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The Timing of Receiving Physical Therapy for Patellofemoral Pain Matters!
By: Jessica Deak, PT, DPT
You just received a script from your physician that says, “Diagnosis: Knee pain. Physical therapy (PT) 3x/week for 4 weeks.” What do you do next? Do you start researching local PT offices? Do you wait a few weeks and see if your knee pain gets better with time? Or do you seek out other options such as injections or medications? Unfortunately, the pathway for receiving appropriate care has not always been efficient. A recent study published by Young et al. in 2021 discussed the benefits of seeking physical therapy first, specifically for patellofemoral pain, and how timing truly matters.
Patellofemoral pain is considered pain in the front of the knee, usually around the kneecap (patella) according to the Mayo Clinic. It is sometimes called “runner’s knee,” and is usually more common in people who participate in sports that involve running and jumping. Patellofemoral pain can affect anyone, however, as it has an annual prevalence of approximately 23% in the general population.
This aforementioned study looked at 3 main groups: 1) individuals who went to PT first for an evaluation of their knee pain, 2) individuals who went to a physician to receive a diagnosis, but went to PT 1-30 days after receiving a script, which was considered “early PT,” and 3) individuals who went to a physician to receive a script, but went to PT 31-90 days after receiving a script, which was considered “late PT.”
Many key findings were established from this study. The researchers found that those in the PT first group needed less treatment visits overall, followed by early PT and then late PT. Knee-related care visits were less in the PT first group at two years follow-up. The PT first group also had lower odds of needing radiographs, MRI/CT scan, prescription medications or injections. Thus, seeking PT first resulted in the lowest total future healthcare costs. Going to PT first had better outcomes than early and late PT, but unfortunately, initial contact with a physical therapist as the first provider was less common than receiving a physician referral according to this study.
This is important, as many people do not know that you can see a physical therapist first without needing to see a physician. The law changed in 2003 to allow you to have Direct Access to see a Physical Therapist without a referral. Some insurance plans might require it, but at db Ortho PT, we will find that out when verifying your benefits.
In closing, by initiating physical therapy early on, this can decrease the likelihood of acute patellofemoral pain developing into a chronic issue and will reduce overall healthcare costs. At db Ortho PT, we can guide you towards the path of receiving skilled, thorough care to help speed up your recovery process. We hope that by reading this article, you will not have to think about what to do next when you are experiencing any kind of pain, and you will choose PT first!
Dr. Jessica Deak is a Doctor of Physical Therapy at db Ortho PT of Manalapan, LLC, located at 100 Craig Rd., Suite 108.
Dr. Deak can be reached at 732-462-2162 or via e-mail at jdeak@dborthopt.com. You can also find out more about our practice at dborthopt.com
