By Janet Wolfson, PT, CLWT, CWS, CLT-LANA
A story was related to me from someone living in a rural part of the US. A family member was in need of ongoing wound care. They were referred to a specialist who was of all things… a physical therapist! This is a response with which I am quite familiar. I have been referred to by a number of "titles" including Wound Coordinator, Wound Specialist, 'Skin Lady', and Wound Nurse, to name a few. If you scan my byline, I do have a good alphabet soup following my name, but to many, "PT" is a surprise.
Physical Therapy and Wound Education
Such is the state of the diversity of patients needing wound care these days and the multitude of providers who have stepped up to the plate to see that they get it. Research has delineated the causes of chronic wounds and they are scattered from diabetes or arterial insufficiency to trauma or post-surgical complications to name a few. It would seem that it can take the entire medical complex to heal a wound. Or just the right diagnosis and the right provider.
As a PT graduating in the 80s, I proudly claim my BS in PT. The whirlpool treatments I provided to numerous clients ignited the passion for wound care decades ago. Thankfully, research has brought us further than dunking wounds in water and wrapping them in gauze. So too have the educational requirements expanded to provide wound care in the 21st century. A survey of the curriculum offered in today's PT programs show the integumentary, immune and cardiovascular systems to be included in coursework, as well as the traditional musculoskeletal and therapeutic exercise courses. This culminates in a doctoral entry level PT. Depending on the clinical experience of the student, wound care specialist may or may not be a claim they can make. Continuing education seminars are abounding for PTs, offering content in wound assessment, debridement, treatment modalities, edema management, etc. These courses have been bridging the gap between classroom and wound specialization.
Giving Wounds a Jump-Start
So what can physical therapists offer that other wound specialists do not? As with the whirlpools, we offer modalities (therapeutic machine-assisted treatments) that can jump-start the healing process, debride wounds, increase circulation, decrease edema, and decrease bacterial burden. Our historical role in the assessment and treatment of neurological, orthopedic, oncologic, metabolic, geriatric, and surgical-based disease processes offers insight and treatment options that can enhance the care provided by doctors, podiatrists, nurses and other specialists.
Mobility/balance assessment and training, therapeutic exercise to improve muscle pumping and to lengthen tendons, soft tissue work to break up adhesions, scar tissue or fibrosis, manual lymphatic drainage, and decongestive exercise are a few of the areas to which we lay claim. We can also offer serial debridement via scalpel, ultrasound, curette or biologics.
In the future, look for this blog to explore physical therapy offerings for wounds due to venous disease, diabetes, neurological deficits, paralysis, gait abnormalities, arterial insufficiency, pressure, lymphedema and trauma.
About the Author
Janet Wolfson is a wound care and lymphedema educator with ILWTI, and Lymphedema and Wound Care Coordinator at Health South of Ocala with over 30 years of field experience.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.