Why Physical Therapy Is Almost Always My First Call

When I was home last week, my uncle asked what he could do for his shoulder pain. Without missing a beat, my brother sarcastically remarks, “I’m not a doctor but I know the advice my sister is going to give: go to physical therapy.” I looked at my brother and retorted, “you are exactly right.”

At this point, everyone knows the advice I am going to give when they come to me with an injury. Even when I recommend surgery for an injury, I often send athletes to physical therapy both before and, of course, after. 

Let’s explore why…

First, An Excerpt From My Upcoming Book

As an orthopaedic surgeon, I'm a huge fan of physical therapy. I refer most of my patients to PT for a variety of reasons, from aiding athletic recovery after injury or surgery, to helping older patients prevent falls. If I am your surgeon, expect to leave my office with a PT referral. Quite frankly, most people don't need surgery -- they typically just need to retrain muscles and improve proprioception (think body awareness, balance). Much like how I waited until my mind felt beyond repair to hire a life coach, many people do the same with their bodies. We wait for an injury to become significant before seeking help. If you engage in any physical activity, you're likely to end up in a doctor's office with a musculoskeletal issue. Why do we wait to get help? Yes, I'm asking you, athletes with six-month-old tendonitis and 40-year-old moms with back pain for two years, putting off treatment because you're too busy. If you don't make time for yourself, who will? Instead of waiting on the couch for the pain to disappear on its own, seek movement. And what better way than working with a physical therapist? Studies show that exercise interventions can improve range of motion and flexibility. A systematic review showed that sports injuries can be reduced to less than one third and overuse injuries can be reduced by almost half with appropriate exercise interventions -- including proprioception and strength training.

What I Actually Do In The Office

When a combat athlete walks into my office (whether it is a BJJ competitor, an MMA fighter, or a recreational grappler), surgery is almost never where my mind goes first. My first question is always: what haven't we tried yet?

The answer is often structured physical therapy. Not the generic kind where you do three sets of clamshells and go home. I mean targeted, sport-specific rehab that addresses the actual demands of grappling. Focusing on hip mobility, shoulder stability, single leg strength, and proprioception under fatigue. Just to name a few. Things that we should honestly be doing regardless of injury status.

I have seen more careers extended by a committed PT program than by any procedure I have ever performed. And I have seen careers cut short not because surgery failed, but because someone skipped PT entirely and went back to training too soon.

You Have To Believe It

I heard a great quote yesterday during a lecture… The doc on the podium said, “physical therapy works when people believe it will work”. Like all things in life, physical therapy only works if you commit. And I do not just mean showing up to your appointments. I mean buying in… this includes trusting the process, doing your home exercises, and resisting the urge to return to full training before your PT and doctor clears you.

The athletes I have seen make full recoveries, and sometimes come back stronger, are the ones who approached PT the same way they approach the mat. With intention, consistency, and a willingness to be a beginner again. Your PT is your coach for this season. So, find someone you trust who knows your sport.

Final Thoughts

Movement is medicine. Slowing down to treat the body is usually the solution. Don’t ignore pain. Physical therapy is often the most powerful tool we have. If you are sitting on an injury right now, waiting for it to resolve on its own, this is your sign. Find a good physical therapist who understands you, do the work, and trust the process.

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Dr. Megan Lisset Jimenez 

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References:

Kubo K et al. Resistance Training Induces Improvements in Range of Motion: A Systematic Review and Meta-Analysis. 2023. PMC: 9935664.

Lauersen JB, Bertelsen DM, Andersen LB. Strength training reduced sports injuries to less than 1/3 and overuse injuries could be almost halved. British Journal of Sports Medicine. 2014;48(11):871-877. PMID: 24100287.