By: Dr. Rebecca Van Heuklon
You have developed pain or have begun having difficulty with an activity that you have enjoyed for years. Maybe your doctor recommended you try physical therapy or maybe you have decided to see a physical therapist on your own to get help. Starting treatment can be daunting because you don’t know what to expect, especially on your first visit. How long will the appointment be? What should I bring? How should I dress? Will I receive treatment on the first day? Being in pain is stressful enough without having to worry about what your appointment will be like. All of these questions and more may come to mind when you are going to start physical therapy and this article will hopefully put you at ease when it comes to your first appointment.
When you come for your first physical therapy visit, it helps both you and your PT to be prepared. If you received a referral from a physician to come to PT, bring it with you, along with any imaging (Xray or MRI) or test results. It is also helpful to bring along a list of your medications and medical history to help your PT learn more about you. If you use any sort of assistive device, including a walker, cane, or crutches, bring them with you to your first visit. In addition, if you are being seen for a lower extremity problem and wear specific shoes or orthotics, it will be helpful to have these as well.
Depending on where your symptoms are, choosing the proper clothing is important. If you are being evaluated for a shoulder or arm problem, be sure to wear a loose shirt or sleeveless/tank top that allows access to your upper body. If you are being seen for a hip, knee, or ankle problem, bring or wear shorts to allow for easy movement and assessment. If you are being seen for a head, neck, or shoulder problem and your hair is medium to long in length, it can be helpful to bring an elastic band to put your hair up. The bottom line is to wear something that allows you to move and is comfortable.
When you first arrive, you will be checked in and asked to fill out some paperwork. Arriving early will give you extra time to fill the forms out thoroughly without feeling rushed (MotionWorks also has these forms available for download and pre-filling out at home at motionworkspt.com under the Patient Info tab). It can be helpful to bring a list of your medications and medical history if it is extensive. The forms ask questions about your general background information, reason for being seen, medical history, medications, and insurance. You will also be asked to fill out a questionnaire to help your PT better understand how your specific injury or diagnosis affects your daily activities. The paperwork may seem extensive but is important for your PT to get to know you and your history, as well as ensure better understanding of why you are coming to physical therapy.
At your first appointment, your PT will begin with asking questions about your injury or diagnosis. Questions may include where your symptoms are located, what makes it better/worse, what treatment you have tried in the past, what limitations you have, and what your goals are for physical therapy. All of this information helps your PT tailor the exam and treatment to address what is important to you. Next, your PT will administer a thorough examination to determine what limitations you have. Depending on your injury, the exam may consist of observing your walking, measuring joint motion, testing your strength, assessing swelling, and using palpation to find soft tissue tightness, administering special tests to rule in or rule out a diagnosis, and observing functional movements like squatting or balancing. Your physical therapist should take the time to explain what the examination findings are and what they mean for you. All of this information is used to determine a diagnosis, prognosis, and plan of care for specific to you for physical therapy.
Once the examination is complete, education is a major component of the initial appointment. Education on how to reduce pain, control swelling, walk safely, use an assistive device, lift with safe mechanics, modify activities, and pain-relieving postures could be discussed. It is also ideal to start treatment at your first visit. Depending on your diagnosis, this might consist of manual therapy to address soft tissue or joint restrictions, modalities including ultrasound or dry needling, and exercises to address limitations in range of motion, strength, or balance. Finally, your PT will likely prescribe exercises to perform at home to help maintain any gains made during your appointment and encourage continued progress between appointments.
Each diagnosis, injury, or disease requires different examination tests, treatment techniques, and exercises. Because each of us is unique, the first visit should be tailored to each person to address individual concerns, limitations, needs, and goals. The primary goal of your first appointment is to identify what those needs are and create a plan of care that allows your PT to thoroughly address them. If you have any questions regarding your upcoming initial evaluation, contact MotionWorks Physical Therapy to speak to one of our Doctors of Physical Therapy via email at firstname.lastname@example.org, direct message on our MotionWorks Facebook page, or call us at 920-215-2050.