For Recovery, Physical Therapy Over R&R. Duh.

When it comes to minor injuries—the kind that hurt but don’t require a blood-curdling scream, some sort of snap-into-place move, or paramedics—a doctor’s first line of defense is something called Wait and See. The main goal of this approach is to put exercise on hold until you see improvements in pain. There’s a lot of doing nothing involved, some icing, elevating, and plenty of wondering whether the Wait part of the whole thing is over.

During my first go-round with knee pain, I tried this technique. I stayed off of my knee as much as a normal human can without hiring a personal assistant. I waited and waited, and followed a printout of leg-strengthening exercises for a few weeks until I was healed. Wait and See was a success!

The third time my knee started quitting on me, I started to wonder if this whole Wait and See thing (with some self-taught physical therapy thrown in for good measure) was really worth being the go-to treatment. That’s because once Wait and See was over, a smaller, less talked-about wait and see started … wait and see if your pain will come back.

It did. Every time. So I started to wonder whether I should be doing something instead of waiting—like, you know, strengthening my muscles. Over the past six years, I’ve had fewer relapses into Knee Hell when I’m training than I ever did as a couch potato. Younger me, I’m sorry no one told you this.

Because it takes science eons to confirm simple things patients already know, Dutch researchers just confirmed that physical therapy is better for people with patella femoral pain syndrome than Wait and See. Go figure.

The study, published online yesterday in the British Medical Journal, enrolled 131 participants in either a six-week supervised physical therapy program or a Wait and See plan of the same length. (No joke: they really called it “wait and see.”) Both groups got the same handout on their condition and a sheet of at-home exercises. After three months, the exercise group reported less pain and better function than those who took it easy. And after a year of follow-up, the exercisers still reported less pain, but were about equal with wait and see-ers when it came to physical function.

Before you mumble under your breath something about those lazy people deserving another year of knee pain, remember: They were doing physical therapy. But instead of getting guidance from a physical therapist, they were following an illustrated sheet with exercises. The problem is, those take-home sheets don’t account for progression or accountability … two major keys to rebounding from an injury.

Progression
The point of physical therapy—aside from making grown men and women feel like little children learning to walk, write, and make arm circles—is to strengthen weakened muscles. For me, killer leg muscles prevent my knee from slipping inward and scraping my thigh bone in all the wrong ways. It doesn’t matter why you’re strengthening or where, chances are the goal of your physical therapy is to build muscle where you’re weak.

A six-step sheet of stick figures might take you the first leg of your journey to recovery, but it’ll never tell you when to add heavier weights, how to modify a move for better results, or whether you’re doing an exercise wrong. Human beings—you know, those living, breathing things that used to answer 1-800 calls before the world was forced to press 72 buttons for customer service—can make sure you’re doing each exercise properly, monitor your improvements, make adjustments to your therapy, and add new moves as needed.

Accountability
Aside from personalizing your treatment, physical therapists can make you stick to a treatment better than a wrinkled or ripped piece of paper. When I was in physical therapy twice a week, I felt obligated to show up. (The $50 no-show charge didn’t hurt, either.) I also felt obligated to keep exercising on my off days … because they always know when you’ve slacked off. During particularly annoying exercises—like a torturous game of pick up the cones while standing on one foot—they will cheer you on and force you to finish.

Why researchers in little lab coats take so long to publish a report on the obvious, I’ll never understand. It reminds me of a study I read the other day: High heels cause more foot pain than sneakers. But that’s another rant for another day.

So, tell me your thoughts: Does physical therapy work better for you than quality time with the TV remote?