RA & Physical Therapy: The Importance Of Finding The Right Therapist

Vanessa Collins Health Guide
  • Physical Therapy can be a wonderful tool in our battle to stay mobile, maintain range of motion, and lessen pain. I have had therapy for my shoulders, my knees, my ankles and my back in recent years.


    A good therapist familiar with RA is a blessing, but sometimes therapists can push us a little too hard. If they ever do that to you, call them and tell them you are in pain. In my experience, they will have you come back in and use passive therapy treatments such as the TENs unit and ice packs or heat to soothe your aching joints and muscles.


    As my RA has progressed over the years, I have come to realize the importance of working with a therapist who is familiar with RA. A cookie-cutter approach cannot be used with RA patients. Unfortunately, some therapists do not appear to know this.

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    If you are ever referred for physical therapy, you might want to “interview” your therapist before you start your therapy program. I ask questions, such as, “Have you treated RA patients previously?” I ask them what their approach is to patients with RA and what specific therapies are available for RA patients. If I am not comfortable with their knowledge of RA, I ask them exactly what they have in mind for me.


    I also ask them what criteria they use to determine whether active or passive physical therapy is appropriate. I find this to be an especially important question. I have had horrible experiences with physical therapy when the doctor checked “Evaluate & Treat” and the evaluation was not correct. The “treatment” has, on occasion, done more harm than good.


    Recently, I was sent to physical therapy because I am having trouble walking. My orthopedic doctor suggested that they use ultrasound and other passive therapies. Unfortunately, she checked the “Evaluate and Treat” box.


    The therapist I had was not good at "evaluating." He put me into a pool with a treadmill and told me to walk. Approximately ten minutes later, I was in so much pain I almost lost my cookies right there in his pristine therapy pool.


    This is exactly why it is so important for RA patients to advocate for themselves.  It is imperative that we speak up and work with our doctors and therapists for the best possible treatment for us as individuals.  Please see A Beginners Guide to RA: How to Be a Self Advocate



    If you have swollen sore joints, it is generally NOT a good idea to exercise them. For instance, if your ankles look like mine in this picture, I would not suggest walking on a treadmill, even a treadmill that is in a pool.


    Swollen Ankle


    When I am in a flare and swollen, I do gentle stretching exercises. That might not seem like much to someone who does not have RA, but I can tell you from experience that stretching does help ease the stiffness that is part of our daily lives.


    Another passive therapy that helps me feel better is the use ice packs for swollen joints, and the use of heat for joints that are aching but not swollen. I abide by this simple rule: If ice eases the pain, I use ice. If heat eases the pain, I use heat. You will quickly learn which one your body prefers.


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    Massage can also ease the pain of muscle spasms and just make you feel more flexible and relaxed. When I schedule a massage, I always inform the therapist that I have RA, and that the massage needs to be a gentle one.

    Wherever you are in your journey with RA, you will most likely be referred for physical therapy at sometime in the future. If you advocate for yourself, and have clear, open communication with your therapist, you will probably find therapy quite helpful. Do you have any stories about physical therapy you would like to share?  

Published On: August 27, 2012