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So in the philosophical debate between physical therapists and personal trainers, it would seem that there are either two choices:  a Deathmatch or a team hug.  Personally, I prefer hugs.  But for the sake of healthy argument lets have a few swings before we buy each other a beer and call it evens…
One of my readers ‘Selena’ wrote an excellent response to my last post (see my responses in blue below)

There isn’t an “ugly” truth between physical therapists and personal trainers.

Truth #1: Physical therapists are licensed providers of care.

Very true!  Physical Therapist are licensed providers of care and also jolly good fellows (which nobody can deny).  But aren’t personal trainers licensed at some level of care?  Even if it is just checking to see if they can touch their toes or if they have any history of heart disease?

Truth #2: The educational background for physical therapists has evolved to the point where physical therapists graduate with a doctorate in physical therapy.

100% agreed – a huge issue is that personal trainers nowadays can have a degree or a weekend cert and the public does not know the difference.  Point to you Selena, well said!

Truth #3: Fellowships and residencies are now post-graduate options for physical therapists.

Ok so this is an extension of #2, so let me ask if these physical therapists are going to actually make their money back on their education or just become professional students.

I mean, any physical therapist will tell you that if they accept insurance then they live according to what scraps the measly, scrooge-like insurance company will begrudgingly toss their way after treating the client with all their heart and soul.

So I will give you a point, yes – they can be very very educated.  But is that to a point where they become so specialized that they become true experts at one very small range and not necessarily what their true market might need?  Educational point to Selena, Philosophical point to be further discussed I think.

Truth #4: Literature indicates that physical therapists are just as well-versed and qualified at evaluating patients with orthopaedic complaints as orthopaedic surgeons.

Ok so I dont want to sling mud at anyone, but are you trying to say that PT’s are as good as Orthopaedic surgeons?  Or are you saying that orthopaedic surgeons are not very good at evaluating patients?  I know the surgeon that wanted to operate on my back after three visits wasnt really helping me feel the love.  Especially since on his desk he had magazines of luxury cars..  I still swear I heard him say ‘I think we need to get you into leather upholstery.. I mean surgery!’

Besides which I am not trying to say that injured people should use personal trainers, but that physical therapists generally are not taught how to get a person to peak fitness – just to ‘not in pain anymore’ fitness.  There is a difference, right?
Truth #5: Physical therapists are knowledgeable about the impact various co-morbidities have on pain and function (i.e. diabetes, congestive heart failure, multiple sclerosis, dialysis, osteoporosis, balance deficits, cerebrovascular accidents, post-operative healing, pharmacological side effects, osteoarthritis, central versus peripheral pain mechanisms, depression anxiety, fear…)

Ok I gotta contest this one.  I can agree that they study it, but I would argue that they dont use it to help people get to their healthiest.

Now I agree that personal trainers should know all of the above.  I think the industry is moving towards that.   So although physical therapists may know more, they dont necessarily get to use that knowledge nor do they use it to help people achieve peak fitness.
Truth #6: Exercise is easy… the skill is in knowing what exercise, when, at what intensity, at what duration, how often, in what manner and the effect the exercise will have on the sometimes multiple co-morbidities.

Now come on.  Exercise is easy?  Have you been to a gym recently?  Did you know that only 16% of the population belongs to a gym?  That we have never had more opportunities to exercise but have record obesity across the globe?

I say that the skill is not in the mechanics you outlay, but in the application to the person behind the flesh and bones and finding the motivation within them to rise to a level greater than they had previously acheived. But I recognize your point in regards to multiple co-morbidities (nice word by the way!  I am totally going to use that one if you don’t mind) however for people with no ‘morbidities’, does a personal trainer become the right option?  (ahh, the moment of zen, where we can consider things in a different light, if ever so briefly).

Truth #7: Physical therapists also aim at educating patients to such a degree that patients can be safe and can independently exercise within their abilities taking into consideration any co-morbidities.

Nup.  You lost me.  When I work with personal training clients I often ask what they do and they show me an old photocopy of some textbook exercises that the therapist gave them to do… 6 months ago.  Now, you may be an exception Selena (and I am sure you are, with all the excellent points and arguments you are making) but I think we can both agree that Physical therapists educate as much as their budget will allow and that they dont necessarily teach them that they need to keep progressing their exercises past whatever black and white rotator cuff handout they have slipped into their workout folder.

In my opinion, public safety is at risk with the lack of regulations on personal trainers – no substantial education and the lack of consistency in certification. Personal trainers can spew out “optimum health” but reality is personal trainers don’t measure “optimum health.” How does a personal trainer measure “optimum health” to ensure clients are optimally healthy? They don’t.

Selena, with all our back and forth – well, all my back and forth 🙂 I agree 100% with the statement of “public safety being at risk with the lack of regulations on personal trainers”.   We need trainers to be better organized in their knowledge and to have standards of care that we all meet and agree on – we dont necessarily have to agree on those standards, but there must be standards nonetheless.

But let me ask you this:

If the physical therapist is not going to ensure the client moves past a level of ‘pain free’ and into ‘optimal health’, then who will?  Are physical therapists taught about exercise periodization?  Do they know the different systems that burn fat?  Do they understand which machine will help with which movement pattern and which wont?  Do they know the difference between the cardio machines and are they willing to train people for free while they build up their business?

Personal trainers are not the best choice for consumers.

I agree that personal trainers are not the best choice for injured consumers.. But I also feel that personal trainers are currently the best choice for those that dont show ‘co-morbidities’ and want to get to a new level of health.

But as I have said in the past, this is changing.  The lines between personal trainer and physical therapist are starting to cross and soon both will have similar skillsets and interests.  And then all we need a marraige between the two and lots of drinkies to realize that we aren’t that different after all (awwwww).

Selena

Thanks Selena for your comment on my post!  I truly appreciate where you are coming from and am truly grateful for your thoughts.  If anyone else would like to comment lets keep it civil and work towards a new understanding of each other, not a division of doctrines, ok? (wow, division of doctrines!  That one sounds awesome!  Selena, I get the co-morbidities and you get the division of doctrines, ok?  Deal!)

  • […] Original post by jamieatlas […]

  • […] Personal Trainer vs Physical Therapist pt 3: the Deathmatch … […]

  • Selena Horner May 9, 2009 Reply

    Hi Jamie,

    The lines of personal trainers and physical therapists will never cross because there is no comparison. You are trying to compare apples to oranges while at the same time trying to make an apple (the personal trainer) be more like the orange (the physical therapist). It’ll never happen. Look at some of the doctorate physical therapist programs and you’ll understand more fully how very flawed your thoughts are.

