Updated: May 10
It seems as though recently, I have had this same conversation with many of my patients, maybe 10 times in the past 2-3 weeks. So I thought... here is a topic that could use more public education and guidance, perhaps now is a good time to break my 2-year blog writing drought. The hot topic of conversation has been this: So I have an acute injury. Maybe I "pulled out my back", sprained an ankle, had a bad fall, or strained my shoulder. What do I do? Go to the ER, head over to Ortho Urgent Care, or go straight to my trusted Physical Therapist?
When to visit the Emergency Room
The ER is good in special circumstances, such as right after a severe motor vehicle accident where you also suspect you may have a head injury, after a new and severe work-related injury with an additional head injury or multiple areas of injury, or if you have any severe new nerve symptoms, such as widespread numbness and weakness throughout an arm or leg. Another time to visit the ER may be after a severe fall with several suspected injuries. You may also consider going to the ER after an injury if you have other additional medical conditions that you fear may be exacerbated by your injury, such as heart disease, history of stroke, or hypertension. These situations are rare in the grand scheme of pain and injury, but these are good times to go to the ER.
When to visit your Ortho Urgent Care
So when do you skip the 6-hour wait at the ER holding area and go to Ortho Urgent Care? Perhaps you had a bad twist or sprain to your ankle, shoulder, or knee and fear you may have also fractured (broken) a bone or tore some ligaments or tendons. You would like an x-ray to rule-out a fracture. You think you might benefit from additional bracing or casting. This is a great time to skip the ER and go to Ortho Urgent care. Every Ortho Urgent Care in the Capital region is equipped provide medical imaging, deal with potential fractures, and to provide any necessary casting or bracing as needed. Your Ortho MD or PA can also schedule follow-ups, recommend additional care such as Physical Therapy, and/or prescribe pain medication.
When to See your Physical Therapist
Now, when do you skip the ER, skip the Ortho Urgent Care, and limp, wheel, or crawl your way into Physical Therapy? This is one of my favorite parts of therapy, and most therapists I know (and certainly the ones I work with at The Green Room PT) love nothing more than taking a patient in acute pain and sending them out of the clinic after 45 to 60 minutes feeling significantly improved and encouraged about their situation. And with NYS Direct Access Laws, the vast majority of patients can sustain an acute injury, call their local PT clinic, and send themselves right in for PT evaluation without a prescription from an MD. Most insurance companies in NY observe these Direct Access laws. With a Doctorate-level education, your PT can perform a series of Special orthopedic tests, range of motion and strength assessments, and manual evaluation to determine your likely cause of pain and injury and an appropriate treatment plan, minimizing any need for unnecessary medical imaging or medication. And with one-on-one visits that on average last much longer than a visit with your local Ortho MD, you will have a chance to tell your whole story and have no stone left unturned. A good PT will love the opportunity to evaluate a brand-new injury and provide patient education, administer pain-alleviating modalities, instruct on specific targeted exercises, and implement manual techniques to take away much of the acute pain and provide the patient with a sense of control and empowerment over their situation.
Whatever your injury, make sure that you start off on the right foot by beginning your road to recovery with the course of action that makes the most sense for your particular situation. And as always if you are unsure of what to do, contact your Primary Care Physician for more guidance.
-Dr. Ashley Bertorelli, PT, DPT/ Owner and Physical Therapist at The Green Room Physical Therapy at 16 North Greenbush Road, Suite 203, Troy, NY 12180
Clifton Park & Troy