The last year has been full of unexpected twists and turns. I opened Embrace PT & Wellness in late 2019 not knowing what the future would hold. Little did I suspect that telehealth would be a boon when all in-person visits ground to a halt in March 2020, just a few short months after my grand opening.
Yet I opened Embrace with the plan to utilize virtual visits from the very beginning. Why did I think telehealth was a viable option, even before the pandemic? As I grew from a newly minted doctor of physical therapy to a board-certified pelvic health expert, I started to notice that I spent the majority of my time talking to clients. I would spend the better part of a session discussing bladder habits to help stop urinary urgency and leaking or the best bowel practices to reduce constipation and leaking stool. Other sessions, most of my time was spent educating clients about the possible reasons--and multifactorial solutions--to reducing pain with sex. I found that the less manual therapy, or hands on work, I did on a client, the more empowered they were to take charge of their own healing. I learned I could perform scar tissue massage once a week for months and make a small change.
However, the large changes came from a client performing scar tissue massage on themselves daily. In the end, I realized that my mission to empower people to take charge of their best pelvic health was supported, rather than hindered, by virtual physical therapy.
In fact, there is mounting evidence that virtual physical therapy can be quite effective. A 2018 study demonstrates a positive impact on patient health outcomes and satisfaction through virtual physical therapy (Grona et al 2018). In a study published recently, Miller et al found that there was 94% patient satisfaction with their telehealth treatment (2020). Further, the World Confederation for Physiotherapy found that a digital practice:
Expands access to specialists
Decreases barriers like parking, travel to appointments, and time in a waiting room
Increases flexibility to schedule therapy at convenient times
Increases a person’s independence in control of their health management
Decreases costs related to travel, assistance, and time lost on other activities
All of these findings resonated with me. I’d heard numerous complaints over the years about commuting through Boston traffic, the lack of early or late appointments, and the non-renewable resource that is your precious time.
Working in telehealth has also benefited me as a physical therapist. I always prided myself in my ability to describe movements verbally in many different ways. Rather than physically correcting your movement, I find that if I can help you figure out your optimal postures and movement patterns, then you will retain those new skills far more effectively. I have gotten much better at describing how to perform different movements, including pelvic floor contractions with such a consistent focus on telehealth.
There are, however, limitations to virtual physical therapy: I cannot get quite as accurate a measure of your pelvic floor strength, weakness, or overactivity. The solution is that now I often teach people how to examine and assess their own pelvic floor. You are the expert of your body, and the better you know yourself, the faster you improve.
Much of physical therapy diagnosis occurs based on your history--when I ask questions about your specific symptoms. Treatment is based on your history, tests and measures, and observation. I perform quite a few tests and measures over video and you tell me what you feel! After all, you know your body better than anyone else.
If you are worried about in-person appointments and want a safe environment to tackle your pelvic health, virtual physical therapy is an safe and effective option.
Dr. Julianna Allen PT, DPT, WCS
Digital Physical Therapy Task Force. Report of the WCPT / INPTRA Digital Physical Therapy Task Force. World Confederation for Physical Therapy and International Network of Physiotherapy Regulatory Authorities; 2020.
Miller, M. J., Pak, S. S., Keller, D. R., & Barnes, D. E. (2020). Evaluation of Pragmatic Telehealth Physical Therapy Implementation During the COVID-19 Pandemic. Physical Therapy.
Grona, S. L., Bath, B., Busch, A., Rotter, T., Trask, C., & Harrison, E. (2018). Use of videoconferencing for physical therapy in people with musculoskeletal conditions: a systematic review. Journal of telemedicine and telecare, 24(5), 341-355.