Maryland is a direct access state for physical therapy. This means that you do not have to see a physician before receiving physical therapy unless your health insurance requires it. As physical therapists, we are trained to be able to determine whether your presentation requires you to also consult with a physician. One of the reasons a physical therapist might refer you to a physician is for you to receive imaging. A physical therapist would suggest this if we feel your injury might have resulted in some type of fracture or tear to a ligament, tendon, or muscle. The only way to determine if this actually happened is through imaging. Your physician will then let you know the results of the imaging and their recommendation for a further plan of care.
Even if you did sustain a fracture or tear, that does not mean surgery is the only option. Depending on the severity of the injury, your physician will recommend your options and many times it is continued physical therapy without a surgical intervention. As physical therapists, we have vast experience with working with patient with positive imaging outcomes that have successful results with only physical therapy. Therefore, it is important to listen to all your health care providers to determine the right course for your treatment.