    Personal trainers are not licensed. By licensed I mean: http://www.dleg.state.mi.us/verify.htm

    I’m not up on all the State Practice Acts in the United States, but I believe 44 of the states have some form of direct access. Direct access is what personal trainers experience. Direct access means that the consumer can walk in the doors of a clinic and choose a physical therapist to assist in their condition – whatever it may be. In the states that have direct access, physical therapists ARE playing a larger role in “wellness.” Who better to guide a person who has a history of deep vein thrombosis, or peripheral artery disease, or coronary artery disease, or a history of cerebrovascular accident, or obesity, or diabetes? What if that person also had a history of some sort of surgical procedure? And the folks that have osteopenia or osteoporosis? And then of course, the folks that have an entire medicine cupboard of prescribed medications… The physical therapist has the training and skill to more successfully assist those people in improving their state of being. The reason I even mentioned fellowships and residencies is because those avenues have a complete, real life, applicable clinical value. If my grandma needed assistance and I was to choose who could help her be more safe and make her more steady in her balance and I had 3 options: personal trainer, physical therapist, or a physical therapist who completed a geriatric residency… I can assure you, I would choose the physical therapist who completed a geriatric residency. That professional is more fully trained to adequately address all my grandma’s physical needs.

    The reason I mentioned #4. Of course physical therapists do NOT do surgery… physical therapists though are just as good at their evaluative skills as an orthopaedic surgeon. The literature indicates that the primary care physician is the weakest in evaluating musculoskeletal problems (which makes sense – a primary care physician has a very, very broad base of knowledge). Evaluative skills (which a personal trainer does NOT have) are very, very key in successfully knowing the plan of action to take to impact the patient’s life.

    For #5, all I can say is… what? See, you have no clue how important knowing all that stuff and the impact it has on the body and on “health” or lack of “health” is very, very relevant. Scary perspective you have. My exact point on public safety – personal trainers are a scary choice for consumers because of your exact response to my #5. Jamie, I use that knowledge every day, with every patient and it completely affects my treatment plans. It’s okay that you don’t get it, I wouldn’t expect you to because you don’t have the same training or expertise, but at the same time, all those co-morbidities that I mentioned impact care, impact health.

    In regard to #7… you could be right. I know I have my patients knowing how to exercise and strengthen and continue on independently. Sometimes it has nothing to do with the budget of physical therapists – I’m not quite understanding your opinion. More often than not, for patients, it has more to do with THEIR resources and community resources.

    From a professional perspective – exercise IS the easiest part of the whole equation. Safety DURING the exercise is what is difficult to ensure. Personal trainers don’t have that training. I don’t mean the mechanics of exercise, I mean the client factors that have an impact on exercise. Personal trainers do not figure that into the equation.

    Personal trainers are great for cosmetics, look at actors and actresses – they all have a personal trainer maintaining their physical image… I saw a few of your posts – “get a better bootie.” Sure, someone who is generally healthy and doesn’t have a slew of co-morbidities – definitely. I hope you are measuring “health” if that is the goal. Personal trainers are more focused on physique, in my opinion.

    Jamie, every day, I get the co-morbidities. I sometimes lose sleep over how some patients can have improved function. It takes sometimes a lot of deep thinking and reading medical literature to figure out how to achieve the best outcome.

    Personal trainers and physical therapists are not even close in training or what they have to offer consumers. I don’t view this as a death match… I’m trying to educate you and readers on physical therapists. The only reason I even responded to your blog is that I don’t want anyone believing your opinion, especially as flawed as it is. I have no idea who reads your blogs, but I do know that I don’t want anyone out there even thinking a personal trainer is like a physical therapist. Your thoughts seem to indicate that there are such similarities that consumers could choose either and have the same outcomes. You and I both know that this isn’t the case!

  • Tom Reeves May 9, 2009 Reply

    PTs know all of the things that personal trainers know. PTs also know many, many things that personal trainers DON’T know. There is only one person in this debate between Selena and Jamie that understands the difference and that is not Jamie.

  • Sean May 9, 2009 Reply

    Wow.. spooky. As I’m reading this article (series) I’m thinking to myself: ‘Aren’t we comparing apples and oranges?’ While they are both fruits they sure are not of the same make and model.
    I have a unique perspective since I’ve floated and lived in both ‘worlds’ as a Certified Athletic Trainer I’ve worked side by side with PT’s in clinics as well as with athletes. I’ve also worked and currently work with clients on a one-on-one basis of personal training.
    These two professions flirt along the same line of care, but deliver and originate their care from two different worlds.
    Personal trainers don’t have the knowledge or education to treat or rehabilitate ACL reconstruction surgeries or recondition over-use injuries like tennis elbow.Having a certificate by passing a one time exam does not familiarize you with the concepts of Kinesiology and Applied Functional Anatomy. And PT’s don’t have the education or knowledge to properly identify and prescribe a proper customized workout regime that involves dietary evaluation and applicable different exercise regimes.
    During the continuum of care for the patient/client the PT sees the patient at a very different time then the Personal Trainer. How can you compare that?
    It’s picking at straws and driving blind to match these professions head to head.
    It’s not only disrespectful to the two professions, but it’s a futile effort.
    Just my 2 cents.

  • jamieatlas May 9, 2009 Reply

    Wow, lots of good stuff in the past few posts.

    Sean, not trying to be disrespectful – I think my writing must be missing the mark – you said it really well so let me use your words to try to redirect where I am coming from:
    You hit the nail on the head with your fruit comparison. The two are both apples and oranges in many ways. I think we have to be careful of labelling personal trainers (or physical therapists) as having a set or limited amount of knowledge. Of course, both are dealing with a person who wants to change where they are at and both classically need a different skillset. But it is my personal opinion that both have trouble understanding what the other does as well.

    I have met some amazing personal trainers who are voracious learners and study under different experts in an attempt to learn their methodologies.

    I also know some physical therapists who integrate care into their practice that extends past the normal therapist scope of care for people who have events or particular goals that require more attention.

    I have also met members of both communities that I was disapointed with. Just like any profession, the certificate or qualification or the professional itself is not a guarantee that the client will actually receive what they should be getting.

    Sean hit it on the head again when he said that the two ‘flirt’ along the same lines of care but originate from different points. I see that line getting closer and closer every day, and I think it is in part because of a lack of communication between the two worlds.

    Personally, I have a dream… a dream where professionals refer to each other and we all trust and understand each others roles. What can we do to make that happen?

    • Chad May 10, 2009 Reply

      I completely agree with Jamie that even though physical therapists AND personal trainers have a certain qualification, this does not particularly guarantee top of the line care for the consumer. That is like saying that every single surgeon in this world is great for the consumer and knows everything and WILL be able to help just because they are all that education and training. Have you ever heard of sugeons/doctors getting sued because of something they did ‘wrong’? Thought so. But, but, but….they are licensed and they passed their tough exam and they have extensive training and they are SURGEONS! This can’t be!! Wow, looks like ALL surgeons/doctors aren’t ALWAYS the best choice for the consumer, just like physical therapists or personal trainers aren’t always best for the consumer….depending on the consumer. One size does not fit all.

