Most view PT’s as the “physical terrorist” who inflict pain and promote fear by telling you your posture sucks. Most view PTs as the profession that helps people recover from a surgery by strapping ankle weights to you, stretching your tight hamstrings, and then putting some shocking pads on you with ice. Most people send their PT a Christmas card because they saw them more than they saw their own family (2-3x per week for 12 weeks) for the bad disc in their back. I wish I could tell you that wasn’t true at all, but it is. The major issues in PT are numerous but look no further than the lack of patient-centered care that promotes dependence, uses harmful words,lacks sufficient understanding of strength and conditioning principles, greatly underloads the body, and fails to reach any level of performance.
If you need help it’s as simple as this:
Rehab = Focuses solely on your pain, mobility, and strength. There is very little carry over and guidance to your activity/sport. Activity can be anything from rising from a chair and cooking in the kitchen without the use of a walker- to overhead pressing during your last WOD (workout of the day)- to change of direction while playing competitive basketball again.
It might look like this:
A PT telling you that you need 5 degrees more dorsiflexion because “normal” is 15 degrees and we have goals to reach for insurance.
Performance= Focuses on anything you want to do to get the most out of your body. That includes balance/coordination, speed, agility, power development, and more. It keeps the end goal in mind and is always deliberate and purposeful when applied.
It might look like this:
A PT telling you that by increasing your ankle dorisflexion that would improve your landing mechanics which would would in turn reduce your risk for injury as well as improve your rate of force development to get off the ground higher and quicker to grab a rebound.
Do you see the difference?
The PT profession was in major need of some remodeling and it’s underway. The revolution is coming.
REHAB MEET PERFORMANCE
In most rehabilitation models a large emphasis is placed on what an individual CAN NOT do, as opposed to what they CAN do. Interventions are aimed at treating pain, symptoms, and anatomical structures with little regard to the person behind the scenes. With a deeper understanding and explanation of how pain works and a deeper appreciation of the bio-psycho-social model; PT version 2.0 is truly patient-centered.
Traditional rehab models, which focuses largely on the injury, completely underestimate the total body healing response that optimal loading and training can have. Furthermore, whether that outcome is physiological or psychological or both, the outcomes are excellent. Protect the tissues is fine and all but ask yourself as a provider or a patient:
Are the short and long term effects that accompany this approach putting the athlete/me at greater risk as progressions are made? What is the risk:reward ratio for unloading essential muscle groups and movement patterns for this individuals success and goals.
While it’s important to understand the broad difference between protecting and restoring tissue health from preparing an athlete for return to competition; the transition needs to be more seamless. There are plenty of strategies to make rehab meet performance. This is founded upon training and coaching movements at the right intensity and load with respect to tissue tolerance and a person’s irritability levels, and one more thing: WITH THE END IN MIND. After all, most injuries occur because the the body and nervous system was exposed to a load-at an
end range it didn’t have the capacity to withstand. So shouldn’t interventions be aimed at increasing capacity to manage load=stress on the body?
When you are looking for the right PT, ASK QUESTIONS. If you need help here are some to consider:
- ● Why did you get into healthcare, specifically into rehab?
- ● What are your specialities or niches in this profession?
- ● Are you current in your knowledge in this profession and do you read scientific journals often?
- ● How can you help me reach my goals?
- ○ How long do expect for it to reach my goals?
- ○ How will you measure progress?
- ○ How will you know when to progress or regress interventions?
- ○ Do you understand the demand of the sport/activity I play?
- Do you understand the demands of the position I play?
- Do you understand the pattern of injuries associated with this sport/activity?
- ● How do passive modalities (heat, electrical stimulation, and ultrasound) assist in my rehab process?
- ● What is the purpose behind a specific exercise and why are we doing it?All of the above listed questions are relevant to any human seeking interventions for their pain or movement limitations. They are beyond relevant→→CRUCIAL for the athlete or active person returning to basketball, football, powerlifting, crossfit, running, cycling, etc.If you or someone you know is dealing with pain or some type of injury and you feel like no one understands your struggle; I want you know there are hundreds of forward thinking and passionate physical therapist working tirelessly behind the scenes to be the change in healthcare. No more unnecessary imaging, surgery, or pain medication. If there is not a provider in your area who understands, start here:
The revolution is coming.