Physical therapy vs. physical training

During a conversation with some colleagues yesterday, we were discussing the true benefits of physical therapy. Personally, I am lucky to work and collaborate with some very talented physical therapists. Still, the reason that people go to physical therapy are different than those who work with strength coaches, personal trainers, and so on. The main goal of PT is to decrease pain, improve range of motion and mobility and restore function. This is not the same as improving function or functional performance, which is a different goal.

Physical Therapy is great for soft tissue therapy and release of adhesions, improving flexibility and joint mobility and improving postural stability and neuromuscular control. They work with patients to regain some pain free motion, firing patterns and control after an injury or a surgery. All too often, however, the patients use physical therapy as a fitness program or a fitness consultant, which is an improper use of their expertise. In an ideal world (one where insurance does not determine treatment decisions) patients would work with a therapist on their specific injury and work with a  qualified fitness professional on maintaining their global health while they recover from their injury. I stress qualified because this changes with the specific injuries and diseases that patients have. A qualified strength coach may not be the best choice for a diabetic with heart disease. This population has specific guidelines and needs that need to be properly understood.

When the therapist and the fitness professional work together to help individuals return to, and improve, their physical capabilities, the patient wins. They are now able to have improved use of their injured limb and maintain and increase their global strength, endurance and capacity for exercise. I personally believe that it is time for treatment programs to focus on the holistic health of the patient and develop programs that help them address and improve all facets of their health. By focusing on one small area, we do patients a disservice. The key with therapy is to address and correct the causes leading to their pain and dysfunction while still exercising around their injury so they are maintaining their fitness and improving other aspects of their physical well-being.