Mar 15, 2017

Interviewer: Physical therapy. It helps in more ways than you might think. We'll examine that next on The Scope.

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Interviewer: You know, many people only have kind of a tip-of-the-iceberg idea of what physical therapy is and what the benefits are, and, I guess, even for me, I primarily think about a physical therapist as somebody who helps me recover after, like, a knee injury, or surgery, or some sort of traumatic injury like a car crash, but Rob Singleton is a physical therapist at University of Utah Healthcare, and he says that there are actually other ways that physical therapists help, and you've been down many of the paths. You started out in the common one, which is, like, the orthopedics.

Rob: Yeah, about 22 years ago when I graduated, I started out in, you know, right out of school in sports medicine, orthopedic rehab. And I think that's kind of the common area that most people think about when they think about physical therapy, is like, you know, your typical ankle sprain, knee sprain . . .

Interviewer: I've got a wrist problem.

Rob: . . . football injury. Yeah, carpal tunnel, all that kind of stuff.

Interviewer: Sure. So you started out there, and then you got more and more specialized. Explain that path.

Rob: Well, I did that for about seven years, and then had an opportunity to come up to the university, and actually filled in for a therapist who was working in wound care.

Interviewer: Wound care?

Rob: Wound care. So physical therapy, we do a lot of wound care.

Interviewer: That just boggles my mind. I never imagined that. And what's the ultimate reason that you would seek out a physical therapist to do wound care?

Rob: Typically it's for ulcers, either like a diabetic ulcer, stasis ulcer, venous ulcer.

Interviewer: And then the goal of that physical therapy for that wound is to keep it from getting worse, to help it heal?

Rob: Yeah, keep it clean, help it heal.

Interviewer: Got you, all right. And then you've moved on from even that, now.

Rob: Yeah. So I did that for a while, and then got really interested in rehabilitation for neurological injuries, brain injury, spinal cord, stroke, and then was on the inpatient rehab unit for about eight years, mainly working on the spinal cord injury team.

Interviewer: Got you. So, boy, we've already learned a couple of things that I didn't know physical therapists did--wound care, and I guess, now that you've mentioned it, like, neurological things. That makes sense. What are some other areas a physical therapist might work in that I never would have guessed before?

Rob: Oh, wow! You know, there's therapists in pain clinics that works, you know, with pain management, and you have, of course, the orthopedic. There's acute physical therapists who work in the hospital, on the hospital floors with, you know, either in the intensive care units or the regular units. And really they're kind of the first line of defense as far as the hospital goes, you know, because your therapy starts right there. So they're the building block, really.

Interviewer: Gotcha. So there's a lot of different areas that physical therapists work. Is their kind of one overriding, though, goal or mission of what it is that you do, regardless of where you are?

Rob: Yeah. I guess if you could put physical therapy, define it by one word, it would be mobility. We're the profession that wants to get people moving, you know, either back on your feet, or moving in your wheelchair, or, you know, however you move. We want to get you back.

Interviewer: Regardless of the reason that is inhibiting your movement?

Rob: Yeah, back functioning, moving, being mobile, being as independent as possible.

Interviewer: So, like, even in the burn unit, it just occurred to me, like, when a young child burns their hands, that can cause mobility issues. A physical therapist would be there helping them with that.

Rob: There are physical and occupational therapists in the burn unit, you bet.

Interviewer: So when it comes to physical therapy and the overall kind of, what they call the continuum of care for patients, I'm trying to think . . . I was going to say, like, toot your own horn, you know. What is it you guys have, but . . . but let's maybe go the opposite direction. What would it be like without physical therapists?

Rob: Wow! That's an interesting question.

Interviewer: Like how it change . . .

Rob: People wouldn't get pushed as hard after their surgeries or injuries to get better, I don't think. You know, and that was, I think, probably historically how it was, that if you had a major surgery, or an injury, or an illness, you would be discharged from the hospital and go home, maybe have some nursing care, and then you'd kind of be just left to your own accord to get better.

Interviewer: To figure out on your own, yeah.

Rob: Yeah, to start getting up, to start moving.

Interviewer: So with physical therapists in the picture now, you push patients to get better, which helps them heal faster, get back to their life in a way that . . . like it was before, so it's not less than?

Rob: Yeah, and research is very clear that, you know, early mobility leads to faster recovery.

Interviewer: And the trend is getting, you know . . . get people up quicker and quicker. My mom had a knee surgery and she was up the next day.

Rob: Yeah, and I know they're doing a study now on in one of the inpatient acute units on really early mobilization in the intensive care units, and that's showing some really promising results because, you know, when I was up there, it was kind of, "Oh, you know, let him be for a little bit. Don't push him too hard. Get him moving." But towards the end of my stay in the inpatient intensive care units, it was really, you know, "We've got to get these people up as quick as we can, as safely as we can."

Interviewer: What are some common misperceptions about physical therapy or physical therapists that you run into?

Rob: I think probably the biggest misconception is that that we like to torture people.

Interviewer: You don't?

Rob: No, we're really . . . well, you know, I speak for myself, for the most part, very loving, giving, healing kind of people, tend to be very gentle, but we can push you. But we certainly don't want to inflict pain. Pain can certainly become part of the process, but it's not our goal to hurt you.

Interviewer: At kind of the end of the day, if, you know, somebody is just finally kind of having their mind broadened as to what physical therapists can do, and that they help in a lot of different areas, how would somebody know if maybe a physical therapist would be somebody they want to seek out for a condition or an issue they have, you know, beyond the obvious?

Rob: Well, I think you know, with the internet and Google, if you type in your condition and how it's treated, with most things, you're going to see therapy, in some sense, come up as a treatment option.

Interviewer: So maybe a good new paradigm for somebody to have is that physical therapists, instead of just being in one place, are probably everywhere.

Rob: Yeah, and I think people, you know, would be quite surprised when they come into clinics and there's a physical therapist there.

Interviewer: It's nice.

Rob: You know, we're in a lot more areas than people really realize.

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