Physical therapist Harry Koster works with a patient.

“Physical therapy” may sound like something that involves a sweaty workout but still produces some sort of soothing afterglow. In some ways, that’s not far from the truth.

And there are misconceptions about PT that can provoke a plethora of reactions, some based on ignorance, others just on a lack of firsthand experience with what physical therapists actually do.

PT, for instance, isn’t chiropractic.

Harry Koster, physical therapist, certified MDT, has seen it all in his 25 years of administering to patients. The founder and president of Spine and Rehab Specialists on El Paso’s East Side agreed his profession has its misconceptions. Or myths.

One is that PT hurts and doesn’t always work.

“We get that from (patients of) all ages sometimes,” he said. “Some of them are elderly and just don’t know (because they’ve never had PT before). Some are coming in just after having surgery.”

Consequently, a PT has to be a bit of a psychologist and work at gaining the confidence of patients. Talking – as often as necessary – with patients before treatment pays dividends. Patience with patients, so to speak.

Another potential snag is when a patient thinks physical therapy means just getting a massage. The latter can be a form of PT, Koster agreed, but it’s not just that alone.

“What we do is more based on exercises,” added Koster, who noted that “exercises” can take many forms, such as stretching, strengthening, stabilizing, balance training, coordination – so there are definite actions patients must perform. You’re not just a passive participant.

In the PT world, stretching can involve virtually all body parts; strengthening can include free weights, elastic bands and sports cords; stabilization refers mostly to the spine; and balance training usually applies to the elderly, but not always.

And coordination goes hand-in-hand with balance training but also can involve basic hand-eye exercises.

Stretching? Yes, it’s a form of exercise. Think of a frozen shoulder – perhaps due to rotator cuff trauma – that needs to be loosened up without surgery.

Balance training? It can be complicated and can be used to overcome inner ear or vision problems, among other things. It’s not uncommon to see patients in PT centers working on balance problems by walking backward on treadmills, for instance.

Koster’s office buzzes with soldiers getting PT, many of them back from Middle Eastern battlefields. He said some are being treated for the effects of head concussion-type injuries resulting from bomb blasts. Picture getting thrown around in your vehicle by a road bomb blast.

He pointed out that all of these, just like concussions sustained on a football field, are traumatic brain injuries.

PT Trey Hancock, owner of Alta Vista Physical Therapy on the West Side, thinks the relationship between physical therapist and patient has changed because the former no longer is viewed as “the boss.”

“I give the patient the ‘control,’” said Hancock, a PT of 15 years. “There’s a window of opportunity for them; it goes hand in hand with direct access.”

Another change in the physical therapy world is the field’s growing popularity. It’s tough to even get into a university’s PT program, but applications continue to grow. And it’s a lucrative profession.

apply for armed with any old undergraduate degree – the prerequisite academic requirements are difficult (one must have the required science and medical courses completed) and one needs a high enough GPA. You must be prepared for three years of post-graduate study.

Koster and Hancock agree that toughened-up Texas state law requiring patients to be referred by physicians is a good thing. No matter how achy you might be, one cannot come in off the street and just sign up for physical therapy treatments.

“If you want PT, you’ll need a prescription from your doctor,” Koster said. “That’s the law.”

“The schools have improved the ways they make evaluations (of potential PT’s),” Hancock added.

Like any physician, physical therapists are battling insurance companies, red tape, paperwork and other assorted impedimenta. Hancock has seen a tightening in the number of visits some insurance companies will allow patients to have.

And Koster thinks exercise – there’s that word again – has been proven to work through research-based evidence.

“Twenty to 30 years ago in El Paso, physical therapy was mostly things like ice packs, ultrasound and massage,” he noted. The field has become much more scientific.

Koster advises patients to go to a PT who truly works with them personally, one on one.

“Physical therapy has gained greater visibility,” Hancock said. “I derive a lot of satisfaction from seeing definite progress in a patient and feeling I’ve helped someone.”