      Selena, it sounds like you are saying that no matter who the person, what they need, what injury they have, or what their goals are, they are ALWAYS better off with a physical therapist rather than a personal trainer. What if the person needs to lose a bunch of weight in order to help the knee? What if what the person is lacking is complete body functionality and not just ‘rehab’ on one certain part of the body? Your scope of practice makes it sound like everyone is the same and can and should be treated the same. This could lead to some problems. What if someone goes to physical therapy and realizes they can’t ‘connect’ with the physical therapist or any other physical therapist or just don’t feel comfortable at a clinic and would rather be in a gym exercising to help them get back to peak fitness?

      Selena, I like where you wrote “(i.e. diabetes, congestive heart failure, multiple sclerosis, dialysis, osteoporosis, balance deficits, cerebrovascular accidents, post-operative healing, pharmacological side effects, osteoarthritis, central versus peripheral pain mechanisms, depression anxiety, fear…) in attempt to prove your knowledge and terminology in the medical field. That is great that you know all of those words. Does you knowing all of those words necessarily GUARANTEE your success in helping the consumer?? I’ll let you answer that question. You see, it’s not always the knowledge you possess, but how effectively you can use it to your advantage. Just because physical therapists have more education and training than personal trainers doesn’t really GUARANTEE anything.

      Selena, you also said this, “Who better to guide a person who has a history of deep vein thrombosis, or peripheral artery disease, or coronary artery disease, or a history of cerebrovascular accident, or obesity, or diabetes? What if that person also had a history of some sort of surgical procedure? And the folks that have osteopenia or osteoporosis? My question to you is, “Who better to guide a person who wants to lose weight (to ease the pain on their injured ACL knee), learn how to make their ENTIRE body stronger and move better, become more flexible, get ready for a competition, or just be able to get back to doing the activities they love to do? There is no way a physical therapist is ALWAYS going to be the best option there for the consumer.

      I’m not putting down physical therapists in any way. I know they are very educated (you have proved that with your constant use of medical terminology…come on, we’re just personal trainers, you know we don’t understand any of those words!!). I also know that physical therapists are USUALLY the FIRST stepping stone for someone who is rehabbing an injury. Personal training is often the second stepping stone to getting the person back to peak fitness. The two professions OBVIOUSLY work together in some sense.

      I recently worked with a person who was rehabbing a shoulder injury. He said he was going to physical therapy but the PT never seemed to switch up the exercises. The PT simply gave them a sheet of exercises to do at home. They had that same sheet of exercises 2 months down the road. Hello adaptation! You really think the average person is going to do all of their exercises on their own at home?? Most likely not. That is where personal trainers come in. We can teach AND motivate the person (not just give them a printout of their exercises) to want to do the exercises. Anyway, going back to my story, the guy quit physical therapy because he wasn’t liking it and decided to join a gym and get a personal trainer. I worked with him for a little over 3 months and he constantly reminded me how great he felt (his entire body). We also improved his shoulder mobility greatly and he lost some weight while we were at it. Wow, a total body conditioning AND shoulder rehab? Maybe personal trainers aren’t so bad after all.

      • Kyle May 14, 2009 Reply

        Yes, surgeons make mistakes. But, if you were going to have surgery would you rather go to licensed surgeon with standarized formal training/licensing or some guy who had read some anatomy books and took one anatomy class? There is no perfect person or perfect field. It is a matter of which field is the best trained, regulated, and able to provide the SAFEST and best services to the public.

        And, to clarify. Personal Trainers NEVER provide rehab. If you did you would need to be held accountable by some type of license and practice act. You provide FITNESS in a business model paradigm. YOU ABSOLUTELY DO NOT PROVIDE REHAB IN A HEALTH CARE PARADIGM. You must, must understand this.

        You said “Who better to guide a person who wants to lose weight (to ease the pain on their injured ACL knee), learn how to make their ENTIRE body stronger and move better, become more flexible, get ready for a competition, or just be able to get back to doing the activities they love to do?”

        The best choice is a physical therapist. We do all of these things Chad. Your post makes it seem like you have a very tainted and ignorant view of physical therapists, the profession of physical therapy, what they do, and how they are trained. Everything you have said about personal trainers, physical therapists do and much, much, much, much more.

        Also, I am with Selena. How do personal trainers measure fitness? Have these measures been researched for their validity and reliability? How do they define peak fitness?

        Cheers.

  • fitprosarah May 10, 2009 Reply

    Jamie-

    As an ignorant meathead Fitness Professional, here’s my $0.02:

    Pit PT’s against Chiroquacktors and that would be REALLY fun! 😀 LOL! Ugh, I am not a Chiro fan…

    I’m happy to say that I KNOW PT is nothing like Personal Training. I have never wanted to have my business remotely mirror that of a PT’s. What would be the point? I help people look and feel better through movement-based training. I educate them on healthy nutrition and help balance out their bodies to PREVENT injury.

    What’s with the “chip on the shoulder” attitude presented by the PT’s above? That’s a really draining way to live. Gotta be exhausting trying to prove to the world that you’re this or that. I wonder how long it took Selena to write that lengthy response? Did it make her feel better? I hope it did something positive for her. I’m all for people doing what they LOVE and doing so with a positive attitude. I feel fortunate to be doing what I love, and work is fun! At times, I feel quite guilty about this!

    Those who know or know of Jamie know that he’s good…and know he’s not out to badmouth anyone or whatever. Sheesh.

    A PT does their job and I do mine. The difference? I feel mine’s a lot more fun, and I get paid good money (not via insurance, thank goodness…that seems like a huge hassle to me) to do a lot for my clients (in person and across the globe).

    I know my stuff, I KNOW I know my stuff, and if I don’t know something, i’ll find someone who does and get back to ya…just as I assume any SMART person in the health field would!

    Yours in Health,
    Sarah

    • Barton May 10, 2009 Reply

      Sarah,

      I, too, am a Fitness Professional. I am also a Physical Therapist. I did some personal training (and still do a bit) before going to physical therapy school. In that respect, I am one of the many who are somewhat qualified to speak intelligently on both topics. And, even though this may discredit me in your eyes, I work with chiropractors (while some may be quacks, not all of them are just like not all personal trainers are not meathead idiots who don’t know their infraspinatus from their biceps – so keep an open mind).

