clinical instructor and will often be found fostering many students throughout the year on the clinic floor.