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Writing Your Story in Rehab: Chapter 4: Evolution of Physical Therapy


By Alexander Germanis

Storytelling has a very long history. It could be said it has evolved over thousands of years — from cave paintings and oral traditions to mass-market printing and digital publishing.

Medical science has evolved right along with storytelling. Like storytelling, it has grown from a limited understanding shared within small circles to an intricate comprehension disseminated on a global scale.

However, while medicine itself has developed and matured over a long time, physical therapy is a relatively new medical science, finding its origins in the early 1800s.

Director of Therapy Bryan Jasker, PT, DPT at McLean County Orthopedics (MCO) Therapy Department indicates how physical therapy has gone from a relatively lengthy infancy to a growing maturity in a very short time. This is particularly true when it comes to returning athletes to play their respective sports after injury.

“Historically, no one really had a good grasp on how to decide when an athlete was ready to return to competitive play,” Bryan says. “Recent literature reports that less than 20 percent of athletes receive the full battery of testing and clearance prior to a return to competitive participation in sports.”

Bryan describes those tests in more depth in previous articles.

“But,” he reminds, “these tests are still gross assessments. We then go from simple, basic movement patterns to more complex to tease out where a problem is; it could be a problem in a joint, in soft tissue, or it could be a problem with how the brain is controlling that muscle. Our job is to figure out which and then to provide focused programming to minimize any of those problems.”

That evolved physical therapy program is how therapists help write an athlete’s individualized story of recovery.

One piece in that story is rate of force development, or how fast an athlete can contract a muscle and coordinate that into power, work, or capacity. Bryan breaks it down: “For example, you’re looking at the ability to go from a bent knee to a straight knee really fast in order to jump. The rate of that contraction is related to the ability to produce force and power.”

In the past, such a test was performed while the athlete was sitting down, utilizing isokinetics. Now, with 3D motion and force plate analysis, the movement patterns can be tracked as the athlete goes through all their sports-specific movement patterns, such as running, cutting, or jumping.

All of this is done while following closely the protocols and guidelines of healing. “You can find them at various orthopedic sports centers and physical therapy clinics across the United States, Europe, South America,” Bryan says. “Anywhere you have orthopedics, there are going to be some general guidelines from a rehab perspective. Tissue needs to heal. How we are optimizing that healing process while helping an athlete regain movement is fine-tuned in our Return to Play protocols through transition points and progressive loading.”

Bryan wants to point out these improvements also extend to older athletes — not just the high school, collegiate, and professional. “There are a lot of us out there that are active in our 40s, 50s, 60s, and beyond. We get aches, pains, and injuries and so we also need to know what is the best path of recovery that is sustainable and has a longer term viability.”

Even with an evolution in rehabilitation storytelling, not every problem can be planned for, Bryan says. “But you can try to create awareness and anticipation. There are a lot of ways to train an athlete as you’re refining quality and building quantity of movement as it is required within their specific sport.”

“It’s tailoring care,” Bryan concludes. “The whole rehab experience is individualized and we’re trying to create different chapters within each athlete’s personal story.”

If you missed the previous articles in this series, you may read them online at or contact Cheryl Eash at

For more information on Physical Therapy or any type of orthopedic problem or injury, contact McLean County Orthopedics, 309-663-6461
or visit them online at Their new office is located at 1111 Trinity Lane in Bloomington.