Physical therapists, chiropractors and massage therapists are getting pretty creative these days, while the novel coronavirus pandemic limits their ability to provide hands-on care to patients and clients.
Colorado Springs physical therapist Scott Rezac, for example, is treating several COVID-19-positive patients via telehealth, instructing them to put a heavy blanket into their clothes dryer, turn on the “perm press” setting and lean up against it while it bangs away. This helps dislodge debris from the lungs, making it easier for the patient to breathe, he said.
These highly contagious patients can’t come into Rezac’s office for the usual manual treatment that would help them cough up mucus and other fluids. But thanks to modern technology and a little outside-the-box thinking, he’s still able to help them get on the road to recovery.
“When you go to a physical therapist, you’re expecting hands-on treatment to some degree, if not to the entirety of the degree,” Rezac said. “So we had to get a little more creative in terms of how we actually treat patients from a remote setting. Rather than us putting our hands on them, we’re teaching the patient how to do several different techniques.”
Colorado physical therapy clinics are prohibited from performing elective, non-emergency procedures right now, which means many providers are turning to telehealth to help relieve pain, improve mobility and, ultimately, keep people out of emergency departments and urgent care facilities.
Though hospitals have largely canceled surgeries like hip and knee replacements, there were plenty of patients who underwent a procedure just before COVID-19 turned the world upside down. The recent warm weather and extra time at home has also resulted in many injuries caused by overexertion or strain while doing yard work, landscaping and other household tasks.
“We do still see patients here in the clinic, based on their situation,” Rezac said, noting that his clinic is taking all possible steps to prevent the spread of illness during in-person visits. “There are some patients who, if they didn’t get seen here, would end up going to the emergency room with their pain, which would only expose them to infectious problems and bog down a hospital system that’s already overloaded. We’re a steam valve for that.”
Since they can’t manually treat people via telehealth, physical therapists are showing patients techniques they can do themselves or with the help of a roommate or partner.
“It’s a team approach,” said Cameron MacDonald, president of the Colorado chapter of the American Physical Therapy Association. “In essence, we can reach through the screen and allow someone else to be our hands.”
With live video, they’re also able to analyze exactly how people are sitting at their new work-from-home desk or watch someone perform a movement that’s causing them pain. From there, physical therapists can offer guidance on adjustments, exercises, stretches and other remedies patients can implement themselves.
“Physical therapy is not just that passive approach of manual therapy to restore joint, soft tissue and nerve mobility and function,” said Boulder-based physical therapist Audrey Waldron. “It’s also education and helping people take care of themselves. We’re still helping people take care of their bodies, especially with workplace ergonomics or those repetitive overuse injuries.”
Above all else, physical therapists are trying to help ease the burden on the medical system as a whole.
In most instances, you don’t need a referral from your physician to see a physical therapist, and nearly all insurers are now covering physical therapy telehealth appointments. So, bottom line, if you threw out your back while shoveling snow or tweaked your knee playing football in the backyard, consider calling a physical therapist before heading to urgent care.
“We can triage and see if it’s truly emergent,” MacDonald said. “If we feel they need to go (to the emergency department), we’ll still tell them they should go.”
As for visiting your chiropractor right now, you’re basically out of luck. They’re not able to offer regular in-person services like adjustments or massage, unless it’s an emergency. Chiropractors are also doing telehealth appointments to answer questions and walk patients through stretches and exercises.
Unfortunately, lots of people have back and neck pain right now because they’re operating outside of their normal routine. Many people are spending more time on the couch watching TV than normal or, on the other end of the spectrum, they’re tackling more intense physical tasks with their extra time at home.
As with anything, moderation is key.
“People are sitting more, so for those patients it’s a lot more of, ‘Let’s get up and move every 45 minutes,’” Denver chiropractor Graham Reinhardt said. “For other people, if you feel like your back is getting pretty tight, you have to listen to that — ice it, rest it. These projects you’ve been putting off, they’re not going to get done in a weekend. Go slow and easy with it.”
Massage therapy studios also have been forced to close (along with nail and hair salons and tattoo shops). But so far, that isn’t stopping Camino Massage Therapy in Colorado Springs from helping people get the care they need.
The studio is offering virtual massage classes that people can take from the comfort of their own homes, said Erin Poovey, massage therapist and owner of Camino Massage Therapy.
The hour-long classes, held every Thursday evening for $10, teach people how to use massage balls (or household items like tennis balls or a hand towel) and how to do cupping, which uses suction to improve blood flow and reduce tension.
Poovey isn’t trying to put herself out of business by teaching people how to massage themselves. Rather, she hopes to provide clients with skills they can use in between their regular appointments with her. When the novel coronavirus struck, the classes became even more relevant.
“A lot of times, we just don’t realize that we can actually work part of our body that a therapist is working, if we have the right tools and just slow down,” she said.
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