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Physical Therapy FAQ: Part One

Physical therapy (PT) is of great benefit to those of us with ankylosing spondylitis. However, many have preconceptions about PT that make them fearful of trying it. Not all experiences are created equal and there are many reasons for this. I hope that this two part FAQ on PT gives you a better understanding of what we as PT’s can do for you!

What training do physical therapists have?

Physical therapists are highly trained movement experts who have a Master’s or Doctoral degree in physical therapy. Beginning in 2020, in the United States, all new PT’s must obtain a doctorate in physical therapy in order to practice.

In graduate school, they receive comprehensive training in not only the musculoskeletal system (bones, muscles, joints, ligaments), but also in the neuromuscular (nerves, brain, spinal cord), cardiopulmonary (heart and lungs), and integumentary (skin) systems. They must pass a board exam in order to become licensed. PT’s are lifelong learners, the requirements vary state-to-state but the attendance of continuing education courses throughout the year is common.

How can I find a physical therapist for ankylosing spondylitis treatment?

The best way to find a PT is to ask your doctor whom they would recommend. Another great idea is to ask friends and family. Although everyone’s experience with PT is different, word-of-mouth is often quite helpful.

Since ankylosing spondylitis may not be a common diagnosis seen in most clinics, it may be helpful to call prior to scheduling and inquire. Ask if any therapists there have experience treating this condition. If not, ensure they are at least willing to do some research. All PT’s are highly trained medical professionals but the school they attended and the experiences they have had can vary.

What issues related to ankylosing spondylitis can a PT help me with?

  • Migraine and tension headaches
  • Temporomandibular joint dysfunction (TMJ)
  • Spine related pain (neck, mid-back, low back, sacroiliac joint)
  • Sciatica
  • Costochondritis and/or rib pain
  • Poor posture
  • Peripheral joint pain (shoulders, hips, knees, ankles)
  • Enthesis (tendon-to-bone inflammation)
  • Achilles tendonitis
  • Plantar fasciitis
  • Cardiovascular deconditioning and fatigue
  • Imbalance

How do I prepare for PT visits?

At your first appointment, the physical therapist will be asking you many questions about your pain and activities. It may be helpful to write down in a notebook answers to the questions below to make the conversation efficient.

  • What is your pain like in the morning, afternoon, night?
  • What activities make your pain worse? Better? (sitting, standing, walking, stairs, cleaning, etc.)
  • How would you describe your pain? (dull, ache, sharp, shooting, burning, numb)
  • How has your pain impacted your life? (work, recreation, etc.)

The above questions help your PT formulate a diagnosis, plan of care, and to make individualized goals

Tip: Wear loose and comfortable clothes such as a T-shirt and jogging pants!

What should I expect during the examination?

The PT will assess how well you move by asking you to replicate various movements of your spine and extremities. The PT may also assess your strength and measure the flexibility of various joints. You may be asked to do things like stand, walk, and roll from your back to your side, or side to your stomach.

Will it cause pain?

If you cringed at the thought of some of the above movements, you are not alone. Although the above description of potential movements is common during a session, it is not expected. Your PT should ask you throughout the session if you feel comfortable performing the movements.

Don’t be afraid to speak up if something hurts or if you are not able to get into a position such as your stomach. However, it is common to feel some discomfort especially during the first visit. The PT is trying to determine how well you move and what movements create discomfort. This helps them to formulate a tailored plan of care. An open line of communication is key to therapy!

Be on the lookout for PT FAQ Part 2!

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