      I digress. The point is not whether we are different or do different jobs – of course we do. In fact, it normally isn’t close. And the point of Selena’s response is not to make her feel better or do something positive for her. The point of Selena’s response is to protect the public. See, when you get involved in healthcare, which is kind of where this post is going, you sometimes get the horns with the bull. If the lay public puts in a Google search for physical therapy and hits on a string of keywords that bring this blog to the top and decides that personal trainers are able to help just like physical therapists because they make people feel better just like physical therapists then they might start going to personal trainers to feel better. The good personal trainers do a proper intake and refer them to me when something doesn’t fit. Then, I send them back to the personal trainer when they are ready – which is something for which physical therapists are uniquely qualified. The problem becomes when personal trainers start “treating” things that are not in their wheelhouse. Conditions like low back pain come to mind. You can certainly exercise lower back pain away, but you can also do irreparable harm to certain low back conditions with exercise. Do ALL personal trainers know what those conditions are and how to determine which ones are okay and which aren’t? NO Do some? I am sure of it. So, without trying to sound rude, in healthcare, where we are dealing with serious potential outcomes, we all need to stick to what we know. We need to protect and think about the public FIRST and foremost.

      All of that being said, I am 100% for working together and coming together. While I don’t see that happening in a professional licensing capacity, it is something that ultimately has to happen in order to take my patients who like to exercise (or need to) into a safe atmosphere post treatment. You will also find, if you look for it, people like me who lecture at fitness professional conferences thus advancing both professions. But, I also know that half of the people at the conference chose to attend a seminar on Cross-Fit instead of listening to me talk about the current concepts in rotator cuff strengthening. And nearly no one attended a lecture by another health care professional on appropriate treatment of neuromusuculoskeletal issues/injuries and instead they did a seminar on kettlebells. Proof positive that not ALL (or even the majority) of personal trainers want to learn that suff.

      Let’s just realize what we all do well and get the person into that realm (and if that person is a patient, they better get to a licensed, trained, educated healthcare professional like a Physical Therapist).

      Barton

      • fitprosarah May 11, 2009 Reply

        Hey Barton!

        Excellent reply, thank you for doing so! I am sharing my thoughts with everyone here.

        I did make a sweeping generalization about chiros…I have worked for 2 of them and that opened my eyes. I witnessed more insurance fraud and misleading of the public than I was comfortable seeing, therefore I quit on both occasions. With this being said, i’m not saying all chiros are quacks…I feel there is some benefit from chiro adjustment…I just don’t get the “straight chiro” mentality and business-building practices. There is some scary stuff out there that the public needs to be more aware of. When someone tries to sell a patient “corrective care” for a year or so…and they must shell out a thousand bucks (or insurance must), this is a problem. I never heard the chiros turn a patient away. I was told to find any type of subluxation I could when I marked the x-rays. I witnessed lots of stuff I felt really bad about, and my conscience knew better. Often times, I asked the last chiro I worked for questions…the response was “because chiro works.”

        Enough about chiro. I was doing my best in my initial response to not come across as a jerk or anything remotely like that. Like Jamie, i’m a happy-go-lucky nice person who gives people the benefit of the doubt more often than not.

        I HATE the fact that, more often than not, trainers are IDIOTS. I’ll be the first to say it. That’s why I was making fun of the profession in my initial response, lol 🙂 It’s easy to obtain a cert. You can get one right now online in probably 10 minutes! I am not happy with the fact that I have a BS in Exercise Science, I have post-grad work towards a Master’s, and I also have completed the prereq’s for med school…scored a 28 on the MCAT. I realized med school wasn’t what I wanted to pursue, so I turned yet again to thinking about PT school. A botched undergrad GPA held me back from trying, and it’s all good b/c i’m where I need to be! In fact, I pride myself on knowing that I am extremely successful working for myself, paving my own way, and continuing to find ways in which I “spread my word.”

        I’m happy doing what I do! I feel there is a lot I can do to educate the public…there are too many numbskull trainers out there…people plunk their money down without asking to consult with several trainers. The public DOES need to know that they have options!

        I always bring up the 80/20 rule…I would venture to guess that 80% of trainers are crap, and the other 20% are worth investing in.

        Don’t even get me started on Jillian Michaels or CrossFit. I will go off on those 2 topics, lol, and I have a gazillion things I need to be doing right now!

        I agree – interaction like this is vital and very interesting, I just wish that people could go about it without getting defensive! Like I said above, I know my initial response probably came across as “snobby” lol…i’m so far from snobby it’s not funny! I am just sick and tired of being lumped in a category that is looked down upon by other health professionals. I am tired of our profession not being taken seriously by those we network with and refer out to. My grammar is sucking right now, so I apologize.

        Like they say…when you assume, you make an ass out of “u” and “me.” I tend to assume most chiros are quacks. I tend to also assume most trainers are crap. I’ll be the first to tell you! I rarely assume a PT is less-than-good b/c I know how hard it is to get into PT school, and I know all that goes into it. I have worked closely with PT’s and picked many brains. I have much respect for you guys, so please don’t think i’m hatin’ on you! I feel those who are thinking Jamie doesn’t know his stuff are completely misguided, though.

        Now, back to work…

        Yours in Health,
        Sarah Rippel

  • As a physical therapist I can see where this argument gets confusing. Physical therapists certainly learn far more than personal trainers. The education for PTs should be considered an ultra-marathon. It is not an easy 3 years of graduate education. With a degree in psychology from one of the top liberal arts colleges in the country at the time, an MBA from a well respected university in Georgia and PT degree and finally a doctorate, I feel I am qualified to comment on the education required to be a PT–PTs are arguable the most well trained allied health professionals. UNFORTUNATELY, the economic model in the US completely works against PTs marketing this information. I know plenty of PTs that decide to practice as personal trainers or massage therapists because the limitations in the referral process ultimately dumb down the profession. I have always worked in private practices and always been challenged by that environment to provide the best quality therapy possible. The conversation about apples and oranges between personal trainers and PTs could also be made between PTs–like any profession there are huge differences between the quality of care provided by PTs. It would probably make a lot of sense for consumers to know that they should shop for a good PT just like they should shop for a good surgeon, hair dresser or car mechanic. So, my first point is that PTs are exceptionally well trained. My second point is that practice environments may dictate how well that knowledge is applied.

    It is interesting that you bring up that someone continues with a set of rotator cuff exercises six months after they have been discharged from PT–that is totally crazy. Do they still have the problem? If they don’t, they should be doing more general exercises and progressing–with a personal trainer if that is their choice. If they still hurt six months after discharge, my question would be “why were they discharged”. You might not understand the limitations of having to work with people within the limitations imposed by their insurance companies–that is a problem with insurance companies, not PTs! How can you hold the PT responsible for someone continuing with the same rather limited program for six months–did they call the PT to ask if they should continue with the program or did they explore the option of a follow up appointment to determine a course of action six months after injury? I don’t want to be held responsible for something I didn’t intend or prescribe. I agree that that doesn’t make sense–but, that probably was not the recommendation by the PT. The fact they weren’t progressed beyond that is that insurance does not reimburse for performance–it reimburses to get someone to a certain point of function and decreased pain not “optimum function”. Given the opportunity, PTs can provide a plethora of “wellness” interventions. Certainly that is done in many clinics. It is not the traditional insurance model but to me that is beside the point. In this discussion, it is exactly the point–I think many have observed PTs function within the limitations of the insurance environment. I see plenty of clients in my practice outside of that model and certainly can provide a lot more without insurance limitations.

