If you have been receiving physical therapy for a foot or ankle problem, you may wonder what a podiatrist can add to your care—especially if you were told that your condition was primarily a musculoskeletal problem that should be treated with therapy.
The answer is simple: a comprehensive podiatrist evaluates, diagnoses, and treats musculoskeletal conditions of the foot and ankle, including conditions that can be managed without surgery.
Physical therapy is an important part of foot and ankle care. But physical therapy is a treatment modality, not a diagnosis. A comprehensive podiatric evaluation can determine whether physical therapy is appropriate, whether another treatment should be added, or whether the original diagnosis needs to be reconsidered.
Dr. Hoy provides individualized foot and ankle rehabilitation based on the diagnosis, stage of the condition, and functional goals. Learn more about Foot & Ankle Rehabilitation.
Your visit starts with a diagnosis
When you see a comprehensive podiatrist, the goal is not simply to continue whatever treatment you have already been receiving.
The podiatrist will want to understand:
- Where your symptoms are located
- How and when they began
- What activities make them better or worse
- Whether there was an injury
- How long the problem has been present
- What treatment you have already tried
- Whether you have improved, remained the same, or become worse
- Whether imaging or other diagnostic testing is necessary
The foot and ankle contain numerous bones, joints, tendons, ligaments, nerves, and soft tissues that can produce similar symptoms. Pain with walking does not, by itself, establish a diagnosis.
Your evaluation may therefore lead to a different or more specific diagnosis than the one you started with.
Physical therapy may still be part of the treatment plan
Seeing a podiatrist does not mean that you need to stop physical therapy.
Physical therapy can be valuable for:
- Strengthening
- Flexibility
- Balance and proprioception
- Gait retraining
- Functional rehabilitation
- Return to activity
- Post-injury rehabilitation
- Postoperative rehabilitation
If physical therapy is appropriate for your condition, your podiatrist may recommend continuing it or may communicate specific goals or findings to your therapist.
But physical therapy is one treatment option among many.
Depending on your diagnosis, treatment may also include activity modification, footwear changes, orthoses, bracing, immobilization, medication, injections when appropriate, extracorporeal shock-wave therapy, or surgery.
What if physical therapy has not helped?
Failure to improve with physical therapy does not necessarily mean that you simply need more therapy.
It may mean that:
- The original diagnosis needs to be reconsidered
- Another condition is contributing to your symptoms
- The tissue needs additional protection or immobilization
- Your footwear or biomechanics need to be addressed
- Imaging is needed
- Another conservative treatment is appropriate
- A surgical condition needs to be considered
A comprehensive podiatric evaluation helps determine what comes next.
Is conservative foot and ankle treatment only physical therapy?
Many patients have been taught to think of treatment as a choice between “physical therapy” and “surgery.”
Foot and ankle medicine is much broader than that.
A podiatrist may manage a condition conservatively for weeks or months before surgery is ever considered. In fact, appropriate conservative treatment is often an important part of determining whether surgery is necessary.
The fact that a condition does not require surgery does not mean that it stops being a podiatric condition.
What if you were told you should see a podiatrist only if surgery is necessary?
That is not how comprehensive podiatric care works.
Podiatric physicians are trained to evaluate and manage foot and ankle disorders using both nonsurgical and surgical approaches. The appropriate treatment depends on the diagnosis and the individual patient—not simply on whether surgery is currently being considered.
You do not have to wait until conservative treatment has failed before seeing a podiatrist.
How do podiatrists and physical therapists coordinate care?
A comprehensive podiatrist and physical therapist can work together effectively.
The podiatrist provides medical evaluation and diagnosis and determines the overall treatment plan. The physical therapist provides specialized rehabilitation when that is appropriate.
These roles are complementary.
If you are already in physical therapy and your foot or ankle problem has not improved, a comprehensive podiatric evaluation can help answer an important question:
Are we treating the right problem, and is this the right treatment plan for me?
At Seattle Foot and Ankle Center, Dr. Hoy begins with the diagnosis and then determine what treatment is appropriate. Physical therapy may be part of that treatment—but it is not automatically the answer to every nonsurgical musculoskeletal foot and ankle problem.
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