PT Does Not Stand For “Pain and Torture”

Physical therapists are weirdly proficient in acronyms. So much so that if you put five of us in a room, we’re likely to say something generally unintelligible like “I saw a TKA with the worst AROM but it improved with MLD,” because saying “I had a knee replacement patient that couldn’t bend his knee at all until I reduced the swelling by draining his lymphatic system” takes a lot more words. And since we’re generally not paid for the time we spend doing our medical notes, it makes sense we’ve shortened everything we can to achieve the greatest efficiency possible. Even the core of who we are…is an acronym. When someone asks what we do for a living, we respond “I’m a PT.” Only when returned with a blank stare do we make the effort to expound to “Physical Therapist.”

We’re not a terribly flashy profession, so it’s not altogether surprising that I often meet people who have no clue what a PT actually does. It’s a common misconception that PTs exist only to rehabilitate patients after sports injuries or surgery. While we can and do help in those circumstances, that’s an extremely narrow view of our profession as a whole. A good quality PT is a movement analysis specialist. That’s a fancy way of saying we are well trained to observe and identify how your entire body moves (bones, muscles, nerves, fascia, skin, etc.) and develop a plan to optimize your movements so you are better able to participate in activities that are meaningful in your daily life. Sometimes that requires building strength. Other times it involves teaching you to use the strength you already have in a more coordinated way. We’d universally prefer to prevent injuries over treating them after the fact, but our profession’s lack of pizzazz (no joke…our conferences are full of people wearing sneakers with dress pants) makes it a challenge to overcome outdated ideas of what it means to see a PT. 

Ever heard that joke…PT stands for “pain and torture”? Not all acronyms are warm and fuzzy. I’ve observed someone’s double knee replacement surgery, then asked that same patient to stand up later that day, so I know that there are specific circumstances when a PT may ask you to do something less than comfortable, but “pain and torture” is a reputation we’d rather not have. Pain serves an important, occasionally vital purpose. Your brain tells you something hurts when it believes you are in danger of doing damage to your body. In some circumstances, it’s safe and appropriate to override that valuable information, but we do our profession and our patients a disservice if we propagate the old idea that all “pain is gain.” In most cases, working within someone's pain tolerance can lead to better outcomes because you’re more likely to heal when you feel safe. 

All improvements in life require effort, so if you find yourself in physical therapy, by all means be ready to do some work. But if you’re asked to do an exercise that causes pain or we’ve placed you in a position that is uncomfortable…don’t put on a brave face and push through. Speak up ASAP! Pushing through pain can lead to unnecessary setbacks and overall feelings of ill will towards your PT the next morning, which we would very much like to avoid. And an excellent PT will always work to find creative ways to get the same results without making you miserable. So let's be done with “pain and torture.” Maybe PT should stand for “progress and transformation.” Or “puppies and taco tuesdays.” I’m just spitballing here…open to suggestions.