The ART of Physical Therapy by Michelle Landsverk

For everything is connected, and just like dominoes, things can stand together and they can tumble down together.

Many times, my patients have questions about what I'm feeling or treating when I work with them. Most people know that physical therapists work with problems within the body, but in my line of practice, people are often befuddled about how and why they were sent to me in the first place. I am going to tell you a little bit about how we (physical therapists) view the patient, how we see and feel their problems and how we justify the treatments that we do.

The first thing physical therapists do is realize that we are treating a whole person, not just a hip, a bladder, or a sciatic nerve, for example. We understand that the things going on inside your body - what is happening in all your organs and tissues - has influences on neighboring, regional and distant areas of your body (so please, do not be too put off if I'm intrigued by your big toe when you were referred to me for your low back pain). For everything is connected, and just like dominoes, things can stand together and they can tumble down together.

There is an ART to what physical therapists do, both literally and figuratively. Please let me explain: ART stands for Asymmetry, Range of motion, and Tissue texture change.

Asymmetry means that your right and left sides don't match. So, when I'm evaluating a woman with any number of problems, I will check to see if her shoulders rest at the same height, if her arms are the same distance away from the body when she is standing up if the hips are level, and/or if the feet are both pointing straight ahead. When there is a remarkable difference between left and right, I make a note of it and see if it may be part of a larger problem.

Range of motion refers to how much your joints move. When I evaluate someone with knee pain for example, I will measure how much her knee moves with an instrument called a goniometer. I will take that measurement and compare it the corresponding knee on the other side, and I will compare it to documented "normal" measurement for her age.

Tissue texture refers to the relative health of anything that I may be evaluating: muscle, nerve, fascia, ligament or tendons. Even bone has a particular texture or feel to it. In general, healthy tissue is soft and resilient (even bone has a softness to it). For example, if I am palpating (feeling with my hands) muscle tissue, I may be feeling something soft and then suddenly something hard. Depending on the anatomy, that particular finding could be completely normal, or it could be a problem.


Once I have evaluated the ART in my patient, I can put the pieces together, come up with a working diagnosis and explain to the patient what we are going to do to reduce pain, restore function, and get her on the path to living a happier, healthier life.

Michelle is a Doctor of Physical Therapy at Women's Care of Wisconsin/PT Center for Women. To see Michelle at PT Center for Women, call or text 920.729.2982. 

PT Center for Women offers women of all ages comprehensive evaluation and treatment for their physical therapy needs. We are one of the only physical therapy centers in Wisconsin that specialize in pelvic pain and pelvic muscle dysfunction!

Once you become a patient, our therapists design a personalized treatment program for you to help improve function and lessen pain. Our gentle, heartfelt approach to healing allows women to feel calm and comfortable, and pursue a program of care that can change their lives. Our goal is to provide women with a successful outcome for a happier, healthier life.

At PT Center for Women, the care we provide is as unique as every woman.

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