Editorial - Journal of Physical Therapy and Sports Medicine (2017) Volume 1, Issue 1
A case for biannual movement checkups.
Department of Physical Therapy Education, College of Allied Health Professions, Western University of Health Sciences, USA
- *Corresponding Author:
- Casey Chaney
Department of Physical Therapy Education College of Allied Health Professions Western University of Health Sciences USA
E-mail: [email protected]
Received date: March 14, 2016; Accepted date: April 19, 2016; Published date: April 22, 2016
Citation: Chaney C. A case for biannual movement checkups. J Phys Ther Sports Med 2017;1(1):3-4.
I have a question: If my basic dental insurance covers my seeing my dentist twice a year for a checkup for my teeth, why doesn’t my health insurance cover seeing my physical therapist twice a year for all the rest of my body?
Children are taught from a very young age to regularly brush and eventually learn about flossing and the importance of visiting the dentist (usually biannually) in order to maintain good oral health over their lifetime. For many healthy adults the biannual visit involves dental cleaning and a “quick check” by the dentist with occasional X-ray imaging. Generally, in adults, we have 32 permanent teeth - including 4 “wisdom” teeth. However, in the adult human body we have 206 bones and 640 skeletal muscles and that is not even counting the essential cardiac muscle- i.e., the human heart! Physical therapists are health care professionals with doctoral level education, which includes cadaver anatomy in order to study all of these bones and muscles, as well as the central and peripheral nervous system within the human body. As importantly, physical therapists are educated to clinically analyze and treat the source of any problems in our neuromusculoskeletal systems in order to maximize our ability to move throughout our lives. This is important because it is believed that movement is key to optimal living and quality of life. This is exemplified in the current vision statement adopted by the APTA in 2013: “Transforming society by optimizing movement to improve the human experience.”
Our health care system has some problems- no doubt about that. But in part it may be that we have become not only dependent upon what third party payers cover, we allow third party payers to dictate how we take care of ourselves. But let’s focus on the positive. How can we move forward? What do we need?
Prevention and early intervention are keys to reducing the catastrophic costs associated with the current reactive and last minute approach that typifies health care today. Identifying cavities even in baby teeth can have an impact on the permanent “keepers”. That is in part why the Surgeon General included “the health of the teeth, the mouth, and the surrounding craniofacial (skull and face) structures” as central to his overall health and well-being objectives for the 2010 Health Campaign in his statements in 2000 and 2002 [1,2]. Similarly, identifying postural problems can improve &/or maintain health and wellness. Weak lengthened muscles and shortened tight muscles that lead to slouched posture can cause chronic back pain. These problems can be identified and treated by a physical therapist, who can prescribe some simple exercises and reminders that can become part of a regular routine, just like brushing your teeth every morning and evening.
It is now common knowledge that exercise is recommended for the prevention of heart disease, stroke and Alzheimer’s disease just to name three major health concerns in this country. But how do we keep healthy people moving, especially as they age. According to Ma and associates among common rehabilitation diagnoses examined, “musculoskeletal conditions such as back pain and arthritis likely have the most impact on the health care system due to their high prevalence and impact on disability.” With low back pain and arthritis affecting over 100 million individuals and costing over $200 million each year, as well as pain and suffering, identifying postural faults and movement dysfunctions early on is critical .
So going forward how can this be reduced?
Direct access to physical therapy is slowly becoming a reality and it is about time. Physical therapists in this country are currently educated at the doctoral level and many have earned APTA Board Certifications in specialties such as Orthopedics, Neurology, Pediatrics, and Women’s Health. However, more people than is desirable are unaware that reducing daily movement or resorting to bed rest may actually make their difficulties moving even worse. The APTA survey on low back pain and subsequent press release entitled Most Americans Live With Low Back Pain- And Don’t Seek Treatment (2012) reported that 72% of Americans use pain medication to relieve their symptoms, not realizing that physical therapists are movement experts that can evaluate what is causing their pain and develop a plan of treatment to restore their ability to move without pain. Physical therapists are educated to clinically analyze the patient’s condition in order to determine the root cause of their problem rather than just treating their symptoms. What we need is acknowledgment that movement, when guided by a skilled physical therapist, can not only prevent most common aches and pains, but also that exercise can be beneficial without the negative “may occur” side effects rattled off at the end of every drug advertisement currently playing on television.
And what about the stoic Americans that attempt to deny there is a problem, hoping that if the physical ailment is ignored it will go away on its own? This just leads to larger problems and often-compensatory dysfunctions. What does that mean? Bring me a weekend warrior who has ignored his/her knee pain long enough and we will end up needing to treat not only his/her knee, but also likely some low back pain that has developed as a result of changes in his/her gait.
So if I can go to the dentist twice a year for a checkup for my teeth, why can’t I see my physical therapist twice a year for all the rest of my body? What can we do to make this happen?
What we need is a twice a year check up to take a look at how we sit, stand and walk. Periodically examining and correcting these three activities of daily living will help people avoid the struggle that often ensues by the time they identify that they have a neuromuscular or musculoskeletal problem.
My suggestion, as long as third party payers are making decisions about coverage, is to urge that coverage for twice a year checkup be not only for the dentists to check on our pearly whites, but also for the rest of the body. If we must start small, why not at least have an annual checkup with a licensed doctor of physical therapy to evaluate posture and the basic movements involved in our daily ability to get out of bed, move to and about our daily work duties both in and outside of the home and improve the way we sleep at night? Yes, a physical therapist can evaluate the way you move and, more importantly, determine what the source of your movement dysfunction is, as well as develop a plan of treatment to restore your ability to move throughout your life, hopefully improving your quality of life in the process. This has been recognized as critically important in the battles against heart disease, stroke and Alzheimer’s Disease just to name a few.
- US Department of Health and Human Services, Public Health Service, Office of the Surgeon General. Oral health in America: A report of the Surgeon General. Rockville, MD: National Institutes of Health, National Institute of Dental and Craniofacial Research. 2000;33-59.
- US Department of Health and Human Services, Public Health Service, Office of the Surgeon General: Healthy People 2010: Understanding and Improving Health, second edition: A report of the Surgeon General. Rockville, MD: National Institutes of Health. 2002.
- Ma VY, Chan L, Carruthers KJ. Incidence, Prevalence, Costs, and Impact on Disability of Common Conditions Requireing Rehabilitation in the United States: Stroke, Spinal Cord Injury, Traumatic Brain Injury, Multiple Sclerosis, Osteoarthritis, Rehematorid Arthritis, Limb Loss, and Back Pain. Arch Phys Med Rehabil. 2014;95(5):986-95.