Why Physical Therapy Is Better Than Surgery

Why Physical Therapy Is Better Than Surgery

For those suffering from physical limitations or recurring pain, the treatment choices available can be overwhelming. Expert opinions tend to vary depending on the expert one is speaking to at the moment, and even casual acquaintances can be full of earnest, if contradicting and confusing, advice. When the choice comes down to physiotherapy or surgery, however, it can be reassuring to look at the evidence.

The Evolution of Physical Therapy

In the medical field, there is an understandable tendency to concentrate on the physical body to the exclusion of other factors. For example, focusing more on repairing nerve or muscle tissue and less on the actual use of the muscle and its functioning in daily life. Physical therapy has evolved in the recent decades beyond merely focusing on physical mechanics to instead concentrate on the factors that directly influence the quality of life and social engagement. The ultimate goal of therapy treatments is now taken to be maximum participation and the fullest life experiences possible.

Physical therapy can be a better option than surgery for many due to the fact that it not only addresses the purely mechanical bodily limitations, but it also improves the individual’s skills and strength. This translates to better integration into daily life activities and therefore better quality of life. All therapy is designed and implemented with the aim of full participation in the family, social, work and community life.

A Scientific Review of Physical Therapy Outcomes

A review of the physiotherapy intervention outcomes of patients with spinal cord injuries (SCI) leads the reviewers to some enlightening conclusions. In an article published in the Journal of Spinal Cord Medicine, the authors examined the existing studies on physiotherapy outcomes in spinal cord patients. It specifically focused on community participation and social integration, important indicators of quality of life. The social aspect of a full and healthy life referred to in the title of the article as participation, includes an individual’s roles in their family, the community, and larger society and is an important rehabilitation benchmark.

The authors searched six major medical databases using specific keywords, looking for studies that conformed to specific criteria. The search terms were tailored for the individual databases and the search results were analyzed for the methodological quality of the studies using the Physiotherapy Evidence Database scale. Five studies were identified as meeting the inclusion criteria. Among the studies the mean age of participants was 43.8 years and 70.6% were men.

Physical Therapy Shown to Improve Participation Outcomes

Results from the five studies reviewed revealed a correlation between physical therapy and improved social participation. Statistically significant results were found that indicated that exercise programs and body weight assisted treadmill training positively affected the participant’s quality of life and their perceived social integration. The majority of the studies attributed the improved social participation and quality of life to a decrease in pain.

As the selection of physical therapy modalities and determining a course of treatment becomes more and more reliant upon published research, the authors call for more peer-reviewed studies to be done specifically focusing on participation outcomes. Particularly given the encouraging outcomes of the five studies analyzed, the researchers would like to see more studies done to determine which physiotherapy interventions lead to the best participation outcomes.

Physical Therapy Essential to Full Recovery

While many choose to forgo surgery altogether in favor of therapeutic intervention, a combination of the two approaches is also possible. Even under circumstances where surgery is medically necessary and unavoidable, physiotherapy is a crucial part of the recovery process. If full integration into social, employment, and family life are taken as the ultimate benchmark for successful outcomes, as they should be, then physical therapy has an essential role to play in any recovery from injury. Herein lies the true value of physical therapy: its ability to integrate an injured person back into the full experience and enjoyment of life.

NYDN Rehab Clinic Provides Answers

The New York Dynamic Neuromuscular Rehabilitation & Physical Therapy Clinic is committed to providing individualized evaluations, advanced diagnostic tools, and cutting edge treatments. Offering a variety of physical therapy modalities, care is taken to create a personalized treatment plan tailored to the unique circumstances of every patient. Included among the many treatments and diagnostic tools that we offer is running and gait analysis. Using the latest technological advancements, the patient’s gait is measured and analyzed using multiple cameras and a motion capture system. A walkway or treadmill collects data which is then analyzed. A summary report with video clips of the client’s gait cycles is then produced. Those suffering from physical limitations or hip, knee, ankle or foot pain need look no further for answers as Dr. Lev Kalika locates the precise source of the problem, thereby leading to its solution.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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