Baylor College of Medicine

Expert says think twice before skipping physical therapy

Dipali Pathak


Houston, TX -
Media Component
Melanie McNeal, certified physical therapist and orthopedic clinical specialist with Baylor College of Medicine

When you hear the term ‘doctor’s orders’ you know that they mean business. So why is it that when the doctor orders physical therapy for pain or an injury, many people skip out? A physical therapist at Baylor College of Medicine says that doing so could make your injury worse.

Melanie McNeal, a certified physical therapist and orthopedic clinical specialist with Baylor, said that the role of a physical therapist is to educate a patient on their injury, the anatomy of the muscles and joints involved and how the injury can impact their body. Physical therapists assess the injury and develop a treatment plan that includes manual therapy as well as a variety of exercises to improve strength, flexibility, range of motion, posture and balance. During manual therapy, the physical therapist may stretch or manipulate a patient’s soft tissue to help with recovery and pain relief.

“My goal as a physical therapist is for the patient to meet their goals,” McNeal said. “Whether it is going back to playing a certain sport, doing a certain activity, returning to work or just driving without pain.”

After a patient is referred to McNeal from their primary care doctor or a specialist, she asks patients what their goal is during the first appointment. She assesses their range of motion, joint movement and strength in the area of the injury, comparing it to the opposite side of the body. She will then lay out a treatment plan.

“I can nail down what specific exercises and what muscles need to be stretched or strengthened,” she said.

She can then work with patients to help meet specific criteria depending on the type of injury. Each patient is different, but there are certain return-to-play criteria that need to be met before she recommends they go back to their activity.


In terms of muscle strains, McNeal said there are three grades:

  • Grade one strains are small injuries in the muscle where nothing is torn, but the fibers are disrupted. Return-to-play usually takes place after a couple of weeks of therapy.
  • Grade two strains occur when some of the muscle tears, but the entire muscle is not torn. This usually requires anywhere from four to eight weeks of therapy.
  • Grade three strains are when there is a complete tear in the muscle, which could require months of therapy or even surgery.

She noted that any injury that is not treated has the potential to get worse, so it is better to see a physical therapist right after the injury occurs. If patients come in as soon as the injury occurs, a physical therapist also can educate the patient in proper mechanics or movements and safe activities to help avoid injury or pain in the future.

“When patients wait to see a physical therapist for an injury, their muscles are weaker, so what would have taken two or three visits if they initially came in when they were injured will now take six weeks,” McNeal said.

Some issues only require one session with a physical therapist, who will then give instructions on exercises to do at home to return to regular activity.

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