    It is interesting you bring up periodization. Periodization does not apply to the rehabilitation process–when appropriately introduced, the intention is to prevent injury. I have worked with my share of professional, olympic, college, highschool and recreational athletes. I can certainly help them design their programs utilizing the concepts of periodization. It may surprise you that many of the concepts utilized by personal trainers came from physical therapy practices–agility drills using Swiss Balls (or exercise balls or whatever you want to call them) came from PTs. Core stabilization was a concept I was taught in 1984 by Greg Johnson a PT that applied concepts from PNF (utilized by PTs since the 1940s) and popularized this concept. The research that explained why stabilization works and when it is necessary comes from research largely performed in Australia inspired by a PT and double doctorate named Paul Hodges. His research explained that core stabilization in the injured person is a totally different issue than when that concept is promoted as a strengthening routine. With back injury, core stabilization is all about retraining firing patterns in muscles–timing, not strength. Unfortunately, if I hear 1 more patient come in to my clinic and tell me they think they need to strengthen their core muscles to resolve their back pain, I will be 1 step closer to insanity. That is just one of the many misunderstandings promoted by a complete misunderstanding of the research that has been published. Much of what is called “modified” Pilates is nothing more than the core stabilization concepts I learned a long time ago. The ground breaking research on the use of Tai Chi for balance was performed by Steve Wolf, a PT at Emory University–that took a $14 million dollar grant. The list goes on an on. I suppose my final point is that PTs are so much more than what the public experiences in many typical PTs environments. If you ever come in contact with a PT that has the opportunity to apply their knowledge, you would have a totally different experience of the application of manual therapy skills that range from thrust manipulation to trigger point massage, the skilled application of exercise principles for rehabilitation that are not learned in a short period of time, the use of various modalites whether it is an ultrasound machine, electrical stimulation or the use of acupuncture needles to treat trigger points in the muscles. The skills of a well trained PT are really impressive–again, unfortunately, our insurance model in the US and the referral model work against many PTs utilizing those skills.

  • Jonathan May 10, 2009 Reply

    Ok,
    This is ridiculous. If a client wishes to get into “Peak fitness” or pain free, or function better at a specific task, personal trainers should not be involved. Do not mistake an ATC for a personal trainer. I have a large amount of respect for ATCs. Most of the time they serve one purpose, send me clients via poor form and exercise progression leading to injury. I can’t believe this conversation is even happening.
    You said: “If the physical therapist is not going to ensure the client moves past a level of ‘pain free’ and into ‘optimal health’, then who will? Are physical therapists taught about exercise periodization? Do they know the different systems that burn fat? Do they understand which machine will help with which movement pattern and which wont? Do they know the difference between the cardio machines and are they willing to train people for free while they build up their business?”
    Who do you think does all the research that is the guide line for these things. It was not a personal trainer. Most times, it is a PT, MD, or ATC. This knowledge is elementary. One personal trainer on this blog tell me the exercise with the Highest EMG level for glut max, or even the force vector exerted on the hip by the glut max.
    I don’t mean to be so aggressive, but this is dangerous for any consumer. I have seen, many things in the gym that personal trainers do that is not only not beneficial, but is dangerous. One of the larger name personal trainers here in Atlanta witnessed a person rupture his distal bicep insertion, and told him to ” rest it, you will lose some strength for a little while, but it will be fine” If a PT had not stepped in who happened to be working out at the same time, that guy would not have had full function of his arm. Another example: I just recently had a client that went to a trainer and he had him perform an excessive amount of push ups and other exercises past excretion, and as a result the man had to be taken to the hospital for urinating blood. Rhabdomyolysis is the name for those of us who aren’t in the medical field. Now he is seeing me for going to the same guy afterward and he performed diamond push ups over his head which is the peel back position for the labrum. He now has a slap tear, and in all likely hood will need surgery which can take up to a year to fully recover from. Now, I’m not saying that PTs do not make mistakes, but not like that. That is poor knowledge base. knowing how to work out and actually knowing the science are two very different things. Many of them are dangerous to consumers, not beneficial.

    • jonathan May 10, 2009 Reply

      Let me clarify one thing I said. Most of the time they serve one purpose, send me clients via poor form and exercise progression leading to injury:”that is a bit more angry than I intended” I have met personal trainers that know how not to hurt somebody, but it is the minority that I have met. some of them are very knowledgeable. and some of them thirst for knowledge and are very intelligent. but they are not trained in physiology, anatomy, movement patterns, any more than the average gym rat( I say that with respect, because I myself am a gym rat). And when they claim to be, it is a false pretense to the public. It is the same thing when a PT, or and MD makes a statement that they are unsure about, but don’t want to admit they don’t honestly know, it can lead to bad things.

  • jamieatlas May 10, 2009 Reply

    You know what is just mind-blowingly awesome? That we are all talking about this topic. I am so encouraged by the enthusiasm and desire by the posters in this topic – even if some of them might have taken things a bit personal or gotten a bit snippy, they are still expressing themselves, and that is great!

    If you are an innocent bystander / non-fitness and health professional reading this, you might feel slightly confused or scared by the variety of responses and anecdotes being given back and forth here.

    So let me say that although we may be in healthy argument right now, some truths will remain the same:

    Know that if you are in pain, you should seek out a physical therapist or some kind of rehabilitative professional with a solid knowledge base. I am not going to argue that point for a second.

    But if you are not in pain, do not have any medical conditions and have a specific goal in mind, there are plenty of other professionals (on top of physical therapists) that can help get you moving in the right direction.
    There are personal trainers out there I would trust with my body 100%. And there are also physical therapists, chiropractors, acupuncturists and massage therapists I feel the same way about. It took me a while to find some of them, but I found them nonetheless.

    Just know that the decision comes down to you, and if you have learned anything from reading this post and these comments it is that there are many choices available, and you should choose the one that makes sense to you. But above all, ask WHY – knowledge is power, and when it comes to your body you are in charge! Do not allow anyone to baffle you with B.S. Ask the questions you want answers to. If your ‘care-giver’ cares enough, he or she will know the answers that make sense.

