What do I do if I feel like physical therapy isn’t working?

Make sure your therapist is aware of how you are feeling about your progress in therapy. It is common to experience occasional “flares” and “setbacks” when managing hip dysplasia conservatively or post-operatively.  This is completely normal!  However, it is very important to make sure to openly share your symptoms with your therapist to make sure that you are progressing properly.

Sometimes an increase in symptoms can be due to the body trying to learn new ways of moving. Sometimes an increase in symptoms means that muscles are not firing in the correct pattern or that there is some weakness or decreased motion in your chain that is causing improper compensations.  In these cases, it might be that you still need more time to focus on basic muscle activation and postural/movement re-training before advancing to higher level activities.  Sometimes your body is still healing and needing more time to recover from a bone or soft-tissue healing perspective.  In these cases, time and patience may be the greatest variables.  Usually reassessing your overall therapy plan of care in these situations and some problem-solving between you and your PT is enough to get past the “flare” or “set-back” and then you will be able to progress again.

Occasionally an increase in symptoms can mean a bigger problem, so it is especially important for you and your PT to be communicating openly and that you communicate with your surgeon to determine if additional medical work-up is necessary before continuing to progress your PT program.

If you have worked through all of these situations and still feel like you are not making the progress in therapy that you are hoping for, it might be appropriate to consider a second PT opinion. All physical therapists, just like surgeons, assess problems through different lenses based on their training, mentors, previous experiences, and clinical biases.  This doesn’t make any one PT less “good” of a PT than another, but sometimes patients need a different “lens” on their case if progress has really stalled.  Even if it feels uncomfortable, it might be worth having the conversation with your PT about getting a second opinion.  A good PT might even recommend getting a second opinion from a PT with a different skill-set and may be able to help facilitate this.  If you do end up seeking a second opinion and perhaps even establishing care with another PT, transparency with your providers will help make sure that you all know what your overall rehab program looks like so that you can determine what is working and what is not working.