Knee injuries are a little bittersweet: For cyclists, they can knock you off the saddle for longer than you’d like, which is brutal. But for others, they can lead you to start cycling for the first time, which is a great thing.
Regardless of your experience with cycling, many knee injuries require some quality one-on-one time with a physical therapist (sometimes virtually, other times IRL). A professional will help guide you through programming designed around your specific injury, oftentimes pointing out imbalances along the way to get you riding or back on the bike stronger than before.
But not all physical therapists are created equal. Finding the right one can make or break your recovery and return to sport. As you narrow down the dizzying amount of options, here’s how to make sure you end up working with the best one.
Consider in- and out-of-network providers.
While it may seem easier to go straight to your insurance provider’s website and only search for physical therapists’ in-network, doing so could prevent you from finding that perfect fit. “[Insurance companies] tend to dictate a lot of what happens to a patient when they go in to see a physical therapist,” says Ziad Dahdul, DPT, orthopedic clinical specialist and owner of Ignite Phyzio & Sports Performance in California. “Patients have to get their visits authorized by their insurance, or they only have a [certain amount] approved and then have to jump through hoops in order to get more.”
Plus, reimbursement rates are continuously decreasing, Dahdul continues, forcing a lot of practices to see more patients per hour in order to meet increasing overhead costs and keep the doors open.
Which is why many clinics are taking insurance companies out of the equation; going the self-pay route instead. “It allows the PT clinic to treat autonomously and spend more time with each patient," says Stephanie Allen, DPT, orthopedic clinical specialist and senior physical therapist at Boston Physical Therapy & Wellness.
Paying this way can also be just as easy on the patient. Simply ask the front desk if they can verify your insurance, tell you what’s left on your deductible, and check your in- and out-of-network benefits, Dahdul says. “They should be able to tell you within 24 hours...everything that you're required to pay so you don't get a surprise bill three months later,” he explains. Sometimes, it ends up costing the same as an in-network provider, he notes anecdotally.
Then conduct a wide search.
The next most obvious place to begin your physical therapist search is correct: the Internet. But straight-up Googling can produce an overwhelming amount of results, so narrow your options by turning to social media. “Searching relevant hashtags on Instagram, like #aclrehab [or #itbsyndrome], can often lead you to posts or pages of [physical therapists] working with this population,” Allen says.
That’ll give you a good idea of their footprint in the physical therapy space, and you can look for content they’ve created—from static social posts and videos to blogs and podcasts—that discuss your specific injury and how they approach it, Dahdul says.
Next up: rating sites like Yelp and Google Reviews. “Typically, people who have had really positive experiences are very specific with detailing the injury that took them in there and how they recovered from it,” Dahdul says. And if they didn’t have a great experience? Well, they’ll probably note that too. (We’ve all seen those horror stories.)
Once you’ve got an idea of who you might want to work with, pick up the phone. Ask the front desk what patient populations they work with most (athletes, older adults, sport-specific, etc), and if there are any therapists who specialize in knee injuries, Allen says. You can also ask to be connected with the clinic director—they’ll truly know the options available at a given center, Dahdul says, and should be able to give you a good idea of whether they can service your needs or if they should instead provide a referral.
Look for their specializations.
Just like it’s a smart idea to work with a cycling-specific physical therapist, it’s best to go with someone focused on knee injuries when that area is the root of your pain. Because even though a PT can generally treat a variety of physical injuries, Dahdul says there are specialization pathways built into the profession that allow your PT to gain more in-depth expertise. Without that, your physical therapist may not be as well-versed with the intricacies of your injury, potentially limiting your bounceback and their ability to provide an individualized approach to your care, he says.
To suss out their level of knee expertise, Dahdul suggests looking for a specialty in orthopedics or sports. The dead giveaway: having OCS, which stands for orthopedic clinical specialist, or SCS, for sports certified specialist, after their name.
But if it’s tough to find a specialized PT in your area, it doesn’t mean you’re out of luck. “High-quality physical therapy goes way beyond just having an in-depth knowledge and interest in a particular body region,” Allen says. “You want someone who is going to really get to know you, thoughtfully create a plan of care, make you an active part of the process, and support you throughout the journey.”
Ask for a free screen.
It’s unlikely you’ll get an entire physical evaluation for free, but both Allen and Dahdul say they offer free phone consultations to help patients get a sense of whether you’ll work well together. “It’s a super helpful way for [them] to decide if they feel comfortable with us, and for the PT to best advise on the course of action that will benefit them most,” Allen says.
That’s when you want to not only tell them about your injury and how it happened, but also outline your goals and what you want to accomplish. From there, the therapist should be able to give you a general synopsis of what the overall plan could look like for getting you on the road to recovery, Allen says. “It won’t necessarily be a detailed protocol, but [they] should absolutely recap their findings, validate [your] concerns, and set realistic and optimistic expectations.”
Make sure they’re a personality fit.
Expertise isn’t the only prerequisite for working with a particular physical therapist—they also need to be someone you feel comfortable being around and talking with. “With a lot of these knee injuries, the [recovery] process can last for months,” Dahdul says. “You’re going to spend a lot of time with your therapist, and you want to make sure it’s somebody you get along with and who can be an advocate for you, that you can confide in and rant to when you’re having bad days, and who you can celebrate with when you have good days.”
At your initial screening, take note of how easy it is to have a conversation with them. Is there a back-and-forth flow to the conversation, or is it tough for you to get a word in edgewise? Are they listening to what you’re saying—and able to repeat it back? Or do you get more of a “yeah, yeah, yeah” vibe as they read from a protocol checklist? These indicators may seem small, but Dahdul says they show from the get-go whether your physical therapist is going to engage with you, supporting not only the physical component of your recovery but the mental side, too.
That’s a big element to remember—while the ability to talk with your PT and ask questions may not seem like a big deal at the beginning, as you move deeper into your recovery, you need to be able to trust not only that you’re ready to take on certain exercises and workloads, but that you’re doing so because they have both your short- and long-term goals and best interests in mind.
Beware of other red flags.
Before you get started, there are a few other signs that a physical therapist may not be the right fit for you. The first: how many patients they see while also working with you. If you’re not getting one-on-one time—a.k.a. they’re seeing upwards of three patients at once—Allen says that makes it difficult to provide the full care and attention you deserve.
Same goes for how long they actually work with you. Dahdul likes to spend a full hour with each patient to really individualize treatment, and says anything less than 30 minutes isn’t going to accomplish much. “There are always things that pop up that you didn’t plan for, and you have to be able to manage and advocate accordingly,” he says. “I just don’t feel like you can do that in anything under 30 minutes.”
Lastly, Allen warns against anyone making claims they can alleviate all pain with one type of manual technique or treatment method because as we know, everyone is different.
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Samantha Lefave is an experienced writer and editor covering fitness, health, and travel. She regularly interviews pro athletes, elite trainers, and nutrition experts at the top of their field; her work has appeared in Runner's World, Bicycling, Outside, Men's Health and Women's Health, Cosmopolitan, Glamour, and more.