    PS I would love it if these comments focused on the concepts and not slagging the people at hand – it hasn’t gone down that road yet, but lets make sure it doesn’t. I think we all agree we get less done that way. Thanks guys! Love your passion and love your dedication to learning and communicating with each other!

    Jamie

  • Evan May 11, 2009 Reply

    I am a recent DPT grad with my CSCS cert. I worked as a personal trainer for a year before school. I have my BS in exercise science and can honestly say that personal training has its place and time. For clients with absolutly no co morbid factors or underlying health concern, personal training can be beneficial. The problem starts when these patients/ clients are more complex. The personal trainer has a a limited skill set (albiet a great one) which cannot compare to that of a physical therapist. I did not understand how much I DID NOT KNOW as a personal trainer until I furthered my education. All aspects of exercise progression including periodization, glucose metab, progression etc are stressed as essential skills for the physical therapist. My personal training background helped with this new learning, however it was not complete. Selena makes great points which honestly cannot be attacked. Personal trainers are great at maximizing function…with healthy populations…after consultation….if needed. It is foolish to say that any personal trainer can provide the same level of care as a physical therapist. Please let me know if you think this is untrue

    • jamieatlas May 11, 2009 Reply

      Hi Evan – thanks for your comment! You are right on the money and we are on the same page. What I am saying though is that personal trainers are getting better and better every day at understanding the human body. While if someone is injured they should not see a personal trainer as their first option, there are also situations where a personal trainer is the correct option. Personal trainers today have more and more options to learn at a higher level and those who are taking those steps and discovering what they don’t know (just like you did) but are also learning more about how to deal with minor joint issues a client might experience. I am not endorsing this, I know too many pt’s who do amazing work to ever try to step on their toes. I do think that a day will come that a personal training cert will offer to teach trainers how to rehab certain injuries which will step on therapists toes – do you think this to be untrue?

  • Kyle May 14, 2009 Reply

    ME
    I grew up as an athlete. I played baseball, football, and alpine ski-raced through high school. Further, I played college football. I have an extensive background in all types of exercise and training through these experiences. I have worked with countless strength coaches, personal trainers, athletic trainers, physical therapists, and orthopaedic surgeons. In college, I also worked as a student athletic trainer in my off-season. My personal experience with exercise, sports/fitness training, injury, and rehabilitation is quite extensive.

    My freshmen year of college I suffered a devastating knee injury. I completely tore my Anterior Cruciate Ligament and Medial Collateral Ligament. I also partially tore my Lateral Collateral Ligament and Lateral Meniscus. I had two knee surgeries requiring extensive physical therapy. But, thankfully was able to play football my last 2 seasons.

    Now, some of my current colleagues and best friends, were personal trainers or certified athletic trainers before coming to school to pursue physical therapy. EVERY SINGLE ONE OF THEM WOULD AGREE WITH SELENA’S POST. The following information is representative of my view as well as my colleagues/friends. We have had many discussions amongst ourselves on this very issue.

    PT EDUCATION
    First just a quick review of what it takes to become a physical therapist. Currently, a 4 year bachelors degree while fulfilling required pre-reqs is a requirement to even apply to physical therapy school. This is followed by 3 years of full time schooling in a Doctor of Physical therapy program. This schooling includes approximately 4 clinical rotations in various clinical settings. Further, as Selena mentioned there are residency/fellowship opportunities after graduation…
    Let me stress, that these are NOT just going to class. These are focused residencies/fellowships where residents/fellows treat patients, but also are involved in academic learning and in-depth discussion/analysis of their patient care choices including EXERCISE PRESCRIPTION involving type, intensity, duration, frequency and PROGRESSION. These discussions and learning take place with certified specialists and experts in that particular area of practice.
    I would encourage you to look at some Doctor of Physical therapy programs and what classes are taken. Do you think MD’s are professional students? Because what Selena described is exactly how physicians are trained. So, wouldn’t it make sense that if PT’s are also now being trained in the same manner that their clinical knowledge, abilities, and patient care are ever improving INCLUDING their exercise prescription and progression?

  • Kyle May 14, 2009 Reply

    TRUTH #4: Literature indicates that physical therapists are just as well-versed and qualified at evaluating patients with orthopaedic complaints as orthopaedic surgeons.

    POINT: PT’s are as good as orthopaedic surgeons at EVALUATING musculoskeletal problems and BETTER than all other physicians.

    “In a study comparing the diagnostic accuracies of physical therapists, orthopedic surgeons, and non–orthopedic medicine providers, Moore et al found that the accuracies of physical therapists and orthopedic surgeons were greater than that of non–orthopedic medicine providers, with no differences between physical therapists and surgeons for patients with MS (musculoskeletal) injuries.”
    Citation: Moore JH, Goss DL, Baxter RE, et al. Clinical diagnostic accuracy and magnetic resonance imaging of patients referred by physical therapists, orthopedic surgeons, and nonorthopedic providers. J Orthop Sports Phys Ther. 2005;35:67–71.

    Study Question: Do physical therapists have the requisite knowledge necessary to manage musculoskeletal conditions in a direct access setting?
    Answer, in short: Yes
    Who Scored the Highest?
    1. Orthopaedic Surgeons
    2. Physical Therapists who were board certified in Orthopaedics or Sports specialist (OCS or SCS)
    3. Physical Therapists (No ortho or sports specialist certification)
    4. Physical Therapy STUDENTS
    5. Other physicians (primary care physicians, etc)
    6. Psychiatrists
    Citation: Childs JD, Whitman JM. Sizer PS, Pugia ML, Flynn TW, Delitto A. A description of physical therapists knowledge in managing musculoskeletal conditions. BMC Muscoloskelet Disord. 2005;6:32.

    Study Purpose: “The purpose of this study was to describe the ability of physical therapists to make decisions about whether management by a physical therapist or referral to a medical professional was appropriate for hypothetical patients seeking care without a referral.”
    Citation: Jette DU, Ardleigh K, Chandler K, McShea L. Decision-Making Ability of Physical Therapists: Physical Therapy Intervention or Medical Referral? Phys Ther. 2006;86(12):1619-1629.

    Further, the exact JOB of physical therapists is to get a person in as little pain while maximizing their function, movement, and health. Many times we are not afforded with the opportunity of being with patients long enough to get them in peak health. But, we are absolutely trained to do so.

    Point #5. Now, let me clear. I am not trying to pit personal trainers vs. physical therapists. And, I do think personal trainers have a useful skill set in specific situations and for particular people. But, if you truly believe your response to Selena’s point #5 then you literally have NO concept to the training and practice of physical therapists. Nor do you fully understand your limitations as a personal trainer.

    Physical therapists are trained and educated to recognize, know, and understand their limitations, what is within their scope of practice. Trained and educated to screen (not diagnosis) for occult medical disorders/diseases Trained and educated to recognize when a patient is not appropriate for physical therapy care. Trained and educated to then refer patients to other practioners when necessary while communicating their findings and hypotheses.

