The Importance of Hands-On Work During Evaluations

One common challenge for new physical therapy graduates is incorporating hands-on treatment during the initial evaluation. There are plenty of reasons for this hesitation: feeling uncomfortable touching or massaging someone you just met, running out of time during the evaluation, spending too much time on objective tests, or focusing heavily on patient education. While these are all important aspects of the evaluation process, skipping hands-on treatment during the first visit can be a missed opportunity.

Hands-on work offers several benefits that can set you up for success and enhance the patient’s experience. Here’s why it’s worth making time for:

Benefits of Hands-On Treatment on Day One

1. Short-Term Symptom Relief: When patients feel immediate relief, even if it’s temporary, they’re more likely to trust your care plan and return for follow-up appointments.
2. Additional Data Points: While the objective phase provides valuable insights, hands-on work can reveal more about the patient’s condition. You gain a better understanding of what’s causing their symptoms and how to tailor treatment.
3. Baseline for Future Sessions: If you don’t try hands-on treatment, you miss the chance to see how their symptoms respond. This delays vital information that could shape your treatment strategy.
4. Builds Rapport: Hands-on work fosters a sense of connection and trust, laying the foundation for a strong professional relationship.
5. Enhanced Patient Education: Demonstrating and explaining findings during hands-on work, such as joint restrictions or tissue tightness, helps patients understand their condition better. For example, showing them a joint’s hypomobility can clarify why they’re experiencing pain.

What “Hands-On Work” Means

When we talk about hands-on work, we’re referring to manual techniques that address the patient’s symptoms and condition. This can include:

• Soft Tissue Massage: Deep or sports massage targeting areas of tension or pain.
• Joint Mobilizations: Gentle movements to restore joint mobility.
• Passive Range of Motion: Helping patients move their joints through their full range without active effort.
• Joint Manipulations: High-velocity, low-amplitude techniques for immediate symptom relief (when appropriate).

Overcoming Common Barriers

If you’re struggling to incorporate hands-on work, here are some tips to address common challenges:

• Time Constraints: Prioritize hands-on techniques by streamlining your objective testing. Focus on the most relevant tests instead of trying to assess everything.
• Comfort Level: Practice hands-on techniques with colleagues or mentors to build confidence and familiarity.
• Balancing Education and Treatment: Integrate education into your hands-on work. Use the time to explain what you’re doing and why it’s important.

Why It Matters

As a certified manual therapist, I’ve seen firsthand how hands-on work leads to quicker and more effective results. While it’s just one component of comprehensive care, it can make a significant difference in both patient outcomes and their trust in you as a clinician.

The Takeaway

Hands-on work during the first visit isn’t just about symptom relief—it’s about gathering insights, building trust, and setting the stage for successful treatment. By incorporating manual techniques early, you create a positive and impactful experience that encourages patients to stay engaged in their care. Make it a priority, and you’ll see the benefits for both your patients and your practice.