Hello, Queen Kong.

I am an orthopaedic physical therapist.

My advice to you would be to seek out a PT with lots of experience treating the spine and shoulder. A McKenzie credentialed PT would be good, but a PT that has an eclectic approach for treatment, IMO, is best.

Every treatment plan is unique in some ways and the same in others. In my opinion as both a PT and a patient, you will need manual therapy for your neck and shoulder joints, gentle, but progressive muscle/nerve stretching, and progressive resistance exercises, postural training, self-treatment techniques, and a home exercise program. Patient education is a huge part of PT.

Just as a precaution, NEVER let anyone MANIPULATE ("crack") your cervical spine (neck)! It is done by the majority of chiropractors and very few PTs. It has the potential to be deadly or to cause a stroke, among other things. The reason specifically for the neck is that there are small, delicate arteries (vertebral arteries) that pass through part of your cervical vertebrae and feed the base of your brain. A forceful manipulation can rupture, tear, or damage these blood vessels and the injury can be catastrophic. There is actually legislation in the works to make cervical manipulation illegal in many states.

Please realize that manipulation is not the same as joint mobilization, which is much more controlled and gentle and will not result in damage to the vertebral arteries. Communication with your physical therapist is very important. A good PT will be appreciative of your immediate and post-treatment feedback. Your plan of care should be suited to meet realistic goals within a certain timeframe. They should be designed to carry over into improving your function and reducing your pain. As a patient, it is important for you to convey your goals and expectations. Your PT will do her/his best to stay on the same page with you.

If you are not comfortable with your PT, ask to see another one. We really don't mind...or shouldn't. A second set of eyes, ears, and hands can be a good thing. In the end, when you find a PT that is a good fit for you, it's best to stay in her/his schedule instead of bouncing around from one PT or PTA (PT Assistant)...some clinics operate this way and it drives me nuts! Continuity of care is important for both the patient and the PT.

Remember that PTs are providing a service, so don't be afraid to shop around and ask questions before you decide to book your appointment. Word of mouth is a great way to find a good therapist. Also, there are PTs that work directly in cancer centers and there are those that are trained in lymphedema and specifically cancers of the head and neck. So, do some research.

Please let me know if I can be of any more help.

I wish you the best in your recovery!

Kerri