    Further, personal trainers do not provide “care” in any sense of the word. No offense, but personal training is a business, and nothing more. I am not saying that personal trainers do not make positive impacts on people’s lives and fitness and health. But, you are not health care providers; you operate as business providin

  • Kyle May 14, 2009 Reply

    TRUTH #5: Physical therapists are knowledgeable about the impact various co-morbidities have on pain and function

    Now, let me clear. I am not trying to pit personal trainers vs. physical therapists. And, I do think personal trainers have a useful skill set in specific situations and for particular people. But, if you truly believe your response to Selena’s point #5 then you literally have NO concept to the training and practice of physical therapists. Nor do you fully understand your limitations as a personal trainer.

    Physical therapists are trained and educated to recognize, know, and understand their limitations, what is within their scope of practice. Trained and educated to screen (not diagnosis) for occult medical disorders/diseases Trained and educated to recognize when a patient is not appropriate for physical therapy care. Trained and educated to then refer patients to other practioners when necessary while communicating their findings and hypotheses.

    Further, personal trainers do not provide “care” in any sense of the word. No offense, but personal training is a business, and nothing more. I am not saying that personal trainers do not make positive impacts on people’s lives and fitness and health. But, you are not health care providers; you operate as business providing a service. You are not licensed practioners of health care, and absolutely NEED to understand that. Both for your legal liability and your patient’s safety.

    Also, as the population becomes more unhealthy/less active there are less and less people who don’t have some type of comorbidity. Everyone has a comorbidity these days. Everyone is taking medications or supplements. The field most ready to FIRST serve the general populations exercise and movement needs are physical therapists. That is not to say that personal trainers do not play, or have, a role.

    • jamieatlas May 14, 2009 Reply

      Kyle you are giving some great information here! I really appreciate you taking the stance of educating and talking about how trainers and therapists can connect and work together. I think anyone reading this post but especially your comments would walk away from the their computer much smarter and much more able to talk about what a physical therapist knows and who and how they best help people at all levels of ability.

      Thanks so much for taking the time to leave a comment!

      Jamie

  • Kyle May 14, 2009 Reply

    TRUTH #7: Physical therapists also aim at educating patients to such a degree that patients can be safe and can independently exercise within their abilities taking into consideration any co-morbidities.

    Your patient shows you (a personal trainer) exercises from 6 months ago. Lets assume that at this time the patient was either acutely injured, or had just had surgery. That is why these exercises seem silly, simple, and low level to you. But, at the time the patient was doing them they were absolutely appropriate. What usually happens is that when a patient reaches a certain level of function they no longer receive insurance coverage for appropriate PT care. And thus, the patient was not able to be progressed in their care/exercise program. Now what? Maybe they pursue personal training, show the personal trainer the exercises, and the personal trainer thinks the physical therapists knows nothing about exercise and training. What you have forgotten to take into account is where that patient was 6 months ago in terms of strength, injury status, functional status, surgical status, and tissue repair.

    Physical therapists are not just out to reduce pain. We are there to ensure patients reach optimal function, movement, and health while under our care. Many times, we do not get the benefit of progressing patients once they are pain free/back to more normal level of function, because of lack of understanding about direct access and lack of insurance coverage for PT care. Insurance does not pay for patients to reach peak function and fitness. They pay for restoration of a bare minimum level of function. Further, most of the public does not know that they can go see a physical therapist without a devastating injury or MD referral. We have amazing, amazing skills in prevention, wellness, peak fitness, etc, etc, etc.

    The point many personal trainers are bringing up is that the PT never progressed or challenged the patient. That is probably because we did not get the chance. And, remember where that patient started…

  • Kyle May 14, 2009 Reply

    PEAK HELATH? Now, you state the personal trainers help consumers reach “peak health.” Jamie, and others, I am asking how YOU and other personal trainers MESURE peak health? Are these objective measures? Why do you use them? In physical therapy we have countless numbers of what we call outcome measures. These are standardized tests, questionnaires, etc. that measure numerous things including a person’s change in functional status, their functional abilities, strength, quality of life, and perceived recovery (to name just a few). Our field stresses the use of outcome measures that have been researched for their accuracy/reproducibility (reliability) and ability to measure what it is they say they measure (validity).

    In personal training you can claim to aid in people reaching peak health, but besides the parameters of the exercises you used, weight loss/gain, and clients subjective reports (I look and feel better!) you do not have objective, track-able outcomes to support the statement that personal trainers help clients “reach peak health.” I am not stating the personal trainers do not help people get stronger, leaner, or faster. But, to claim that you help people reach peak health without track-able outcomes to say so, is like me saying that I help people lose weight. Maybe I do, maybe I don’t…But if I don’t track it, I can’t prove it. So, I am not going to claim it.

  • Kyle May 14, 2009 Reply

    Are physical therapists taught about exercise periodization?

    Absolutely. We CAN periodize based on the patients goals, activities, strengths, weaknesses, and their current status. We can focus on strength, endurance, power, or speed. But, many times, our focus is restoring normal muscle recruitment, movement, body (neuromuscular) control, posture, strength, etc, etc, etc. PLEASE SEE HERB’S POST FOR MORE INFO, it is excellent!!

    Physical therapists must know which exercises to prescribe, how often, when to progress, how to adapt to the individual patient, etc…
    But, they also must know when patients are ready for certain intensities/types of exercises and how to systematically progress them to get there. If a patient who had an ACL reconstruction comes to you because he wants to get stronger/more powerful do you know how to assess if he is ready to begin a plyometrics training program? If he is not, do know how to progress his exercises to get there? How will determine if he is ready to progress his exercises? What muscle groups should be targeted? How will determine where to start? How will you prioritize?

    The physical therapist is trained to examine and evaluate this patient to determine his strength, body control (especially femoral rotation/body position with activity), his balance, and his joint range of motion (to name just a few). The PT will also take into account how long ago his surgery was to determine how strong his new ACL is. They will also take into account which surgical technique was used. Further, the therapist then knows which exercises/intensity is appropriate and which muscles to strengthen. They also know how much force those exercises put on the knee joint, the patellafemoral joint (knee cap), as well as the ACL. The therapist will then systematically progress this patient and will assess when the patient is ready for a plyometrics program. This is only the tip of the iceberg in this example…

    Do they (physical therapists) understand which machine will help with which movement and which won’t?

    Absolutely. Not only that they know which muscles are most active with that exercise, the proper posture/positioning to execute that exercise .They also know whether that particular exercise, or muscle group, or movement should be done/exercised closed chain or open chain. They also know which angles throughout the range of motion of each exercise produce the most stress at specific joints. They also know the lines of pull of muscles and the effect of that particular muscles contraction on movement at that joint and the entire body.

