Spring is a heavy season for physical therapists. Walk into any physical therapy facility at any time of day, and you'll see evidence of it.
In the morning there's the retiree getting friction massage on his tennis arm for the tendinitis that flared up after a recent match. In the afternoon, you'll see the high school lacrosse player soaking his sprained ankle in an ice bath. Late in the day, the sedentary office worker will arrive for heat treatments after wrenching her back turning over the garden on the first sunny weekend of the season.
Even baby boomers, who grew up in the Kennedy years when lifelong physical fitness was touted as a national goal, are now making demands on physical therapists.
Warm weather brings out the weekend warrior, and all that activity leads inevitably to injury. But health professionals are quick to point out that injuries during outdoor activity only aggravate an already swelling demand for physical therapy. Everyone, it seems, from chronic neck pain sufferers to accident victims to recovering cancer patients is discovering that life can be improved with a few weeks or months of physical therapy.
Whirlpools, swimming pools, hot packs, cold packs, electrical stimulation, ultrasound, traction, hands-on therapy, and rooms full of exercise equipment that would make a health club pale in comparison are among the treatments therapists -- both private and hospital-affiliated -- make use of.
Therapists agree that a combination of factors are involved in the rather recent increase in demand for physical therapy. They note an aging population, improved medical and surgical techniques that allow us to survive devastating illness, an overall shift from in-patient to out-patient hospital care, a preoccupation with physical fitness that can lead to injury, and some all-American impatience.
Indeed, in our fast-paced society, people are no longer willing to wait for nature to take its course, says Neil McDonald, director of the Sports Medicine Center at Union Memorial Hospital.
"It was not unusual years ago to have a knee or hip replacement and hear the doctor say, 'Go home and walk a little and wait for it to heal.' But nowadays people aren't comfortable with taking months to recover," he says.
"We want fast food and instant results, and that's true in our health care, too."
In addition, Mr. McDonald notes, medical advancements in the last decade have shifted the emphasis in treatment from in-patient to out-patient care.
"Look at knee surgery to repair a torn cartilage," he notes. "It used to be done on an in-patient basis under general anesthesia with two or three days in the hospital. Now it's done as an out-patient, with local anesthesia and you go home right away."
The first health professional such a patient sees after his release is often a physical therapist to help speed his recovery, says Mr. McDonald. Union Memorial recorded more than 25,000 out-patient visits to its physical therapy centers last year, including its hand, spine, sports medicine and general out-patient facilities.
The fact that the population in general isn't getting any younger only exacerbates the need. The older people are, the more bones they break, the more illnesses they suffer and the more need they have for post-surgery assistance.
And those baby boomers, with their emphasis on physical fitness, are more frequently subject to injury.
"That's a segment of the population that was educated that fitness is important, and exercise has become an important component of their lives," Mr. McDonald notes. "They want to stay active, but they're older now and not quite as flexible. They're starting to suffer from overuse."
In fact, "people who work out on weekends only are our biggest customers" says Mr. McDonald, a licensed physical therapist and certified athletic trainer.
The American Physical Therapy Association says about 350,000 people are treated daily by physical therapists. It estimates that while there are about 75,000 physical therapists practicing in the United States, the need for therapists is growing so rapidly that a shortage is expected to continue well into the next century.
"Traditionally, you think of a physical therapist in a hospital setting," says APTA spokeswoman Alexis Waters. "But today they are practicing in a large variety of places, including nursing homes, industry and public schools. In fact, the trend is toward private practice."
She notes that while therapists used to concentrate on treating spinal and neurological problems, today their services are being demanded for a variety of reasons that reflect the times. A typical patient today could have carpal tunnel syndrome (an industry-related condition involving repetitive hand movement), or need to regain her strength after breast cancer surgery or a joint replacement, or be recovering from a sports injury.