Why workout and train with a physical therapist?
I am a physical therapist (PT) and am aware that there is a disconnect between public perception of what I do and my actual scope of practice. Acquaintances, family, and friends generally assume that as a PT, my profession is mostly hospital-based and that I retrain people how to walk after injury or how to use new adaptive equipment. That is only partially true, as it is a very small portion of the professional potential of a physical therapist.
According to the American Physical Therapy Association, it is within a physical therapist’s scope of practice (that is, skill sets) to work in fitness, wellness, prevention, and health promotions (http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/Practice/AssociationRoleAdvocacy.pdf and http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/Practice/PTRoleAdvocacy.pdf ). In fact, the APTA has set lofty goals – indicating that they will change the health of society, through “optimizing movement” (http://www.apta.org/Vision/). Movement, as in physical activity and exercise, is medicine – in fact, exercise is considered a 5th vital sign (https://www.ncbi.nlm.nih.gov/pubmed/21292925), it is a known preventative for many non-communicable diseases (ex. https://www.healthypeople.gov/2020/topics-objectives/topic/physical-activity ) and has been linked as a tool in the management of over two dozen diseases (physical and mental health) (https://www.ncbi.nlm.nih.gov/pubmed/?term=pedersen+%22exercise+as+medicine%22) .
Further, sedentary behavior is a separate, equally pernicious and detrimental indicator of health, parallel to physical inactivity (https://www.ncbi.nlm.nih.gov/pubmed/25599350). Any encouragement in decreasing sit time and increasing activity can have long-ranging benefits, potentially worldwide (https://www.ncbi.nlm.nih.gov/pubmed/?term=Lee+2012+effect+of+physical+inactivity+worldwide ) as well as to the economy (https://www.ncbi.nlm.nih.gov/pubmed/27475266 ) Physical therapists know this, teach this, and are expanding upon this; that is, as a profession we utilize lifestyle changes, particularly physical activity, to augment our patient’s/client’s health and wellbeing (https://www.ncbi.nlm.nih.gov/pubmed/26678448 and https://www.ncbi.nlm.nih.gov/pubmed/25016946 and https://www.ncbi.nlm.nih.gov/pubmed/25908523 and https://www.ncbi.nlm.nih.gov/pubmed/19842862 )
Fitness, wellness, prevention are within a physical therapist’s scope of practice, physical activity is a critical piece of quality of life and disease prevention and management, and much of the knowledge adjoined to this profession (stress management, nutrition, sleep hygiene, physical activity promotion, smoking cessation) and tools utilized by physical therapists (exercise prescription, diaphragmatic breathing, pain management, posture assessment, soft tissue mobilization, etc) are the exact mechanisms needed for long term, sustainable health, wellbeing, and disease prevention.
Physical therapists often work in the fitness industry. They can be found working in higher-end gyms (such as CrossFit or private gyms, see http://www.apta.org/AboutPTs/ ) to support “weekend warriors”, and PTs can be associated with sports teams and high end athletes (https://www.nba.com/lakers/features/secretweapon) . By aligning themselves with fitness facilities, physical therapists assist clients in preventing pain or future injury, analyzing and adjusting their posture, and “optimizing” their movement to maximize their potential achieving their fitness and wellness goals (ex. https://newgradphysicaltherapy.com/physical-therapy-and-crossfit/). For example, if someone has increased thoracic kyphosis and forward head posture, with tight pectoralis major and minor, that client is prone to injury from increased muscle stress/strain from impaired length/tension relationship within their muscles (ex. https://slidingfilament.webnode.com/applications/length-tension-relationship/ ). Tight muscles can be painful, have inefficient firing patterns, and impair the firing patterns of surrounding, synergistic muscles, change the length/tension relationship within the antagonistic muscles, all contributing to progress pain symptoms, muscle inefficiency, and other related symptoms (like overuse injuries, such as tendonitis, and trigger points). A physical therapist can recognize these impairments and work with a client to adjust them before they require formal rehabilitation (i.e. prevention) to maximize their strength and function. The downside to being a physical therapist: when I am out in public, I see impaired posture and gait patterns (i.e. walking patterns) EVERYWHERE, indicating the need for this professional assistance and education of the general public.
Physical therapists are familiar working with a variety of body types, abilities, and medical histories. This alone makes us unique (or, my preferred term “wild”) in the fitness industry. Some of my previous work history includes a rehabilitation hospital with inpatient and outpatient settings. I’ve exercised and rehabilitated individuals that had urinary catheters, utilized wheelchairs of different types, had tremors and spasticity, anxiety and depression, MS, brain injury, stroke, spinal cord injury, recent surgery, various body sizes, impaired standing balance, etc. A personal trainer might not have the experience and comfort working with individuals with a history of illness, injury, or a progressive, neurological disorders. As a physical therapist, however, I do. My profession’s knowledge of anatomy, biomechanics, exercise prescription, and various medical screening and disorders allow us to provide exceptional care and skill to the fitness industry. Additionally, I LOVE helping clients figure out how to improve and maximize their movement and quality of life, and I LOVE solving problems others’ missed; my knowledge of human anatomy and movement science allow me to observe what other practitioners or fitness professionals might not notice. For example, I had a client with a progressive neurological disorder that complained of dizziness and fatigue to me. Her descriptions did not fit the usual dizziness and fatigue pattern attributed to her primary disorder, and she displayed other musculoskeletal symptoms that had been written off and attributed to her primary condition. She had an appointment with her physician, which I agreed was a great idea. A blood test later showed she had a secondary disorder, this one impacting her musculoskeletal system, causing the unusual fatigue and dizziness. Another client with a neurological disorder had groin pain when walking that was glossed over with other healthcare practitioners; this pain was keeping her from exercising as much as she had in the past, a significant detriment to quality of life. With my anatomical and systems knowledge, I was able to identify and reproduce her pain with palpation of a trigger point in her hip adductors (which she was likely overusing with walking), and I taught her self- management skills of her trigger point so she could reduce her pain and continue walking.
Many physical therapists are skilled in diverse techniques, depending on their interests. Our profession has access to evidence-based continuing education for professional learning, such as kinesiotaping, dry needling, cupping, Active Release Technique (ART), pilates, and pelvic health. My interests and background include yoga (RYT 500) with training in yoga therapy, meditation, nature therapy, green exercise, kinesiotaping, personal training, with plans for additional training in strength coaching (CSCS), and additional movement analysis. If you utilize a physical therapist, choose one that has skills and interests matching your specific needs, though therapists can easily adapt to your requirements or make referrals accordingly.
Does your fitness facility have a physical therapist on staff? If not, why not? When your medical doctor educates you about exercise, do they refer you to a physical therapist? – I have found that, unfortunately, not all medical doctors are aware of the physical therapist’s abilities to augment fitness and wellness needs and goals; indeed, some articles referring to the importance of exercise lament how there are not reliable fitness professionals to refer patients and clients too (physical therapists ARE!!!).
When pursuing fitness and wellness goals or new physical activities, seek out the skills of a physical therapist at your local gym (or ask your gym to hire one). We would LOVE to help you – that’s why many therapists do what they do – our enjoyment and pleasure in helping improve lives.
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Written by Dr. Allison Mitch, PT (DPT) (they/she), CSE, CSC, RYT 500, reiki master
If you are in the metro Chicago area and interested in training with a physical therapist, email me at [email protected]
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