    In my current clinical rotation we had a patient come into an appointment with her personal trainer, and we talked with him and went over a bunch of exercises/recommendations. Further, he was able to show us some exercises and we were able to analyze if those were appropriate. We advised the trainer. Also, we made a visit to a one patient’s gym to help her formulate a home exercise program. Making recommendations on cardio and weight machines, proper form, etc.

  • Kyle May 14, 2009 Reply

    A day will come that a personal training cert will offer to teach trainers how to rehab certain injuries which will step on therapists toes?

    ABSOLUTELY NOT. Personal Trainers will never REHAB injuries. That would make you a health care professional requiring a health care degree and passing a health care licensing examination and being regulated by a health care practice act. If you want to rehabilitate injuries go to physical therapy school!!

    As we move forward though (especially with insurance coverage what it is) you might see personal trainers TRAINING/EXERCISING patients who are being discharged from PT, but still need have exercise needs. In other words, they would either be supervised by a PT or work closely with a PT as a patient nears, or is, discharge. BUT, do not get confused this is NOT formal rehab. Please see my post on TRUTH #5 above…

  • Kyle May 14, 2009 Reply

    We don’t need pissing matches or contests. What we need is a better harmony between PT and personal training. Personal trainers absolutely must recognize their limitations. Physical therapists need to do a better job of bridging the gap between physical therapy care and patient pursuit of personal training. There is a gap between when patients end their physical therapy care and when they can/should pursue a personal trainer’s services. But, unfortunately, during this gap many patients fall into the hands of personal trainers when what they really need is further skilled physical therapy care. Unfortunately, this is a multifaceted problem (consumer/public knowledge of direct access to PT, insurance coverage, etc, etc). Further, PT’s need to do a better job of integrating patients into community based exercise programs (including personal training). Thus, there may be a point when a person is starting personal training, etc, but is still seeing their physical therapist once every 1, 2, or 4 weeks (for example). Thus, we need COMMUNICATION between physical therapists and community based fitness providers such as personal trainers. This communication needs to be two way. PT’s need to call personal trainers and personal trainers need not be afraid to contact PT’s. Personal trainers need to be comfortable working within a PT’s recommendations, etc. We all want to help people!!!

    If we work together we can solve this problem. But, we need to communicate and be wiling to communicate. Personal Trainers need to embrace the thought of sending potential clients to physical therapy FIRST. Further, they need to recognize their limitations and understand they do NOT rehabilitate or treat injuries. If your client has LBP, Knee pain, etc you SHOULD be sending them to physical therapy. For there safety and yours!!
    Physical therapists need to be helping patients pursue appropriate training/exercise avenues…once they are ready. To integrate patients. To be a resource for personal trainers. If you start referring clients to physical therapy clinics those therapists will work with you and help you obtain appropriate clients. EVERYONE can benefit if we understand each other. That means personal trainers need to do a better job of knowing what physical therapy entails and the training of PT’s. Many of the posters on this blog have claimed that PT does not involve certain things, or we lack certain skills, or we have failed patients in this particular way. But, many of you make these claims without knowing the entire story…

    Are you willing to do all this? If so, both physical therapy and personal training can benefit…

  • Jeanette Feb 23, 2010 Reply

    After two complete knee replacement surgeries, I received physical therapy at a local hospital after rehab. The first was done in the gym and the other in the water. I was also diagnosed with lumbar and cervical stenosis and two herniated discs. After the physical therapy sessions allowed by insurance, it was recommended that I continue the exercises performed in the water at a health club or local Y. I have had several weeks of exercise in a class in the water but now feel that I need something added. Any suggestions? I was wondering about a personal trainer.

    • jamieatlas Feb 23, 2010 Reply

      Wow Jeanette – I would say that if you were going to use a personal trainer I would find one that worked closely with or at least had a very good conversation with your physical therapist before starting to work with him/her. If you can find an instructor that is also an aqua instructor that might help you out as well. Hope that helps! With such complications you really want to make sure you take small, steady steps 🙂

  • Wonderlich Sep 14, 2011 Reply

    I know it is a late reply but here it goes: Personal Trainers vs Physical Therapists? Really? Why are you wasting your time? Personal trainers work as they do based off of client’s cash flow. They are not provide reimbursable service as they have no means to code. And there is a reason. Instead of saying that physical therapists do not have the ability to bring a patient back to their optimal level of function. Might say this: Physical therapists may have done a sports medicine residency, may hold there ATC credential, or a CSCS next to their PT credentials. Hands down, I would put an athlete who needs conditioning to their optimal level in the hands of physical therapist especially with the ATC credential. I would put the ATC above EVERYONE in the rehabilitation and return to play or high level functioning.

    Regards

    • jamieatlas Oct 15, 2011 Reply

      Wonderlich, where were you when the debate was going rampant! You make a really good point about the financial forces at play. While I think you could well be right to say the athlete should go to the ATC, that’s unfortunately not the case of how it plays out, don’t you agree?

  • Rob Feb 22, 2012 Reply

    As a PT student with interests in bodybuilding, fitness, and nutrition I’ve thought about this for a while. In regards to exercise and training to become the best one can be, I used to believe that PTs were the best and that personal trainers were just meatheads from high school who couldn’t get any other job (over exaggeration and stereoytyping; no offense intended of course). However, now that I’ve progressed through my program, by observing my peers and teachers, most PTs don’t know nearly enough about fitness than they should. When it comes to fitness, most PTs are generally mediocre at best. They understand things that personal trainers generally don’t but they don’t know how to apply it well to fitness. The problem I’ve always had with personal trainers is that they tend to base too much information on what they think works, or what they read in some magazine, and don’t have the educational background to filter the information or think critically. This can be moderately overcome however, by fully studying anatomy and kinesiology, as this would provide a very strong base to fully understand everything. So in the end there tends to be pros and cons of both and there is a happy medium. Everything said above was just a generalization referring to the average PT and the average personal trainer. The best case scenario that I have found is a PT that that has branched out into something else like CSCS (as Wonderlich as said), since they are individuals who tend to be well versed in both fields, giving them a strong base to provide the best treatment/ training/ resource for information.

    PS- I just realized that Personal Trainer can also be abbreviated as PT. But I refer to Physical Therapist as PT out of habit.

  • Opinionator Jan 30, 2014 Reply

    I won’t repeat the above comments from PT’s, but I will also add that as reimbursment continues to be cut clinics are looking for other options for revenue to keep the doors open. One option gaining popularity is having an ATC lead a small exercise group or work with them individually that is cash pay after the patient can no longer attend therapy. I believe this will become more common because companies will believe they can keep patients with staff they trust, have therapist eval if needed, & keep there doors open.