Run Wild

Injury Prevention with PT Screenings By Sarah Hauge

OVER THE PAST COUPLE OF YEARS, my running life has been peppered with guest appearances by a rotating cast of unwelcome characters. Calf tightness. Small muscle tears. Stiffness in my right foot. Occasional knee aches. Most recently, a tight left Achilles paired with ankle pain. Nothing major, everything annoying.

When the more debilitating issues come up, I make an appointment for physical therapy, where probable causes are assessed and next steps are determined. This is helpful, but I’ve started to wonder: What if I could do this assessment before any sidelining injuries occurred? Could we all benefit from turning to PT for prevention versus a cure? To ask about all of this, I talked to Dominic Severino, assistant professor in Whitworth University’s Doctor of Physical Therapy program and a PT at Newport Hospital. Through our conversation I learned that while preventive PT screenPHYSICAL THERAPIST ings are a novel concept KELLY RISSE. // PHOTO COURTESY OF to me, they’re certainly PT ASSOCIATES not a new one internationally or among physical therapists, and they’re promoted by the

American Physical Therapy Association.

“This topic has been kind of simmering on the burner for quite a few years,” says

Severino.

Severino sees several reasons why regular

PT screenings to assess the musculoskeletal system would be beneficial. For one, if you’ve ever had an issue, your history is a strong predictor that you’ll have another one in the future. “Musculoskeletal injuries, they tend to linger, they tend to come back,” he says. Regular PT screenings can help address those recurring issues before your body loses its ability to compensate and they become larger problems.

When I mentioned my occasional knee pain, Severino talked me through what a PT screening or evaluation might be like. “The physical therapist would be looking at lumbar spine mobility, hip mobility, hip strength, quad strength, hamstring strength, foot position, and ankle mobility. Can we find errors in the system? And what might be the recommendation to address it?” Next steps could include stretches, strength training, or new footwear.

For people transitioning between very different sports like, say, triathlons and downhill skiing, a screening between seasons could be very helpful. “It’s not a bad idea to have an evaluation or a check-up to make sure the joints, muscles, and systems that are involved are ready,” says Severino.

PT screenings also offer potential benefits for aging clients, assessing physical indicators like range of motion and balance. Early signs of arthritis, Severino says, can easily be picked up in a PT screening, with next steps given to the patient, whether that be a handout for gentle stretching to do at home, recommendations for better footwear, or a course of physical therapy.

This all made a lot of sense to me. There is just one major issue: cost. In the U.S., insurance generally covers PT when it’s referred by a primary care physician. Preventive screenings are not a covered benefit, so they would require cash payment. And because all of this is outside the norm, anyone interested in a PT screening would be wise to have a detailed conversation first with a trusted PT clinic about cost, what the screening will cover, and how long the appointment will last.

If cost weren’t an issue, Severino says he’d recommend for the average adult to receive a PT screening once a year (echoing the recommendation of the APTA), and for someone transitioning between two very different sports to come in as often as twice annually.

While I anxiously await the day when our healthcare system catches up and we recognize preventive PT as the time-, pain, and money-saving tool it is, I’m going to see if I can find room in my budget to cover regular screenings. An ounce of prevention is worth a pound of cure, right?

Severino thinks so. “Our bodies, when they change or they have a new pain, that pain means something,” says Severino. “Rather than ignoring it, or trying to drown it out with ibuprofen, [we should be] trying to find out what that is.”

Sarah Hauge is a writer, runner, and editor who lives in Spokane with her husband and two kids.