• Tyler Balfour

Do I Need to See a Doctor Before a Physical Therapist?

How many people have gone through this scenario: You begin to feel some pain somewhere, maybe your back, or in your knees. You try all the normal relief routes- ice, rest, ibuprofen, etc. Several days of this pass and although the pain goes down a little, it is largely unchanged. Now it’s getting to the point where you need to see a professional to get the injured body part checked out so you can find some answers.


Physiatrists and orthopedic specialists are great resources for diagnosing and treating an injury, however your journey often begins at a primary care doctor. Here, you might receive a referral to a specialist for another opinion. This may involve x-rays at each office, and even an MRI, before any decision regarding your treatment is made. Before you know it, it’s been 6 weeks of imaging and doctor appointments and you’re still in pain, taking medications daily, icing, and resting, just like you were when the pain began. Assuming surgery is not required, you will often receive a diagnosis with a doctor recommendation of PT for another 6-12 weeks with visits multiple times per week...and all of this after 4-6 weeks of imaging, specialists, and MD appointments. WOOF.


There’s good news though! You can avoid all this! What I love about being a physical therapist in Georgia is that we can treat patients through direct access, which simply means a doctor's order is not required to see a PT. Our evaluation will guide you in the next steps of your recovery, because going directly to a physical therapist following injury does not mean you shouldn’t see a doctor at some point.


We offer a thorough, hands-on assessment and provide actionable advice applicable to your unique situation and/or the initial phase of injury. For example, I had a client recently who injured her knee playing tennis and came in for a visit the day before her appointment with the orthopedist. Based on her assessment, I encouraged her to see the doctor, but gave her some exercises to do in the meantime to help her maintain flexibility and strength in her knee. These exercises were appropriate to the findings of her evaluation, as well as where she was in the healing process.


I find it much more difficult to treat someone’s knee in physical therapy after they’ve been limping around and guarding it for 6-10 weeks while seeing multiple doctors. An injury usually leads to weakness in the muscles and stiffness in the joint, so getting ahead of that with some basic stretches, exercises, and direction on how to approach an injury can lead to better outcomes in the long term.


By coming to our clinic prior to seeing her doctor, my client was able to find practical ways to deal with her injury that could set her up for better long term outcomes. We serve a unique role in injury management early on because we can show our clients how to manage an injury in the early stages of healing to minimize pain, stiffness, and weakness in the long term.


What do I need to see a PT?

As of May 2015, people in Georgia have been able to see a physical therapist without a referral from their doctor under several conditions.


A referral from the patient’s doctor is needed in the following situations:

  • After 8 visits or 21 days (whichever comes first).

  • To continue dry needling after 6 days following the initial evaluation.


The patient does not need a referral under the following conditions:

  • The services are for health promotion, wellness, fitness, or health maintenance.

  • The patient received a new diagnosis for a condition related to something they were already receiving PT for.

  • If the patient has a diagnosis and referral for PT that is less than 90 days old.


Here at Functionize we usually ask for a physician to sign off on our plans of care due to the dry needling stipulation. It also allows us to communicate and work with our clients physicians to provide a more comprehensive treatment for their condition.



Wait a minute - PTs can help even if I’m not injured?


Providing hands on treatment and helping people deal with pain is a wonderful aspect of my job. However, in order to get back to being able to do yard work, playing tennis, or riding your bike again, you usually need to use exercise to bridge the gap between pain relief and performing at a higher level.


One thing that’s great about working at Functionize is that we’ve combined our knowledge and equipment in the clinic to provide modern wellness and fitness options to our clients.


Everyone on our staff has gone through some kind of advanced training on managing fitness athletes, running analysis, golf fitness, or Pilates. Our goal is to provide our clients with the latest education and advice on all things exercise, fitness, and wellness.


Our view on health maintenance goes beyond being able to stand up and walk around your house and office. We view health maintenance as a program that keeps you fit enough to perform at the absolute highest level. For example, if you want to be able to run 10 miles off the couch, then our goal with a maintenance program is to provide you with some kind of an exercise routine that helps keep you at that level.


Wellness is more than just basic self care. We think sleep, stress management, movement, and nutrition are extremely important to maintaining health. We work with Allyson Balzuweit, MPH, RDN/LD who is an excellent resource for nutrition advice and counseling.


Also, check out our 5 Point Checkup! This is our version of an annual physical that includes neurological screening, general mobility assessment, strength and endurance assessments, and an Inbody scan to measure body composition (% muscle and body fat). This can serve as a great check-in once a year to make sure you're staying on top of your fitness and health goals.


What if I cannot come into the office?

Not a problem! We have several digital options for physical therapy or health and wellness resources. The pandemic has changed our workplace just as it has for many others, and we now have telehealth as one of our offerings. A telehealth PT visit is done over a Zoom call. This is really helpful for patients unable to get out of the house. Others really enjoy it because it allows us PTs to create an exercise program that’s customized to our clients space and equipment at home instead of the clinic’s equipment and space.


We also use the Train Heroic app to digitally program workouts that can be done at home, on the road, or at the gym. This is a little different from a typical PT home exercise program in that you will be challenged with higher intensity workouts with very specific instructions on reps and sets.


Our clients often like using the Train Heroic option as a bridge from doing an exclusively PT-driven home program to working out in the gym following an injury or pain. It’s also great for people new to exercise or who have a medical condition they’d like a physical therapist to take into account while scheduling a program.


So, what are you waiting for!?!

We have two locations in the Atlanta metro area- one in Dunwoody and one Decatur. If you are looking to get past pain, improve your performance, or just get stronger, give us a call! We’d love to work with you!

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