Return to prior level of function is one of the most common goals a physical therapist will have for his/her patient. But what does prior level of function mean? Prior level of function is the condition you were in before you were injured. For some of you, this may be playing a competitive college sport, running 5 miles a day, rock climbing, or competing in triathlons. For others, this may be playing golf on the weekends, walking the dog, climbing a flight of stairs, or driving a car. Prior level of function is an umbrella term including anything that you could do before the injury that you are unable to do now, even things as simple as getting dressed, sleeping, and performing household chores. It may be something you could do a few weeks ago or something you haven’t done in years. If you haven’t skied in years because you have been living with chronic back pain, then that is considered part of your prior level of function and your physical therapist will work with you to get you back to that level of function.
My favorite part of being a physical therapist is sharing the experience of a successful rehab experience with my patients. Some of my favorite rehab experiences are post-operative rehab, specifically ACL reconstruction. When someone undergoes surgery to repair a torn ACL (ligament in the knee) they literally need to learn to walk again without the use of crutches. Often times, after an ACL injury, the surgery will not be scheduled until up to a month later.
It is important to start physical therapy during that time, for what we call pre-hab. A physical therapist can work with the patient to gain ROM and build strength prior to the operation in order to promote faster healing after the surgery. Once the surgery is performed, it is usually 6-9 months before you can return to full sport activity. The reason I enjoy working with people who have undergone an ACL reconstruction is because I get to see day one when the patient is barely walking with the use of crutches and a brace to the final day when the patient is running, jumping, and dancing around the clinic. It is a very rewarding experience to be a part of each step along the way back to prior level of function.
I worked with a patient who had torn his/her ACL this past winter. He/she came into the clinic 2 weeks after the surgery and I described what the rehab experience would be like. When I asked the patient what his/her goals were for physical therapy, he/she told me he/she wanted to get back to cage fighting. I knew this was going to be a fun rehab experience, because at the time, he/she couldn’t even go up and down stairs without a railing, crutches, and knee brace, but several months later they would be back to getting into the cage to fight. We started with simple exercises to engage the quadriceps muscle, practiced putting weight on the leg, increased range of motion, and practiced walking without the use of crutches. Weeks later the patient had full range of motion and we worked on more aggressive strengthening, normal walking, and balance exercises. After 4 months, he/she was able to start running and at 5 months we began working on agility, speed, and change of direction while running. After 6-7 months he/she was able to get back in the cage and fight again…until he/she needed surgery to fix an old shoulder injury.
No matter the type of injury you have, how long you have had it, or what your goals are, a physical therapist can work with you to help get you back to doing the things you love to do. The best part of what I do is seeing someone on their final visit for physical therapy and seeing him/her smile knowing he/she is ready to get back to doing the things he/she loves. If you have an injury that is preventing you from doing something you were once able to do, speak to a physical therapist and see what they can do to help you achieve your goal!
