What You Don’t Understand About Physical Therapy.
Physical or Personal
Often when people ask me what I do and I explain it to them and they say, “Oh you’re a physical trainer.” And every time I correct them and tell them, “No I’m a personal trainer.” Very often, I am greeted with confused looks.
Some people know that a personal trainer is different from a physical trainer, but they don’t understand what each of us do and how we can work together to help people.
So, I went to talk to my friend Kelsey. Kelsey is a physical therapist, triathlete, and Santa Cruz native among other titles. She recently graduated from Pacific University in Hillsboro, OR with her Doctorate of Physical Therapy and then moved back home for work.
I asked Kelsey to take a few minutes and explain exactly what a physical therapist does, how she got into the field, and how physical therapist interact with both personal trainers and mindfulness.
What do most people think physical therapists do and what do you actually do? How is this different from the work of a personal trainer and a sports trainer?
Most people expect physical therapists to offer treatments that primarily consist of either soft tissue work or exercise prescription. Often that can be suggested with a mere mention of an ailment.
I have been asked many times by friends and acquaintances if there is an exercise or stretch I can suggest for: knee pain, back pain, etc with no other information given. Every person is individual. And understanding a person’s movement habits, patterns and injury/health history provides great insight to specifically target the source of the pain. As well as the tissue that is sending the pain signals itself.
The more I am in the field, the more patterns I am learning to see, with typical injuries and how people hold themselves, but I would be amiss to assume each person perfectly follows every part of the patterns I am seeing.
Here are 5 things that come to mind when I think about what a physical therapist is:
- PT may stand for pain and torture. (We get people in this sedentary culture to move, surprise surprise that it might be difficult. Or, think day one post-op total knee replacement: PT means time to get up and go for a walk!)
- We do much more than exercises with patients, but our treatments are primarily focused on finding active ways to relieve pain and regain function, when possible and within our scope. Very much not a passive choice of treatment.
- We can do wound care, chest PT to help with breathing treatments, lymphadema massage/wrapping, burn care, acute care, school PT for kids that need adaptations to be able to participate, caregiver training, vestibular issues, balance training, post: stroke, traumatic brain injury, spinal cord injury rehabilitation, and the more commonly thought of joint aches, sprains, breaks, replacements and pains. Among other treatments.
- We are movement specialists, trained to see the intricacies in how people move dysfunctionally (not necessarily painfully, yet) and then target the correct tissues to regain proper movement patterns per joint.
- We are also trained to recognize the physiologic factors that show when people are at their limits for movement, to push them to their boundaries so they progress and heal, but not too far to push them over the edge or do more damage.
Like personal trainers, we are trained to teach people how to get stronger or more aerobically conditioned, how to lose weight, and encourage self-motivation to continue these changes apart from us. (Forgive my generality.)
Unlike personal trainers, we are often paid with insurance, which demand medical necessity for our services. The population we work with includes people that require rehabilitation from an injury, disease, condition, surgery etc.
Therefore, though we often send people home with a home exercise program, their treatments are in concordance with their healing, pain relief and return to functional movements: reaching, lifting, carrying, bending, walking, stairs, running, return to sports, sitting posture for work etc.
What drew you to the field of physical therapy? and how have you grown as a person as you have pursued your studies?
Good question. Like many PTs, I was drawn to this field because I was a patient at one time, and I was inspired by the way I could leave without the pain I brought in to my appointments.
I was interested in the health field, but I can’t stand needles. So, nursing and MD were out. I learned taping strategies, stretches, and exercises in athletic training, but disliked the emergency aspect of working the sidelines.
I loved anatomy and learning about the body. I found teaching others about the body fascinating. And I enjoyed one-on-one time with people.
Although this was never my end-all, be-all choice, the doors kept opening and I continued forward.
As I’ve pursued this career, I have grown to appreciate my listening nature and how feeling heard is therapeutic for patients. I am improving my ability to communicate without medical jargon.
I appreciate the nuances of working with people of different generations, at different levels of understanding, who sometimes don’t speak English.
I would say the biggest traits I have gained in this process are: The confidence to stand behind what I think. The grace not to need to know everything. The ability to take the next step forward. And the flexibility to adjust depending on each patient’s response.
What are the limitations of physical therapy and what are some ways that trainer and physical therapist might work together to support one another’s work?
The main limitation I would say at this point is the payment system. Most insurance requires a justifiable medical necessity to receive care. The system is reactive, and poorly set up for preventative care, a skill we are more than qualified to prescribe.
The company I work for has begun the process of remedying this by offering training classes and programs with periodic screenings at gyms. We are actually employing personal trainers to help run the classes and refer clients for screenings if they are having pain or movement issues.
It seems like the start of a great system to prevent injury and help people maintain their health safely. I’m sure this is just one way that therapists and trainers can work together.
Are there any aspects of mindfulness that you use when helping your clients? And how do you think mindfulness effects our ability to function and to recover from injury?
One of the biggest tools I use in my practice is getting people to grow an awareness of how they are using their bodies. And how that is repeatedly causing their symptoms.
Because our bodies will choose the easiest movement pattern to accomplish a task, we tend to use muscles that are easiest to recruit, instead of using proper muscles for precise joint mechanics.
They don’t cause pain right away, but the continued wear and tear on our joints from these dysfunctions can eventually send pain signals to our brains.
The way I use mindfulness is by teaching my patients to be aware and mindful of how they move themselves and hold themselves throughout their day. I would rather make a small adjustment to how someone walks or how they stand. Then we get thousands of repetitions with a corrected pattern without adding more exercises to a likely already busy schedule.
The other way I use mindfulness is in establishing a connection between the way my patients feel pain and how they respond to it. For now, I teach a physical, active change response to pain vs. some form of passive relief. But I hope to learn how to incorporate more dialogue about the emotional response that patient’s experience, especially when conditions are more chronic.
I think mindfulness in that instance can be a powerful tool to allow recovery and empowerment in the midst of healing, bringing hope forward from small steps and seeing the changes happening bit by bit.
How do you think people can transform their lives for the better?
Find a way to move that you enjoy, which gives you energy and personal reward. Then do it a bunch.
Invite others to join you and share the experience, or go solo. Whether it’s an outlet, a social space, a time to clear your mind, or a way to gain energy for the day, the key is to get moving. Movement has so many benefits for your health with few costs.
I want to thank Kelsey for taking the time to answer these questions. I know it’s been helpful for me to better understand the challenges of a physical therapist. And I’m sure it’s helped my readers as well.
If you live in the Santa Cruz Area and need an excellent PT please take the time to check Kelsey out by going here prefitpt.com.
I’m curious to know what you think of this topic: Have you ever been to a physical therapist or a personal trainer? What’s you experience? Let me know by commenting below.
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