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Blog Post

Gotham Physical Therapy’s 4-Phased Approach to Care

A roadmap to getting out of pain

If you have any familiarity with physical therapy at all, hopefully you know that it’s almost never a one-shot deal. Instead, it usually requires several sessions over the course of weeks or months because the changes you want take time. That’s just the nature of the musculoskeletal and neurological systems where healing usually takes place with relative rest followed by graded exercise and exposure to previously painful or difficult tasks.

At Gotham Physical Therapy we strive to follow a basic roadmap to get you out of pain and back to doing what’s important to you. We call it our 4-Phased Approach to Care. It’s not a clever name and it’s not a groundbreaking concept, but knowing where you are and where you need to go is important for staying on the right path and reaching your destination.

Here it is.

Phase 1: Pain reduction

Most people that walk through our doors the first time are in pain. Getting out of pain is usually their first and biggest concern, so that’s what we focus on initially. We’ll use our manual therapy techniques and exercises to reduce your symptoms. We’ll also be educating you about things you can do on your own to decrease stress on the painful tissues and help them start to recover.

Phase 2: Restore load tolerance for necessary daily activities

Once we get the pain a bit more under control, then we want to focus on helping you get through your normal daily activities and work without the pain roaring back. That means we’ll focus a bit more on exercises and advice about activity modifications in order for you to do what you need to do more comfortably and without having a setback.

Successful achievement of this stage is often where people are beginning to think about quitting PT. Their original problem isn’t bothering them as much and they figure they’re good. In reality, we’ve just barely gotten them back to baseline and it could go either way depending on what they do next. It’s kind of like stopping a 6-day course of antibiotics on day 3 when you’re feeling better. Not a good idea. That’s why if you really want to conquer the problem that brought you to us we should keep going and complete the plan of care.

Phase 3: Restore normal motion and prior levels of strength

In this phase, we’ll use manual therapy as needed to restore your joint mobility to normal. Or, if you were living with mobility deficits, we’ll try to correct those as much as possible. We’ll also do more difficult exercises to help you return to your normal levels of strength. At the end of this phase you should be feeling pretty close to your old self. But to really get the lasting benefit of physical therapy, we propose one more phase.

Phase 4: Build a buffer

Here is where we introduce you to an exercise plan to help you build a buffer that ensures your body can handle things beyond just your normal daily activities. You want to be fit for the unexpected as well as the expected. So if you hike just a little farther than usual, push for a weightlifting PR, or play one extra game of basketball your body is prepared to handle it without reinjuring yourself. We’ll also focus on the best strategies you can employ to prevent future painful episodes.

All told, these 4 phases can be as little as 6 weeks for relatively minor injuries/pains and on up to 12 months if you’re recovering from surgery or dealing with chronic persistent pain. Regardless of the timeframe, we think working through these phases to the end is important for helping you deal with the problem and avoiding reinjury. 

If you’d like to see this plan in action and fitted specifically to your needs and goals then give us a call or inquire about the next available visit.