PT settings with the least amount of manual therapy?

[Wildlifelover]

Hi everyone,

I am considering PT as a career, and I have worked and shadowed in a variety of settings. One thing that concerns me about choosing this career is the fact that I have a previous injury to my wrist that never healed correctly and I have chronic pain now. It seems I have developed some arthritis and it flares up when I use my thumbs and hands a lot. This concerns me because from what I have seen, therapists really use their thumbs to do manual therapy on patients. It is my dominate hand and wrist that is effected.

My question is, what settings of PT typically don't do very much (if any) manual therapy. I know outpatient ortho is out as that is very manual heavy. From what I have seen, pediatrics uses less manual, as do neuro based clinics.

What are your thoughts? Are these settings easy to break into, or would you say all the jobs in PT that are in high demand require a good bit of manual therapy? I think manual therapy is a wonderful tool. I just worry about my ability to perform it on patients. Rubbing my significant other's back causes flare ups immediately upon massage. I would be doing this day in and out as a therapist.

I am otherwise able to live with the pain, work out (with modifications of course) and it will flare up some from workouts. But massage seems to be something that truly flares it up immediately.

What settings in the PT world would you suggest for someone who can not do much manual on patients?

Thank you!

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[noyceguy]

Hi everyone,

I am considering PT as a career, and I have worked and shadowed in a variety of settings. One thing that concerns me about choosing this career is the fact that I have a previous injury to my wrist that never healed correctly and I have chronic pain now. It seems I have developed some arthritis and it flares up when I use my thumbs and hands a lot. This concerns me because from what I have seen, therapists really use their thumbs to do manual therapy on patients. It is my dominate hand and wrist that is effected.

My question is, what settings of PT typically don't do very much (if any) manual therapy. I know outpatient ortho is out as that is very manual heavy. From what I have seen, pediatrics uses less manual, as do neuro based clinics.

What are your thoughts? Are these settings easy to break into, or would you say all the jobs in PT that are in high demand require a good bit of manual therapy? I think manual therapy is a wonderful tool. I just worry about my ability to perform it on patients. Rubbing my significant other's back causes flare ups immediately upon massage. I would be doing this day in and out as a therapist.

I am otherwise able to live with the pain, work out (with modifications of course) and it will flare up some from workouts. But massage seems to be something that truly flares it up immediately.

What settings in the PT world would you suggest for someone who can not do much manual on patients?
Thank you!

I work in outpatient and do very minimal manual therapy and almost never use my thumbs. Try outpatient with a focus on ther ex and ergonomics.

 

[NewTestament]

Who said you have to do manual therapy? You can get great results with patient education and exercise.

Also, outside of outpatient, PT's do very little manual therapy, if any at all. There's little reason to do manual therapy in home health, SNF, acute care.

You might want to avoid the clinics that call themselves, "manual therapy-based clinics." They might not have the equipment that you need to do exercise.

 

[Wildlifelover]

The clinic I have the most experience in is an outpatient ortho clinic and they are heavy on the manual. They also have the patients do exercises but it is split between about half the session manual and half exercise. After being exposed to it for so long, I just thought that you had to do a lot of manual in outpatient and I know that I physically can't.

So its still reasonable for me to pursue this career? I was just so afraid that I would pursue it only to realize that every outpatient ortho job would need heavy manual and I wouldn't be able to provide it. I did gather that there really isn't much point to it in inpatient, pediatrics, and SNF clinics. But I wasn't aware that you can work in outpatient and actually do much less manual. Do you guys care to elaborate more on what a session with your patients is like?

Thanks so much!

 

[NewTestament]

Look for a clinic that doesn't brand itself as a "manual therapy clinic." You don't need to spend half a session doing manual therapy. I think that's excessive. You can work in most outpatient clinics and not do any manual therapy. If you do home health, you'll never use it.

 

[noyceguy]

The clinic I have the most experience in is an outpatient ortho clinic and they are heavy on the manual. They also have the patients do exercises but it is split between about half the session manual and half exercise. After being exposed to it for so long, I just thought that you had to do a lot of manual in outpatient and I know that I physically can't.

So its still reasonable for me to pursue this career? I was just so afraid that I would pursue it only to realize that every outpatient ortho job would need heavy manual and I wouldn't be able to provide it. I did gather that there really isn't much point to it in inpatient, pediatrics, and SNF clinics. But I wasn't aware that you can work in outpatient and actually do much less manual. Do you guys care to elaborate more on what a session with your patients is like?

Thanks so much!

Yes, we typically do 55 mins of ther ex/ther act. Warm up on bike, a couple open chain isolation motions to get things moving (bridges/SLR) , harder functional exercises focusing on the patients motion impairments (squats, lunges), then simple stretching/mobility work on tight areas at the end. Ice/heat/stim/ or manual at the end if they are acute. Skip the manual entirely and it makes little difference in overall patient outcomes.

 

[Wildlifelover]

I'm not sure if this clinic necessarily brands itself as a manual therapy clinic but it is certainly listed on its therapy provided list. And from what I have experienced it is very heavy on it. I always wondered how therapists stay in the field for most of their life when providing manual therapy can be pretty taxing on the therapists body themselves. This gives me hope. Thank you.

 

[jblil]

If you do home health, you'll never use it.

That's correct. I am in home-health, and have never had to do manual therapy.

 

[DrEvil518]

I was having some issues with premature aches and pains, and I found that being a rehab intake liaison was a good fit for me. You need a rehab or RN degree to do that job, plus you're working with patients every day to evaluate them for whether they're appropriate for acute inpatient rehab. The only drawback is that the jobs like to see a few years in patient care before you can transition into them. But once you've worked for a few years, they're a good plan B if you're getting achy!