From reading stuff here I think there are wildly different forms of PT people are getting. I agree on finding a sports-centric or at least sports-aware practice.
For me “PT or at home exercises” is not an either/or: what I get from the PT is an assessment of strength and range of motion and a discussion of the result I want, and then some targeted exercises and stretches to work on same. The real improvement comes from doing the exercises regularly. Usually what happens when I need PT is that I go a few times at 2x/week or so to get a routine built up, maybe once or twice more at 1-2 week intervals to make sure it’s still working, and then maybe one more followup a while later to talk about long-term care strategies.
At least for me, PT mostly isn’t about fixing me (although sometimes in the first couple of visits are pretty transformative if I have an acute probem), it’s about giving me tools for my own long-term care. I’m still doing targeted exercises and stretches I got from PT years ago when I feel twinges in various places. My experience is not really far from what I think people get from a good personal trainer.
PT unfortunately is hit or miss for me…in the old days they actually put hands on and did some deep tissue stuff. The last time I went I felt like I was at the gym with a bunch of other people. So I quit it and went to my Chiro who puts hands on and gives me exercises to do at home. She did for me in 3 months what no PT and meds did in a whole year. I now have ways to help myself by following her regime and occasionally go in for an adjustment.
I’ve done PT multiple times, both for surgery and chronic issues, and they’ve always involved at-home exercises that build upon what happens during the appointment.
Most recently it’s been for back issues and shoulder pain (unrelated).
If you need PT for “core strength” I highly recommend looking for a PT that has a Pilates certification, and bonus if they have access to a Reformer. I was able to find this and it was amazing. I had weekly sessions on the Reformer and had at-home exercises as well.
While most of the standard PT core strength exercises run parallel with Pilates, I’ve found that those who are familiar with Pilates pay extra attention to the little things that make a huge difference. I’m fortunate in that I transitioned to a weekly Pilates class taught by a former PT.
With my shoulder it wasn’t an acute injury, it was just a build up that finally got to the point where the pain was impacting my daily life. I got a recommendation for someone who specializes in shoulders. It was essentially me not using my shoulder/arm correctly which led to overcompensation in some muscles and weakness in the correct ones, as well as some minor impingement in my shoulder blade movement.
The PT did manipulation/massage for the impingement and then went through a strengthening program with me. I got at-home exercises that increased in reps/movement as I progressed. Because of my home exercise compliance and increased strength/range of motion, I was able to spend more of my appointment on the manipulation/massage side rather than the appointment being him watching me run through the exercises I already knew and was supposed to be doing at home.
He was also able to help me with some basic ergonomics such as how to properly use my arm/shoulder muscles to pick things up and how to scoop poop properly! LOL
Lots of PTs still do this, so maybe you need to find someone else. But of course it depends on the issue. For many people, a deep tissue massage might feel great, but what they really need is core strength, plain and simple. And all the deep tissue massage in the world doesn’t fix that.
My PT does a lot of deep tissue/pressure point releases, fascia stretches, cupping and electric stim. He made me do exercises with him at first, and now he expects they are being done at home and my follow up is tracking my progress based on my feedback, plus massage/manipulation, cupping and electric stim. I only go once every 2-3 weeks now but I am expected to stretch and do strength 3-5 x a week.
